Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 10-01-2014 , and ending 09-30-2015
BCheck if applicable:
CName of organization
Sturdy Memorial Hospital Inc
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
211 Park Street PO Box 2963
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Attleboro, MA027030963
D Employer identification number

04-2768252
E Telephone number

G Gross receipts $ 267,664,807
F Name and address of principal officer:
Bruce Auerbach MD
211 Park Street PO Box 2963
Attleboro,MA02703
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.sturdymemorial.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1913
M State of legal domicile: MA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: providing safe, high quality, cost-efficient health care, and the broadest range of diagnostic, inpatient, outpatient and emergency services for a community hospital.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 1,557
6 Total number of volunteers (estimate if necessary) ............. 6 508
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 63,854
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 15,515
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 404,151 74,901
9 Program service revenue (Part VIII, line 2g) ......... 163,888,813 164,434,853
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 15,921,826 7,074,672
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 180,214,790 171,584,426
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 39,915 27,000
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 97,071,513 101,783,068
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 51,626,630 52,671,807
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 148,738,058 154,481,875
19 Revenue less expenses. Subtract line 18 from line 12....... 31,476,732 17,102,551
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 388,607,249 364,918,137
21 Total liabilities (Part X, line 26)............. 31,998,559 31,591,532
22 Net assets or fund balances. Subtract line 21 from line 20..... 356,608,690 333,326,605
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THE HOSPITAL'S MISSION IS TO PROVIDE HIGH QUALITY CARE TO THE SICK AND INJURED, ON BOTH AN INPATIENT AND OUTPATIENT BASIS, WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, AGE, GENDER, DISABILITY, OR ABILITY TO PAY. (CONTINUED ON SCHEDULE O)
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 135,204,108 including grants of $ 27,000 ) (Revenue $ 164,434,853 )
Sturdy Memorial Hospital, Inc. is a not-for-profit acute care community hospital which is dedicated to providing a broad range of health care services to the residents of Attleboro, Massachusetts and surrounding communities. The Hospital generates virtually all of its revenues in pursuit of its exempt purposes, which is to provide comprehensive diagnostic, therapeutic, and educational health care services to residents of its communities. (CONTINUED ON Schedule O)
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet135,204,108
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
167
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,557
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
16
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJOSEPH FX CASEY
211 PARK STREET PO BOX 2963
Attleboro,MA027030963 (508) 236-8150
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Patricia Cochrane........................................................................
Director
2.0
.......................1.0
X           0 0 0
(2) Frank Cook........................................................................
Director
2.0
.......................1.0
X           0 0 0
(3) Richard Digiacomo........................................................................
Associate Director and Clerk
2.0
.......................1.0
X   X       0 0 0
(4) Kevin Dumas........................................................................
Director
2.0
.......................1.0
X           0 0 0
(5) Dwayne Demond........................................................................
Director
2.0
.......................1.0
X           0 0 0
(6) Greg Kayata........................................................................
Director (thru 10/14)
2.0
.......................1.0
X           0 0 0
(7) Dennis Kelly........................................................................
Director
2.0
.......................1.0
X           0 0 0
(8) Donna Kimmel........................................................................
Chairman
2.0
.......................3.0
X   X       0 0 0
(9) John Korona........................................................................
Director
2.0
.......................1.0
X           0 0 0
(10) Thomas Noel........................................................................
Director
2.0
.......................1.0
X           0 0 0
(11) Timothy O'Neill........................................................................
Chairman (thru 1/15)
6.0
.......................4.0
X   X       0 0 0
(12) Mark Robbin MD........................................................................
Associate Director & Physician
2.0
.......................47.0
X           0 263,916 41,000
(13) Ethel Sandbach........................................................................
Director
2.0
.......................1.0
X           0 0 0
(14) Ralph Schlenker........................................................................
Associate Director
2.0
.......................1.0
X           0 0 0
(15) Thomas Sprague........................................................................
Director (thru 1/15)
2.0
.......................1.0
X           0 0 0
(16) Robert Thresher........................................................................
Director
2.0
.......................3.0
X           0 0 0
(17) Michael Thursby........................................................................
Director
2.0
.......................1.0
X           0 0 0
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Catherine White........................................................................
Director
2.0
.......................1.0
X           0 0 0
(19) Bruce Auerbach MD........................................................................
President & Associate Director
42.0
.......................5.0
X   X       1,503,150 0 78,393
(20) Joseph Casey........................................................................
Treasurer & CFO
37.0
.......................11.0
    X       526,888 0 65,132
(21) Brian Kelly MD........................................................................
VP/Chief of ER & Ambulatory
45.0
.......................2.0
      X     457,043 0 64,032
(22) Cheryl Barrows........................................................................
VP of Human Resources
39.0
.......................6.0
      X     220,934 0 57,403
(23) Lisa McCluskie........................................................................
VP of Marketing & Planning
37.0
.......................11.0
      X     221,307 0 76,286
(24) Marita Prater........................................................................
VP of Patient Services
45.0
.......................0.0
      X     235,425 0 69,235
(25) Robin Morris........................................................................
VP of Clinical Services
45.0
.......................0.0
      X     195,266 0 41,706
(26) Peter Fischer MD........................................................................
Physician
40.0
.......................0.0
        X   344,249 0 54,649
(27) Mark McGuire MD........................................................................
Physician
40.0
.......................0.0
        X   361,048 0 43,879
(28) Brian Patel MD........................................................................
Physician
40.0
.......................0.0
        X   404,076 0 42,024
(29) Allan Raskin MD........................................................................
Physician
40.0
.......................0.0
        X   297,073 0 67,981
(30) Eric Schwam MD........................................................................
Physician
40.0
.......................0.0
        X   259,512 0 75,872
(31) Linda Shyavitz........................................................................
Former President & CEO
0.0
.......................0.0
          X 253,860 0 16,236
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,279,831 263,916 793,828
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet123
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
IN Compass Health Inc,
318 Maxwell Road Suite 500
ALPHARETTA,GA30009
Hospitalist Services 1,099,328
Arup Laboratories Inc,
500 Chipeta Way
SALT LAKE CITY,UT84108
Lab Sendouts 881,882
New England Inpatient Specialist L,
120 Waters Street Suite 404
NORTH ANDOVER,MA01845
Hospitalist Services 558,910
Purity Services Inc,
405 Myrtle Street
NEW BEDFORD,MA02746
Laundry Services 490,634
MedAssets Supply Chain System LLC,
po Box 742081
ATLANTA,GA303742081
outside labor 294,378
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet24
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 74,901
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 74,901
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 621400 161,555,370 161,555,370    
b PATIENT RELATED REVENUE, OTHER 621990 421,351 421,351    
c RADIATION THERAPY 621990 896,619 896,619    
d CAFETERIA SALES 722514 985,568 985,568    
e REBATES, REFUNDS AND DISCOUNTS 621990 366,332 366,332    
f All other program service revenue . 209,613 149,529 60,084  
g Total. Add lines 2a–2f........MediumBullet 164,434,853
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 5,071,891   3,770 5,068,121
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 98,083,162  
b Less: cost or other basis and sales expenses 96,080,381  
c Gain or (loss) 2,002,781  
d Net gain or (loss)..........MediumBullet 2,002,781     2,002,781
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See Instructions......MediumBullet 171,584,426 164,374,769 63,854 7,070,902
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 27,000 27,000
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 0  
4 Benefits paid to or for members .... 0  
5 Compensation of current officers, directors, trustees, and key employees .... 4,073,118   4,073,118  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages .... 75,396,799 69,814,199 5,582,600  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 5,189,397 4,558,877 630,520  
9 Other employee benefits ....... 11,486,413 10,090,796 1,395,617  
10 Payroll taxes ........... 5,637,341 4,952,395 684,946  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 204,666   204,666  
c Accounting ........... 123,650   123,650  
d Lobbying ........... 75,504 75,504    
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 654,325   654,325  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 6,611,122 5,603,619 1,007,503  
12 Advertising and promotion .... 362,045 318,587 43,458  
13 Office expenses ....... 4,066,410 3,256,912 809,498  
14 Information technology ...... 1,899,121 1,351,658 547,463  
15 Royalties .. 0      
16 Occupancy ........... 3,109,257 2,357,128 752,129  
17 Travel ............ 47,214 24,505 22,709  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 95,989 66,969 29,020  
20 Interest ........... 0      
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 9,004,522 6,826,328 2,178,194  
23 Insurance .............. 1,246,224 1,078,540 167,684  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 21,753,128 21,753,128    
b MAINTENANCE & REPAIRS 2,259,433 2,235,351 24,082  
c INCOME TAXES 46,507   46,507  
d ALL OTHER EXPENSES 1,112,690 812,612 300,078  
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 154,481,875 135,204,108 19,277,767 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 1,598 1 383,428
2 Savings and temporary cash investments ......... 9,389,114 2 10,661,297
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 16,149,708 4 15,479,279
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 2,952,013 8 3,279,750
9 Prepaid expenses and deferred charges .......... 37,456,712 9 11,180,592
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 185,216,389
b Less: accumulated depreciation ..... 10b 130,085,129 57,384,850 10c 55,131,260
11 Investments—publicly traded securities .......... 243,705,921 11 255,291,841
12 Investments—other securities. See Part IV, line 11 ..... 15,317,316 12 6,408,126
13 Investments—program-related. See Part IV, line 11 ..... 791,431 13 972,027
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 5,458,586 15 6,130,537
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 388,607,249 16 364,918,137
Liabilities 17 Accounts payable and accrued expenses ......... 25,094,514 17 25,428,607
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 67,929 19 0
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 6,836,116 25 6,162,925
26 Total liabilities. Add lines 17 through 25......... 31,998,559 26 31,591,532
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 356,571,258 27 333,290,115
28 Temporarily restricted net assets ........... 37,432 28 36,490
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 356,608,690 33 333,326,605
34 Total liabilities and net assets/fund balances ........ 388,607,249 34 364,918,137
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
171,584,426
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
154,481,875
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
17,102,551
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
356,608,690
5
Net unrealized gains (losses) on investments ...............
5
-12,314,596
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-28,070,040
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
333,326,605
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Sturdy Memorial Hospital Inc
 
Employer identification number

04-2768252
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (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.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (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.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) right arrow (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.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
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)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
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)
 
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)
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)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Sturdy Memorial Hospital Inc
 
Employer identification number

04-2768252
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
3,315
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
75,504
j
Total. Add lines 1c through 1i ...............................
78,819
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C, Part II-B, Line 1g Certain Employees of the Hospital meet quarterly at the hospital with local and state representatives to discuss current issues affecting the delivery of healthcare. These employees also make periodic phone calls and write letters to state and federal legislature officials as necessary. The allocation of salaries allocable to lobbying activities are approximately $3,315.
Schedule C, Part II-B, Line 1i The hospital pays dues to the Massachusetts Hospital Association, Murphy Donoghue Partners and Associated Industries of Massachusetts. A portion of the Massachusetts Hospital Association dues, $75,504 is used to support lobbying by the associations. Total invoices paid for lobbying expenditures are $78,819
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Sturdy Memorial Hospital Inc
 
Employer identification number

04-2768252
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land ................. 0 1,262,721 1,262,721
b Buildings ................ 0 117,207,525 75,328,141 41,879,384
c Leasehold improvements ............        
d Equipment ................ 0 62,989,629 51,303,806 11,685,823
e Other ................. 0 3,756,514 3,453,182 303,332
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 55,131,260
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
INSURANCE CLAIMS, LONG TERM 2,603,058
ACCRUED POSTRETIREMENT HEALTH BENEFITS 1,866,100
WORKERS' COMPENSATION SELF-INSURANCE RESERVES 975,398
ASSET RETIREMENT OBLIGATION 718,369





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 6,162,925
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 133,033,243
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a -12,314,596
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d -25,570,040
e Add lines 2a through 2d ..................... 2e -37,884,636
3 Subtract line 2e from line 1..................... 3 170,917,879
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a 666,547
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c 666,547
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 171,584,426
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 156,315,328
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 2,500,000
e Add lines 2a through 2d...................... 2e 2,500,000
3 Subtract line 2e from line 1..................... 3 153,815,328
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a 666,547
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c 666,547
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 154,481,875
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Endowment Funds Schedule D, Part V, Line 4 Sturdy Memorial Foundation, inc. maintains endowment funds (restricted to principal) for the benefit of Sturdy Memorial Hospital, INC. and affiliated organizations. The investment earnings on the endowment funds are almost entirely unrestricted. As income is earned on endowment funds (unrestricted as to income), it is transferred to the unrestricted fund (within the Foundation). From time to time, the Board of Directors has authorized transfers from the unrestricted fund to Sturdy Memorial Hospital, Inc. and Sturdy Memorial Associates, Inc. A small portion of the endowment is held in a fund with the income restricted for "free care" for patients. The income on this fund is transferred on a semi-annual basis to Sturdy Memorial Hospital, Inc. and is used as free care in accordance with the Hospital's free care policy.
ASC 740 Schedule D, Part X, Line 2 The Hospital is a not-for-profit organization as described in Section 501(c)(3) of the Internal Revenue Code, as amended (the Code), and is generally exempt from income taxes pursuant to Section 501(a) of the Code. The Hospital is required to assess uncertain tax positions and has determined that there were no such positions that are material to the financial statements.
Reconciliation of Revenue per Audited Financial Statements Form 990, Part XI, Line 2d Pension and other postretirement benefit adjustment (25,688,000) Transfer from affiliate 117,960 ------------- Total (25,570,040) Reconciliation of Expenses per Audited Financial Statements Form 990, Part XII, Line 2d Transfer to affiliate 2,500,000
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Sturdy Memorial Hospital Inc
 
Employer identification number

04-2768252
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    2,197,481 1,177,556 1,019,925 0.660 %
b Medicaid (from Worksheet 3,
column a) ....
    26,963,484 22,380,710 4,582,774 2.970 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
    2,553,593 2,098,297 455,296 0.290 %
d Total Financial Assistance
and Means-Tested
Government Programs .
    31,714,558 25,656,563 6,057,995 3.920 %
Other Benefits
    299,391   299,391 0.190 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    125,764   125,764 0.080 %
g Subsidized health services
(from Worksheet 6) ..
    8,923,134 3,435,028 5,488,106 3.550 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    92,484   92,484 0.060 %
j Total. Other Benefits ..     9,440,773 3,435,028 6,005,745 3.880 %
k Total. Add lines 7d and 7j .     41,155,331 29,091,591 12,063,740 7.800 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 1   4,500   4,500 14.300 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 1   20,000   20,000 63.540 %
7 Community health improvement advocacy 1   3,975   3,975 12.630 %
8 Workforce development 1   3,000   3,000 9.530 %
9 Other            
10 Total 4   31,475   31,475 100.000 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
2,708,505
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
764,572
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
53,500,370
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
59,969,491
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-6,469,121
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Sturdy Memorial Hospital Inc
PO Box 2963 211 Park Street
Attleboro,MA02703
www.sturdymemorial.org
2100
X X         X      
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Sturdy Memorial Hospital Inc
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Sturdy Memorial Hospital Inc
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Sturdy Memorial Hospital Inc
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Input from Persons Who Represent the Community Schedule H, Part V, Section B, Line 5 Sturdy conducted a needs assessment in 2014 in collaboration with city and town health agents, city and town public health nurses, public schools, area councils on aging, area YMCAs, Community VNA, Women, Infants and Children WIC, and our Patient Family Advisory Council. Surveys were mailed and or emailed to 38 individuals and entities. Eighteen responses were received. The Hospital also utilized other data about its service area and participated in community advisory groups, boards, medical committees, and partnerships as part of the assessment. For Sturdy, needs assessment involves review and analysis of various data such as patient satisfaction surveys, Hospital service utilization statistics, clinical issues, health insurer data, and other local and State health data. We also take into account the results of feedback from and conversations and interactions with a multitude of other sources, actively soliciting information and ideas from area public health professionals, members of the Hospital's Patient and Family Advisory Council PFAC, members of the Hospital's Medical Management Committee, social services agency personnel, school nurses, as well as participating in professional forums. Findings are reviewed for trends or needs in the community. Clinical trend data and patient education needs recognized by clinicians while providing medical or follow up care are also considered. Additionally, members of the community are encouraged to, and often do, relay programming suggestions directly to the Hospital or through program evaluation tools. The Hospital has drawn from this extensive bank of information to make recommendations for community benefits activities and programs. As a result of ongoing needs assessments, Sturdy can continue to focus its health programming resources and services to most effectively meet the needs of the communities we serve. Hospital Facility's Website Schedule H, Part V, Section B, Line 7 http://www.sturdymemorial.org/images/pdfs/SMH2013_CHNA_Report.pdf Significant Needs Schedule H, Part V, Section B, Line 11 One of several criteria used to prioritize the important needs in the communities served by Sturdy includes our ability to effectively impact and to improve upon the identified health issue, e.g. represents an issue we can address. Sturdy is currently recruiting Primary care Physicians to meet the current needs in the community, along with specialists in the areas of Gastroenterology, Ophthalmology, Orthopedics, and Urology. Another significant need that has been identified is the need for more private rooms at Sturdy. Sturdy is currently constructing a new 20-bed private room unit that will eliminate the use of current multi-bed rooms. The plan is designed to encourage peaceful healing in a quiet, nurturing atmosphere. Utilizing single bed private rooms will also significantly cut down on the need to move patients limiting interruptions and fostering faster healing. Programmatically, Sturdy continues to address significant needs and has developed programs to address diabetes prevention, diabetes disease management, and weight loss programs. As Sturdy continues to assess the needs of the community, new programs will be considered as additional services as needs are identified. The 2016 Community Health Needs Assessment Sturdy will be used as a guide to strategically plan and execute programs to address newly identified needs. In 2013 the Community Health Needs Assessment respondents identified three issues identified as important to improving the health of the community that did not meet Sturdy's mission as service areas and although they could not be specifically addressed in Sturdy's implementation plan, Sturdy continues to work with community partners and at the State level to address these issues. The three identified areas include behavioral health disorders or related issues, cost of affordable medications, and substance and or alcohol abuse or addiction. Sturdy will continue to facilitate care and referrals to ensure that patients are directed toward the necessary resources to fill those needs. Sturdy is planning to improve social workers' availability at Sturdy by engaging professionals from McLean Hospital and to follow the new guidelines set by the state of Massachusetts to limit opioid prescriptions. Other Policy Publicity Methods Schedule H, Part V, Section B, Line 16 Acute care hospitals in Massachusetts are responsible for MassHealth (Medicaid) outreach. This happened many years ago as regional MassHealth offices closed. Sturdy Memorial Hospital employs two full-time financial counselors who meet with patients and "walk-in" members of the community to assist them in completing a single application for free care, MassHealth, or subsidized care. MassHealth and other community resources routinely refer community members in need to our counselors. Although we have no formal program on educating the community on the resources we provide, we have provided education or attended relevant meetings in the past. For example, when the state first introduced state subsidized health plans, we held public meetings to explain all financial assistance programs available at the hospital. We have also on occasion met with other community resources who might know of community members in need of financial assistance for their healthcare needs. Notification of Financial Assistance Schedule H, Part V, Section B, Line 20 For planned admissions, patients are notified of the financial assistance policy prior to admission. For emergent admissions, patients are notified prior to discharge or the next business day. For outpatient visits, patients are notified of the financial assistance policy with the bill that is mailed to them. Determination of Maximum Amounts Schedule H, Part V, Section B, Line 22 All patients including FAP eligible patients, whether insured or not, are charged the same amount for services rendered. For uninsured patients, a bill is sent with all charges included, less a 22 percent discount, with a letter stating to contact the Financial Services office to discuss a payment arrangement that will work best for the patient. The discount is calculated based on the average reimbursement from the Hospital's three largest insurance payers. calculated based on the average reimbursement from the Hospital's three largest insurance payers.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?3
Name and address Type of Facility (describe)
1 Mansfield Health Center
200 Copeland Drive
Mansfield,MA02488
Licensed output clinic Physician practice
2 Radiation Therapy of Southeastern MA LLC
89 Forbes Boulevard
Mansfield,MA02048
Output Radn Therapy clinic
3 Attleboro High School Clinic
100 Rathburn Willard Drive
Attleboro,MA02703
Licensed School based
4
5
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Financial Assistance and Other Community Benefits Calculation Schedule H, Part I, Line 7 Lines 7a/b/c were calculated using Worksheets 1, 2, 3 provided in the instructions. Lines 7e/f/h/I were calculated by using expenses and revenues from the general ledger. Additionally, where employee labor was included, the number of hours spent on each program was multiplied by a standard rate (direct cost) plus a benefit factor (indirect cost). Line 7g: Net losses for both the Multiple Sclerosis Center and Cardiac/Pulmonary Rehab were calculated using department specific cost to charge ratios (CCRs) from a modified (to isolate the departments on individual lines) Medicare Cost report and department specific payment percentages (PAFs). The reported net loss for each services equals the sum of the net revenue for all payers (gross department charges for each payer multiplied by the payer specific PAF) less the cost of providing the services (total gross department charges multiplied by the department specific CCR). The net loss for maternal child health service was calculated using the implied cost to charge ratio (CCR) for the obstetrics service and the newborn service from the State required Cost Report. (The state cost report better captures the obstetrics service than the Medicare cost report where obstetrics is grouped with the med/surg floors and separated from the "ancillary service" of deliveries.) The implied CCR is calculated using the total service costs divided by the total service charges. The reported net contribution equals the sum of the net revenue for all payers (gross service charges for each payer multiplied by the service and payer specific PAF) less the cost of providing the services (total gross department charges multiplied by the department specific CCR). Net contributions for obstetrics and the newborn hospital stay are calculated separately. The net loss for the diabetes education service is simply the net revenue for the diabetes education service less the salary and benefit cost of the nurses who provide the service. Community Building Activities Schedule H, Part II Sturdy Memorial Hospital continually fosters positive and cooperative relationships with area businesses, civic organizations, local and regional health care associations, and affiliated medical staff. Sturdy actively seeks out and facilitates strong partnerships that promote the health and wellbeing of the people in our communities. Key organizations Sturdy collaborated or partnered with in FY 2015 included: AARP; American Cancer Society; American Diabetes Association; American Heart Association; American Stroke Association; Area Elementary Schools (HealthyChoices); Attleboro Area Community Council; Attleboro Area School-to-Career Partnership; Attleboro High School; Attleboro Rotary Club; Attleboro YMCA; Bristol Community College; Bristol County Homeland Security Task Force; Brown University School of Medicine; Councils on Aging; EMTs (training for municipalities); Greater Attleboro Area Council on Churches; Hockomock Area YMCAs; Massachusetts Service Alliance; Mothers Against Drunk Driving (MADD); National Multiple Sclerosis Society; Reach Out and Read (ROAR); Rhode Island Blood Center; Southeastern Massachusetts Homeland Security Regional Council; STAR Program Certification (Survivorship Training and Rehabilitation) Town Health Agents; United Way of Greater Attleboro/Taunton; and Wheaton College. Major community building activities with some of the aforementioned partners in FY 2015 included: Sturdy ER physicians and nurses training area EMTs, at no cost to them; diabetes prevention and education programming involving Sturdy's medical staff in conjunction with the Attleboro YMCA and Hockomock YMCA; hosting a day-long Nurse's Day event with Attleboro Area School-to-Career Partnership for high school students considering nursing careers; youth mentoring programs with area secondary schools; public and clinician education about palliative care, including distribution of materials from The Conversation Project; sharps disposal program with area fire departments; a multi-dimensional public stroke awareness campaign; educating town health and safety officials, and the public, about flu and vaccination; regional disaster planning with area municipalities; hand washing public education; Healthy Choices, a school-based health fair education program done in conjunction with the area's elementary schools; continuing to educate people about access to health care in Massachusetts and their options under the new health reform law; and running a school-based health clinic at Attleboro High School. Five examples of initiatives undertaken: Free support groups are offered on a continuous basis that include; Prostate Cancer Support Group, Pregnancy and Infant Loss Support group, Friends and Family of Patients with Cancer Support group, Cancer Support Group, Breathing Club (Respiratory Care), Diabetes Support Group, and others. Sturdy Memorial Hospital offers transportation assistance to indigent patients who would have otherwise missed important medical appointments. $4,935 was spent to transport patients to and from appointments in 2015. Sturdy Memorial Hospital hosts an annual Cancer Survivors Day event at no cost to its participants. The event is designed as part of the National Cancer Survivors Day initiative. Members of the community are invited to hear inspirational speakers and receive healthy information, as well as, full descriptions of programs offered at Sturdy to assist both cancer patients and survivors. Sturdy invests $20,000 into this program. Stroke awareness - multi-faceted initiative to provide the community with pertinent information relevant to the prevention, warning signs, risks and symptoms of a Stroke. Educated the community about the need to act F.A.S.T. when Stroke symptoms are present (i.e.: Call 9-1-1). Time is of the essence. Spent approximately $4,500. Physical activity for youth - partnered with the Attleboro YMCA on its annual youth step challenge. Spent approximately $3,000. Also worked with Hockomock YMCAs and Sturdy child care physicians using a "prescription" to promote the concept of moving more and eating less.
BAD DEBT EXPENSE Schedule H, Part III, Lines 2, 3, and 4 The Hospital's audited financial statements do not contain a footnote describing bad debt expense. The Hospital's bad debt expense (Schedule H, Part III, Section A, Line 2) was estimated as the product of the Hospital's bad debt (stated as revenue) multiplied by the Hospital's overall cost-to-charge ratio calculated on Worksheet 2 of the instructions. Estimated bad debt expense attributable to patients eligible for financial assistance (Schedule H, Part III, Section A, Line 3) was calculated as the ratio of, accounts for which patients were unemployed to the total patient accounts, multiplied by bad debt expense.
Shortfall Treated as Community Benefit Schedule H, Part III, Line 8 The shortfall experienced by the Hospital from providing care to Medicare beneficiaries should be treated as a community benefit as it represents the Hospital's contribution to providing care to Medicare eligible citizens of the community it serves beyond the amount it receives from the Medicare program. This contribution is consistent with the Hospital's overall charitable mission to provide care to all individuals, regardless of the level of payment received for providing that care. The Hospital's Medicare Cost Report was used to determine the amount reported on line 6.
Debt Collection Policy Schedule H, Part III, Line 9b The Hospital's collection policy contains procedures to be followed for patients who are known to qualify for financial assistance. Once it is determined that a patient qualifies for free care, all collection procedures cease and the full balance is written off, with exception to patients where free care is secondary to their primary insurance and a copay is owed based on their primary insurance plan (deductibles/coinsurances are written off and copays are subject to normal collection practices). If the patient qualifies for partial free care, the amount that qualifies under partial free care is written off and the remaining balance (copays from their primary insurance) is subject to normal collection procedures. Massachusetts hospitals are required to adopt credit and collection policies. State regulations (114.6 CMR 13.08(1)(c)) outline the specific process for determining eligibility for public assistance programs and hospital collection practices. The Hospital provides patients with information about free care available through the hospital (a significant portion of which is coordinated through the state's Health Safety Net program) as well as financial assistance programs such as MassHealth (Medicaid) and the state's subsidized Connector Care program which are available through the Massachusetts Executive Office of Health and Human Services. The Hospital employs two full-time financial counselors that assist patients, and anyone else presenting who requires assistance, in applying for free care and state financial assistance programs through the state's uniform application. The Hospital credit and collection policy, that outlines its charity care practices, is filed with the Massachusetts Center for Health Information and Analysis and also available to patients upon request.
Community Health Needs Assessment Schedule H, Part VI, Line 2 Sturdy has voluntarily submitted a Community Benefits Report to the Massachusetts Office of the Attorney General since the 1990s. With guidance and oversight from the Hospital's Planning Committee, Sturdy's Community Benefits Report is constructed to reflect on activities from the prior year and provide recommendations for the Hospital's community benefits focus for the subsequent year. Community benefits planning is integrated into Sturdy's annual planning and budgeting processes to ensure we effectively support community benefits programming. Sturdy Memorial Hospital is involved in ongoing assessment of health needs in our communities. Continually being engaged in and attuned to our communities provides us with opportunities to identify health issues of greatest concern to our care providers and community partners, and consider committing resources to those areas, if appropriate, to guide efforts to improve community health and wellness. At the core of Sturdy's community benefits activities and planning are the Hospital's Statement of Purpose, which is attached, and Community Benefits Mission, which is displayed below. Sturdy Memorial Hospital is dedicated to providing safe, high quality, cost efficient health care and the broadest range of diagnostic, inpatient, outpatient, and emergency services appropriate for a community hospital. The Hospital works to ensure that ample, high quality primary and specialty physician services are accessible to area residents. Additionally, we try to avoid costly duplication of health care services by coordinating with other area health care providers to the extent practicable. The Hospital provides leadership while working in cooperation with public and private health organizations, as well as civic and business organizations, to meet the health care needs of our communities. As described above in Supplemental Information for Part V, Section B, Line 3 Explanation, Sturdy's needs assessment involves review and analysis of various data such as patient satisfaction surveys, Hospital service utilization statistics, clinical issues, health insurer data, and other local and State health data. We also take into account the results of feedback from and conversations and interactions with a multitude of other sources, actively soliciting information and ideas from area public health professionals, members of the Hospital's Patient and Family Advisory Council (PFAC), members of the Hospital's Medical Management Committee, social services agency personnel, school nurses, as well as participating in professional forums. Findings are reviewed for trends or needs in the community. Clinical trend data and patient education needs recognized by clinicians while providing medical or follow up care are also considered. Additionally, members of the community are encouraged to, and often do, relay programming suggestions directly to the Hospital or through program evaluation tools. The Hospital has drawn from this extensive bank of information to make recommendations for community benefits activities and programs.
Patient Education of Eligibility for Assistance Schedule H, Part VI, Line 3 Patients are informed of the availability of financial assistance by way of posted notices throughout the hospital. All itemized bills and patient statements are printed with financial assistance information. Upon discharge from the Emergency Care Center (ECC), uninsured patients are encouraged to meet with a Financial Counselor. If unable to see a Financial Counselor following discharge, the patient is given a financial assistance letter outlining the application process, the documents required, telephone numbers and directions to the financial counselor's office. Following an ECC visit, uninsured patients receive a phone call from a Credit Representative encouraging the patient to meet with a Financial Counselor for financial assistance. Scheduled Self Pay Surgical Day Care (SDC) & Inpatients are reviewed prior to admission to determine payment arrangement or to coordinate a meeting with a Financial Counselor. SDC & Inpatients who are unable to leave a deposit or make a payment arrangement towards a large out of pocket expense are also encouraged to meet with a Financial Counselor.
Community Information Schedule H, Part VI, Line 4 The Hospital serves a total population base of 228,800 (based on 2010 U.S. Census data) in 12 suburban communities located between Boston, MA and Providence, RI that is largely educated (completed high school), employed, and English speaking. As a community resource, the Hospital has a primary commitment to serve the residents of Attleboro, Foxboro, Mansfield, North Attleboro, Norton, Plainville, Seekonk, Rehoboth, and Wrentham. Norfolk, Sharon, and Walpole are considered part of our secondary service area. We also serve bordering towns in nearby Rhode Island. However, anyone who requires care will receive it, regardless of place of residence.
Promotion of Community Health Schedule H, Part VI, Line 5 In addition to offering a vast array of community benefits programming and providing more than $4.9 million in free care in FY15, Sturdy furthered its exempt purpose by promoting the health of the community in numerous other ways, including having an open medical staff that is required to provide free care and accept Medicare and Medicaid patients; sharing the expertise of its leadership on various community non-profit boards including members of the community on hospital committees that influence health promotion activities, i.e. Planning Committee, Patient Family Advisory Council, etc.; and using surplus funds to appropriately expand our facilities (without borrowing) and acquire the technology our clinicians need to care for patients in our service area so that they can get their care locally. State filing of Community Benefit Report Schedule H, Part VI, Line 7 Massachusetts
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Sturdy Memorial Hospital Inc
 
Employer identification number
04-2768252
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) Attleboro Area Council of Churches
95 Pine Street
Attleboro,MA02703
04-2301039 501(c)(3) 6,000       Chaplaincy Program
(2) City of Attleboro
77 Park Street
Attleboro,MA02703
04-6001378 GOV'T 16,000       city programs




















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Procedures for Monitoring Use of Grant Funds Schedule I, Part I, Line 2 The Hospital rarely provides outright grants, but rather concentrates in coordinating care in the community and delivering substantial uncompensated care (see Schedule H). On the rare occasion when grants are made, they are either approved or discussed by or with the Board of Managers. The low volume of grants awarded enables the Hospital to monitor their use.
Schedule I (Form 990) 2014


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Sturdy Memorial Hospital Inc
 
Employer identification number

04-2768252
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
No
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Mark Robbin MDAssociate Director & Physician (i)
(ii)
0
...............................
262,730
0
...............................
0
0
...............................
1,186
0
...............................
41,000
0
...............................
0
0
...............................
304,916
0
...............................
0
2Bruce Auerbach MDPresident & Associate Director (i)
(ii)
491,013
...............................
0
327,414
...............................
0
684,723
...............................
0
56,014
...............................
0
22,379
...............................
0
1,581,543
...............................
0
0
...............................
0
3Joseph CaseyTreasurer & CFO (i)
(ii)
359,081
...............................
0
87,414
...............................
0
80,393
...............................
0
42,478
...............................
0
22,654
...............................
0
592,020
...............................
0
0
...............................
0
4Brian Kelly MDVP/Chief of ER & Ambulatory (i)
(ii)
353,615
...............................
0
20,245
...............................
0
83,183
...............................
0
37,930
...............................
0
26,102
...............................
0
521,075
...............................
0
0
...............................
0
5Cheryl BarrowsVP of Human Resources (i)
(ii)
179,266
...............................
0
30,099
...............................
0
11,569
...............................
0
32,249
...............................
0
25,154
...............................
0
278,337
...............................
0
0
...............................
0
6Lisa McCluskieVP of Marketing & Planning (i)
(ii)
175,708
...............................
0
38,414
...............................
0
7,185
...............................
0
53,632
...............................
0
22,654
...............................
0
297,593
...............................
0
0
...............................
0
7Marita PraterVP of Patient Services (i)
(ii)
200,791
...............................
0
33,848
...............................
0
786
...............................
0
45,408
...............................
0
23,827
...............................
0
304,660
...............................
0
0
...............................
0
8Robin MorrisVP of Clinical Services (i)
(ii)
171,204
...............................
0
23,414
...............................
0
648
...............................
0
29,370
...............................
0
12,336
...............................
0
236,972
...............................
0
0
...............................
0
9Peter Fischer MDPhysician (i)
(ii)
310,860
...............................
0
32,865
...............................
0
524
...............................
0
29,255
...............................
0
25,394
...............................
0
398,898
...............................
0
0
...............................
0
10Mark McGuire MDPhysician (i)
(ii)
341,982
...............................
0
2,414
...............................
0
16,652
...............................
0
20,534
...............................
0
23,345
...............................
0
404,927
...............................
0
0
...............................
0
11Brian Patel MDPhysician (i)
(ii)
374,788
...............................
0
11,917
...............................
0
17,371
...............................
0
17,727
...............................
0
24,297
...............................
0
446,100
...............................
0
0
...............................
0
12Allan Raskin MDPhysician (i)
(ii)
279,575
...............................
0
2,414
...............................
0
15,084
...............................
0
44,426
...............................
0
23,555
...............................
0
365,054
...............................
0
0
...............................
0
13Eric Schwam MDPhysician (i)
(ii)
243,549
...............................
0
2,172
...............................
0
13,791
...............................
0
49,636
...............................
0
26,236
...............................
0
335,384
...............................
0
0
...............................
0
14Linda ShyavitzFormer President & CEO (i)
(ii)
140,292
...............................
0
102,538
...............................
0
11,030
...............................
0
13,892
...............................
0
2,344
...............................
0
270,096
...............................
0
0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
Tax indemnification and gross-up payments Schedule J, Part I, Line 1a When the Hospital makes payments to retirement plans that are taxable upfront, they are partially grossed up for taxes. During Calendar Year 2014, such payments were made for some senior managers (see Schedule J, Part I, line 4 explanation for more detail). Also, the Hospital paid a flat bonus (the same amount to each employee prorated for hours worked) to all hospital and associate employees, and announced the net amount (effectively paying the taxes). The Hospital also provides its senior managers with long-term disability insurance. The cost of this insurance is grossed up to effectively pay for the related taxes and is added to the managers' gross earnings. This benefit was provided to Bruce Auerbach MD, Joseph Casey, Robin Morris, Marita Prater, Lisa McCluskie, Cheryl Barrows and Brian Kelly MD during Calendar Year 2014.
APPROVAL FOR GROSS-UP PAYMENTS Schedule J, Part I, Line 1b As explained in 1(a) above, there are few instances where a gross up is used. The Board of Managers approves the hospital bonus (net of taxes) and the Executive Committee approves the supplemental retirement plan.
Methods used to establish Compensation Schedule J, Part I, Line 3 See Schedule O - line reference: Form 990, Part VI, Section B, line 15.
Severance Agreements Schedule J, Part I, Line 4a Bruce Auerbach, MD has a provision in his employment contract that states the termination of his employment by the board results in him receiving his base salary for one year from the date of termination, in bi-weekly payments, net of normal and customary state and federal taxes. During that period, the Hospital will continue to offer him life and health insurance, provided he continues to pay the employee contribution amount for his health insurance.
Supplemental Nonqualified Retirement Plan Schedule J, Part I, Line 4b SUPPLEMENTAL RETIREMENT CONTRIBUTIONS WERE MADE THROUGH A NON-QUALIFIED RETIREMENT PLAN FOR SENIOR MANAGERS IN CALENDAR YEAR 2014. THE TOTAL OF non-qualified retirement contributions in 2014 were as follows: Bruce Auerbach, MD - $648,077 included as taxable wage in W-2, and $53,414 deferred compensation as not vested. Brian Kelly, MD - $64,445 included as taxable wage in W-2, and $35,330 deferred compensation as not vested. Joseph Casey - $61,281 included as taxable wage in W-2, and $39,878 deferred compensation as not vested. Lisa McCluskie - $5,181 included as taxable wage in W-2, and $51,846 deferred compensation as not vested.
Non-fixed Payments Schedule J, Part I, Line 7 Compensation packages for the CEO, Senior Managers, and listed physicians include opportunities to earn incentive compensation based on a combination of meeting or exceeding pre-determined goals. All incentive compensation is subject to review and approval by the compensation committee and has been reported on Schedule J, Part II, column B (ii).
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
Sturdy Memorial Hospital Inc
 
Employer identification number

04-2768252
Return Reference Explanation
ORGANIZATION'S MISSION (CONTINUED) FORM 990, PART III, LINE 1 THE HOSPITAL WORKS TO ENSURE THAT AMPLE, HIGH QUALITY PRIMARY AND SPECIALTY PHYSICIAN SERVICES ARE ACCESSIBLE TO AREA RESIDENTS. ADDITIONALLY, WE TRY TO AVOID COSTLY DUPLICATION OF HEALTH CARE SERVICES BY COORDINATING WITH OTHER AREA HEALTH CARE PROVIDERS TO THE EXTENT PRACTICABLE. THE HOSPITAL PROVIDES LEADERSHIP WHILE WORKING IN COOPERATION WITH PUBLIC AND PRIVATE HEALTH ORGANIZATIONS, AS WELL AS CIVIC AND BUSINESS ORGANIZATIONS, TO MEET THE HEALTH CARE NEEDS OF OUR COMMUNITIES. PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) FORM 990, PART III, LINE 4A The Hospital provides high quality care to the sick and injured, on both an inpatient and outpatient basis, without regard to race, creed, national origin age, gender, disability, or ability to pay. In fiscal year 2015, the hospital provided 5,011 free care visits and 568 partial free care visits. The hospital treated 9,100 inpatients and observation patients, including births, of which there were 661. The hospital treated 51,769 patients in the emergency room during the year. The hospital performed surgery on 1,637 inpatients and 6,897 outpatients. The hospital provides many other services of which the following is a partial list: Oncology - 7,118 visits; Mansfield Health Center - 23,143 visits; Cardiac Rehabilitation - 13,348 visits; and Wound Care - 4,819 visits; and cardiac Catheterizations - 119 procedures. In addition, the hospital provides a variety of ancillary services - a partial list includes: laboratory, radiology, mammography, computerized tomography, MRI, nuclear medicine, vascular, ultrasound, sleep study and physical therapy. The hospital provided $4,892,982 in services for those who could not pay (free care) or would not pay (bad debt) in fiscal year 2015. In addition, the hospital provided approximately $4,829,751 in un-reimbursed MassHealth (Medicaid) services during the year. Further, the hospital provides a number of programs to benefit our community either at no charge or at reduced rates. The hospital also provides leadership in the integration of health services for the communities it serves. EMPLOYEES REPORTED ON FORM W-3 Form 990, Part V, Line 2a Sturdy Memorial Hospital, inc. is the common paymaster for Sturdy Memorial Associates, inc. and Sturdy Memorial Foundation, Inc. Therefore, the total number of employees listed in Part V, line 2a includes only employees from the Hospital 1,557. The total number of employees on the Form W-3 is 1,921. VOTING RIGHTS OF GOVERNING BODY Form 990, Part VI, Section A, Line 1a The bylaws of Sturdy Memorial Hospital, Inc. state that "the Executive Committee shall have the power to transact all regular business of the Hospital during the interim between the meetings of the Board of Managers 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 Managers of Sturdy Memorial Hospital. BUSINESS RELATIONSHIPS WITH GOVERNING BODY Form 990, Part VI, Section A, Line 2 Joseph Casey, Dennis Kelly, and Patricia Cochrane have a business relationship.
Members or Stockholders Form 990, Part VI, Section A, Line 6 Sturdy Memorial Foundation, Inc., a Massachusetts charitable corporation, acting through its Board of Directors, is the sole Member of the Sturdy Memorial Hospital. Members or Stockholders who may elect members of governing body Form 990, Part VI, Section A, Line 7a The Board of Managers of Sturdy Memorial Hospital, Inc. consists of those persons who serve as the Directors of Sturdy Memorial Foundation, Inc. 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 three 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 Under the direction of the 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 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 Managers of any new conflicts. Article V, Section 12 of the Hospital 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 President and Chief Financial Officer and any potential conflicts are resolved. DOCUMENT RETENTION AND DESTRUCTION POLICY Form 990, Part VI, Section B, Line 14 The hospital does not have a written document retention and destruction policy but does comply with Massachusetts law with respect to record retention requirements. For example, Massachusetts law requires that the hospital maintain its medical records for a minimum of 20 years. Where state law does not require retention limits, the hospital 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). The hospital has begun drafting a formal policy.
Process for determining compensation Form 990, Part VI, Section B, Line 15 The CEO and senior managers, as well as all other hospital employees, are compensated on a merit system. 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 evaluation extends to his responsibilities as the Chief Executive of Sturdy Memorial Associates (an approximately sixty three physician multi-specialty group practice) as well as his responsibilities at the remaining affiliated corporations. The CEOs compensation is paid entirely by the hospital (there is no additional compensation from the related organizations). Several of the other senior managers have responsibilities that extend to the affiliated corporations and their compensation is paid entirely by the hospital as well (there is no additional compensation from related organizations). 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 Center for Health Information and Analysis. The 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) 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 (incentive) 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 hospital senior managers (key employees). The CEO compares the senior managers' current base salary and bonus (incentive pay) to the survey data. The senior managers' performance is evaluated based on the goals established at the start of the year. The CEO determines the base pay amount and bonus for each senior manager based on performance and the compensation survey. Base salary and bonus payments for each senior manager, including survey information, are reviewed with the Executive Committee by the CEO. The Executive Committee votes to accept the recommendations of the CEO except for the CFO, the Executive Committee votes to approve the CFO's compensation. PARTICIPATION IN JOINT VENTURE ARRANGEMENTS Form 990, Part VI, Section B, Line 16b The Hospital has drafted a policy requiring evaluation of its participation in joint venture arrangements under applicable Federal and State Law, and Internal Revenue Service Form 990 instructions. The Hospital requires that any venture or arrangement with third parties not engage in any activities that would jeopardize the Hospital's exemption, such as political activities, substantial lobbying, private inurement or substantial nonexempt activities. The Hospital shall maintain control, prioritize its exempt purposes, enter contracts at arms-length, require transparent reporting, and ensure any venture comply with Internal Revenue Code Section 501(r). The Hospital's management shall negotiate any ventures or arrangements with the assistance of legal counsel, if necessary, and the Hospital's Board of Managers approves any venture or arrangement. The Hospital currently participates in several ventures, all related to health care operations.
How Documents are made available to the public Form 990, Part VI, Section C, Line 19 The Hospital makes available copies of its by-laws, conflict of interest policy, and financial statements to the general public upon request.
Other Changes in Net assets Form 990, Part XI, Line 9 Pension and other postretirement benefit adjustment (25,688,000) Transfer to affiliate (2,500,000) Transfer from affiliate 117,960 --------------- Total (28,070,040)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
Sturdy Memorial Hospital Inc
 
Employer identification number

04-2768252
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1) Sturdy Memorial Associates Inc
211 Park Street PO Box 2963

Attleboro,MA02703
04-2709501
Physicians MA 501(c)(3) 11-type II SMF
 
 
No
(2) Sturdy Memorial Foundation Inc
212 Park Street POBox 2963

Attleboro,MA02703
04-2103631
Development MA 501(c)(3) 11-type II NA
 
 
No
(3) Emory Street Radiology Associates Inc
213 Park Street PO Box 2963

Attleboro,MA02703
04-3137282
Radiology MA 501(c)(3) 11-type II SMH
 
Yes
 








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) SHV Inc

127 Pearl Street
Attleboro,MA02703
04-2855097
sales and rental MA SMF
 
C Corp         No












Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Related Tax-Exempt Organizations Schedule R, Part II Sturdy Memorial Associates, Inc.'s primary activities: Recruit physicians to expand and improve the availability of quality medical care in the Sturdy Memorial Hospital service area. Sturdy Memorial Foundation, Inc.'s primary activities: Engaging in philanthrophic activities to support the mission and purpose of sturdy memorial hospital, inc. Emory Street Radiology Associates Inc.'s primary activities: Provided radiology service - Operations have been suspended as of June 1998.
Related Organization Taxable as a Corporation Schedule R, Part IV SHV Inc., which does business under the trade name Attleboro Area Medical Equipment Co, is a for-profit corporation actively engaged in the sale and rental of medical equipment and accessories in the Greater Attleboro Are. The company extends credit to its customers and is paid directly or by private insurance.
Schedule R (Form 990) 2014
Additional Data


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