Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
STURDY MEMORIAL HOSPITAL INC |
042768252 | 3 | Yes | 0 | 0 | |
|
Total 1
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 | ||||
| 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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| ORGANIZATION MISSION (Continued) | FORM 990, PART III, LINE 1 STURDY MEMORIAL FOUNDATION, INC. WAS ORGANIZED TO SUPPORT THE ADVANCEMENT OF THE KNOWLEDGE, PRACTICE, EDUCATION, AND RESEARCH OF MEDICINE, SURGERY, NURSING AND ALL OTHER SUBJECTS RELATING TO THE CARE, TREATMENT AND HEALING OF HUMANS. WITH THE GOAL OF IMPROVING THE HEALTH AND WELFARE OF ALL PERSONS, AND SPONSORING, DEVELOPING AND PROMOTING SERVICES AND PROGRAMS WHICH ARE CHARITABLE, SCIENTIFIC OR EDUCATIONAL; AND WHICH ADDRESS THE PHYSICAL AND MENTAL NEEDS OF THE COMMUNITY AT LARGE. THIS CORPORATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF STURDY MEMORIAL HOSPITAL, INC. AND ITS AFFILIATED ORGANIZATIONS, IN THE CONDUCT OF THEIR CHARITABLE, EDUCATIONAL AND SCIENTIFIC FUNCTIONS. IN ORDER TO FULFILL ITS HEALTH CARE MISSION IN THE TWELVE COMMUNITIES THAT IT SERVES, THE FOUNDATION SOLICITS FUNDS FROM A WIDE VARIETY OF RESOURCES. DURING THE PAST TWENTY FIVE YEARS, THE FOUNDATION HAS SPENT OVER $ 13.8 MILLION TO PURCHASE LAND, BUILD, AND MAINTAIN EIGHT NEW MEDICAL CENTERS IN THE TOWNS OF FOXBORO, NORTON, NORTH ATTLEBORO, REHOBOTH, AND IN THE CITY OF ATTLEBORO. THE FOUNDATION HAS ALSO PROVIDED $26,100,000 OVER THE PAST 35 YEARS TO STURDY MEMORIAL ASSOCIATES TO PROVIDE ON-GOING SUPPORT OF ITS PHYSICIAN GROUP PRACTICE THAT, AT THE END OF FISCAL YEAR 2019, EMPLOYED SEVENTY-ONE PHYSICIANS. THE PHYSICIAN GROUP PRACTICE WAS DEVELOPED TO MEET THE NEED FOR PRIMARY AND SPECIALTY CARE SERVICES IN OUR SERVICE AREA. |
| EMPLOYEES REPORTED ON FORM W-3 | FORM 990, PART V, LINE 2A STURDY MEMORIAL HOSPITAL IS THE COMMON PAYMASTER FOR STURDY MEMORIAL FOUNDATION. FORM W-3 IS FILED UNDER STURDY MEMORIAL HOSPITAL'S EMPLOYEE IDENTIFICATION NUMBER, THEREFORE THE FOUNDATION DOES NOT FILE A W-3. THE TOTAL NUMBER OF STURDY MEMORIAL FOUNDATION EMPLOYEES IS 2, WHICH IS LISTED ON LINE 2. |
| FEDERAL EMPLOYMENT TAX RETURNS | FORM 990, PART V, LINE 2B STURDY MEMORIAL HOSPITAL, INC. IS THE COMMON PAYMASTER FOR STURDY MEMORIAL FOUNDATION, INC. AND FILES ALL REQUIRED FEDERAL EMPLOYMENT FORMS. |
| AUTHORITY DELEGATED TO EXECUTIVE COMMITTEE | FORM 990, PART VI, SECTION A, LINE 1A THE BY-LAWS OF STURDY MEMORIAL FOUNDATION STATE THAT "THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS EXCEPT FOR SUCH MATTERS AS ARE SPECIFIED IN SECTION 55 OF THE (MASSACHUSETTS) GENERAL LAWS, CHAPTER 156B." THE EXECUTIVE COMMITTEE CONSISTS ONLY OF MEMBERS OF THE BOARD OF DIRECTORS OF STURDY MEMORIAL FOUNDATION, INC. |
| BUSINESS RELATIONSHIP WITH GOVERNING BODY | FORM 990, PART VI, SECTION A, LINE 2 DENNIS KELLY, EDWARD DION, AND PATRICIA COCHRANE--BUSINESS RELATIONSHIP. JOSEPH CASEY, DENNIS KELLY, AND EDWARD DION--BUSINESS RELATIONSHIP. PAUL HEROUX AND LAURA GIGNAC--BUSINESS RELATIONSHIP. IN ADDITION, OTHER PERSONS LISTED IN PART VII HAVE A "BUSINESS RELATIONSHIP" WITH ONE ANOTHER DUE TO THE OVERLAPPING BOARD STRUCTURE OF STURDY MEMORIAL FOUNDATION AND ITS AFFILIATES. |
| MEMBERS OR STOCKHOLDERS | FORM 990, PART VI, SECTION A, LINE 6 AND 7A STURDY MEMORIAL FOUNDATION'S BOARD OF DIRECTORS ARE MEMBERS OF THE CORPORATION. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY STURDY MEMORIAL'S TAX FIRM, 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. THE FORM 990 IS THEN PRESENTED TO THE AUDIT COMMITTEE FOR REVIEW AND RECOMMENDATION OF APPROVAL. PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE, THE COMPLETE FORM AND ALL SCHEDULES ARE PROVIDED TO EVERY BOARD MEMBER AND ANY QUESTIONS ARE ANSWERED. |
| CONFLICT OF INTEREST POLICY MONITORING AND ENFORCEMENT | FORM 990, PART VI, SECTION B, LINE 12C STURDY MEMORIAL FOUNDATION, INC. IS THE PARENT OF STURDY MEMORIAL HOSPITAL, INC. AND FOLLOWS THE HOSPITAL'S CONFLICT OF INTEREST POLICY. ALL FOUNDATION LEADERSHIP AND BOARD MEMBERS 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 RESPONDENT. IN ADDITION, THESE SIGNED STATEMENTS ARE REVIEWED BY THE INTEGRITY OFFICER AND ANY POTENTIAL CONFLICTS ARE ADDRESSED AND RESOLVED. THE INTEGRITY OFFICER DISCUSSES DISCLOSED POTENTIAL CONFLICTS WITH EMPLOYEE AND OR OFFICER OF THE HOSPITAL, SO THAT THEY UNDERSTAND WHAT CONSTITUTES AN INAPPROPRIATE BUSINESS ACTIVITY. ANY GIFTS RECEIVED THAT CREATE A CONFLICT OR ARE IN VIOLATION OF THE CONFLICT OF INTEREST POLICY MUST BE RETURNED. INDIVIDUALS WITH DOCUMENTED CONFLICTS MUST ABSTAIN FROM ANY DECISION MAKING SPECIFIC TO THE IDENTIFIED AREA. AN ANNUAL REPORT IS PREPARED AND PROVIDED TO THE HOSPITAL'S PRESIDENT AND CEO AS WELL AS BOARD OF MANAGERS; THIS COMPREHENSIVE REPORT INCLUDES ALL INTEGRITY COMPLIANCE ISSUES AS WELL AS ANY NEWLY IDENTIFIED CONFLICTS OF INTEREST. |
| PROCESS OF DETERMINING COMPENSATION | FORM 990, PART VI, SECTION B, LINE 15A 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 FOUNDATION AS WELL AS HIS RESPONSIBILITIES AT THE REMAINING AFFILIATED CORPORATIONS. THE CEOS COMPENSATION IS SHARED BY THE HOSPITAL AND FOUNDATION AS HIS RESPONSIBILITIES EXTEND TO BOTH CORPORATIONS. 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 IS 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. |
| HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC | FORM 990, PART VI, SECTION C, LINE 19 STURDY MEMORIAL FOUNDATION, INC. MAKES AVAILABLE COPIES OF ITS BY-LAWS, THE CONFLICT OF INTEREST POLICY OF STURDY MEMORIAL HOSPITAL, INC., AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC UPON REQUEST. |
| Reconciliation | PART XI, Line 9 TEMP. RESTRICTED ENDOWMENT ASSETS RELEASED FROM RESTRICTIONS $(116,511) NET ASSETS RELEASED FROM RESTRICTIONS $ (25,390) EQUITY TRANSFER FROM AFFILIATE $ 294,265 ---------- TOTAL $ 152,364 |
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