TY 2020 Form 990PF

- TIN:

Form990-PF
Click to see attachment

Department of the Treasury
Internal Revenue Service

Return of Private Foundation

or Section 4947(a)(1) Trust Treated as Private Foundation

Do not enter social security numbers on this form as it may be made public.
bullet

Go to www.irs.gov/Form990PF for instructions and the latest information.

OMB No. 1545-0052

2020

Open to Public Inspection

For calendar year 2020, or tax year beginning 01-01-2020 , and ending 12-31-2020

Name of foundation
ST MARY'S & ROCHESTER METH HOSP

Number and street (or P.O. box number if mail is not delivered to street address)P O BOX 1802
Room/suite

City or town, state or province, country, and ZIP or foreign postal code
PROVIDENCE, RI029011802

A Employer identification number

04-6788009

B Telephone number (see instructions)

(888) 866-3275

C If exemption application is pending, check here bullet

G Check all that apply: Initial returnInitial return of a former public charity
Final returnAmended return
Address change Name change

D 1. Foreign organizations, check here............. bullet

2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet

E If private foundation status was terminated
under section 507(b)(1)(A), check here ....... bullet

H Check type of organization: Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust Other taxable private foundation

F If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here ....... bullet

I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16) bullet

$3,965,509J Accounting method: Cash Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)

	Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)	(a) Revenue and expenses per books		(b) Net investment income	(c) Adjusted net income	(d) Disbursements for charitable purposes (cash basis only)


1	Contributions, gifts, grants, etc., received (attach schedule)
2	Check .............
3	Interest on savings and temporary cash investments
4	Dividends and interest from securities...	57,510		57,510
5a	Gross rents............
b	Net rental income or (loss)
6a	Net gain or (loss) from sale of assets not on line 10		73,391
b	Gross sales price for all assets on line 6a 821,586
7	Capital gain net income (from Part IV, line 2)...			73,391
8	Net short-term capital gain.........				0
9	Income modifications...........
10a	Gross sales less returns and allowances
b	Less: Cost of goods sold....
c	Gross profit or (loss) (attach schedule).....
11	Other income (attach schedule).......
12	Total. Add lines 1 through 11........	130,901		130,901
13	Compensation of officers, directors, trustees, etc.	48,074		28,844		19,230
14	Other employee salaries and wages......			0	0	0
15	Pension plans, employee benefits.......			0	0
16a	Legal fees (attach schedule).........					0
b	Accounting fees (attach schedule).......		1,250	750	0	500
c	Other professional fees (attach schedule)....					0
17	Interest...............					0
18	Taxes (attach schedule) (see instructions)...		10,370	280		0
19	Depreciation (attach schedule) and depletion...		0	0
20	Occupancy..............
21	Travel, conferences, and meetings.......			0	0
22	Printing and publications..........			0	0
23	Other expenses (attach schedule).......		583	548		35
24	Total operating and administrative expenses.
	Add lines 13 through 23..........	60,277		30,422	0	19,765
25	Contributions, gifts, grants paid.......	164,308				164,308
26	Total expenses and disbursements. Add lines 24 and 25	224,585		30,422	0	184,073
27	Subtract line 26 from line 12:
a	Excess of revenue over expenses and disbursements	-93,684
b	Net investment income (if negative, enter -0-)			100,479
c	Adjusted net income (if negative, enter -0-)...				0

For Paperwork Reduction Act Notice, see instructions.

Cat. No. 11289X Form 990-PF (2020)

Form 990-PF (2020)

Page 2

Part II		Balance Sheets	Beginning of year	End of year
Part II		Balance Sheets	(a) Book Value	(b) Book Value	(c) Fair Market Value
	1	Cash—non-interest-bearing.............
	2	Savings and temporary cash investments.........	393,034	145,104	145,104
	3	Accounts receivable
		Less: allowance for doubtful accounts		0	0
	4	Pledges receivable
		Less: allowance for doubtful accounts
	5	Grants receivable.................
	6	Receivables due from officers, directors, trustees, and other
		disqualified persons (attach schedule) (see instructions).....
	7	Other notes and loans receivable (attach schedule)
		Less: allowance for doubtful accounts 0
	8	Inventories for sale or use..............
	9	Prepaid expenses and deferred charges..........
	10a	Investments—U.S. and state government obligations (attach schedule)
	b	Investments—corporate stock (attach schedule).......	2,502,099	2,657,533	3,820,405
	c	Investments—corporate bonds (attach schedule).......
	11	Investments—land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	12	Investments—mortgage loans.............
	13	Investments—other (attach schedule)..........			0
	14	Land, buildings, and equipment: basis
		Less: accumulated depreciation (attach schedule)
	15	Other assets (describe )
	16	Total assets (to be completed by all filers—see the
		instructions. Also, see page 1, item I)	2,895,133	2,802,637	3,965,509
	17	Accounts payable and accrued expenses..........
	18	Grants payable.................
	19	Deferred revenue.................
	20	Loans from officers, directors, trustees, and other disqualified persons
	21	Mortgages and other notes payable (attach schedule)......
	22	Other liabilities (describe )
	23	Total liabilities (add lines 17 through 22).........		0
		Foundations that follow FASB ASC 958, check here
		and complete lines 24, 25, 29 and 30.
	24	Net assets without donor restrictions...........
	25	Net assets with donor restrictions............
		Foundations that do not follow FASB ASC 958, check here
		and complete lines 26 through 30.
	26	Capital stock, trust principal, or current funds........	2,895,133	2,802,637
	27	Paid-in or capital surplus, or land, bldg., and equipment fund
	28	Retained earnings, accumulated income, endowment, or other funds
	29	Total net assets or fund balances (see instructions).....	2,895,133	2,802,637
	30	Total liabilities and net assets/fund balances (see instructions).	2,895,133	2,802,637

Part III

Analysis of Changes in Net Assets or Fund Balances

Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............

2,895,133

Enter amount from Part I, line 27a .....................

-93,684

Other increases not included in line 2 (itemize) bullet

1,188

Add lines 1, 2, and 3 ..........................

2,802,637

Decreases not included in line 2 (itemize) bullet

Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .

2,802,637

Form 990-PF (2020)

Page 3

Part IV

Capital Gains and Losses for Tax on Investment Income

(a) List and describe the kind(s) of property sold (e.g., real estate, 2-story brick warehouse; or common stock, 200 shs. MLC Co.)		(b) How acquired P—Purchase D—Donation	(c) Date acquired (mo., day, yr.)	(d) Date sold (mo., day, yr.)
1 a	5. AMAZON COM INC		2013-10-25	2020-08-27
b	165. AUTOMATIC DATA PROCESSING INC		2016-09-23	2020-08-27
c	70. BERKSHIRE HATHAWAY INC DEL NEW CL B COM		2014-11-06	2020-08-27
d	50. BOEING CO		2019-06-25	2020-06-22
e	1. BOEING CO		2014-11-06	2020-06-22
	13408.738 INTERMEDIATE AGGREGATE BOND CTF		2020-01-10	2020-03-31
	15. CARRIER GLOBAL CORP COM		2016-09-23	2020-06-19
	160. CARRIER GLOBAL CORP COM		2006-02-16	2020-06-19
	36131.711 COLUMBIA SHORT TERM BOND FUND INSTL3 CL		2014-11-19	2020-01-07
	5076.142 COLUMBIA SHORT TERM BOND FUND INSTL3 CL		2018-04-30	2020-01-07
	3138.075 COLUMBIA EMERGING MARKETS FUND INSTL3 CL		2017-03-21	2020-01-07
	5. FACEBOOK INC CL A COM		2018-04-30	2020-08-27
	25. FACEBOOK INC CL A COM		2015-01-28	2020-08-27
	15. GENERAL DYNAMICS CORP		2018-04-30	2020-08-27
	35. GENERAL DYNAMICS CORP		2016-09-23	2020-08-27
	95. GENERAL DYNAMICS CORP		2014-11-06	2020-08-27
	75. GOLDMAN SACHS GROUP INC		2019-03-05	2020-08-27
	.3 INGERSOLL RAND INC COM		2019-06-25	2020-04-13
	110. INGERSOLL RAND INC COM		2019-06-25	2020-08-27
	.5 OTIS WORLDWIDE CORP COM		2016-09-23	2020-05-29
	7. OTIS WORLDWIDE CORP COM		2016-09-23	2020-06-19
	80. OTIS WORLDWIDE CORP COM		2006-02-16	2020-06-19
	15. RAYTHEON TECHNOLOGIES CORP COM		2016-09-23	2020-08-27
	160. RAYTHEON TECHNOLOGIES CORP COM		2006-02-16	2020-08-27
	15. SCHLUMBERGER LTD COM		2018-04-30	2020-02-03
	10. SCHLUMBERGER LTD COM		2010-05-11	2020-02-03
	80. SCHLUMBERGER LTD COM		2018-08-30	2020-02-03
	175. SCHLUMBERGER LTD COM		2006-02-16	2020-02-03
	100. SCHLUMBERGER LTD COM		2019-03-05	2020-02-03
	360. US BANCORP DEL COM NEW		2014-11-06	2020-08-27
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P
	CAPITAL GAIN DIVIDENDS	P

(e) Gross sales price		(g) Cost or other basis plus expense of sale	(h) Gain or (loss) (e) plus (f) minus (g)
a	17,204	1,808	15,396
b	23,357	14,615	8,742
c	15,199	10,024	5,175
d	9,178	18,441	-9,263
e	184	125	59
	170,000	169,339	661
	324	288	36
	3,458	1,735	1,723
	361,317	359,511	1,806
	50,761	50,000	761
	45,000	33,487	11,513
	1,492	864	628
	7,459	1,934	5,525
	2,273	3,037	-764
	5,303	5,389	-86
	14,394	13,448	946
	15,806	14,638	1,168
	8	10	-2
	3,877	3,512	365
	26	27	-1
	403	376	27
	4,606	2,427	2,179
	911	850	61
	9,718	5,122	4,596
	500	1,039	-539
	334	672	-338
	2,668	5,176	-2,508
	5,837	10,012	-4,175
	3,335	4,471	-1,136
	13,317	15,818	-2,501
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577
			15,577

Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69			(l) Gains (Col. (h) gain minus col. (k), but not less than -0-) or Losses (from col.(h))
(i) F.M.V. as of 12/31/69	(j) Adjusted basis as of 12/31/69	(k) Excess of col. (i) over col. (j), if any
a			15,396
b			8,742
c			5,175
d			-9,263
e			59
			661
			36
			1,723
			1,806
			761
			11,513
			628
			5,525
			-764
			-86
			946
			1,168
			-2
			365
			-1
			27
			2,179
			61
			4,596
			-539
			-338
			-2,508
			-4,175
			-1,136
			-2,501

2	Capital gain net income or (net capital loss)	If gain, also enter in Part I, line 7 If (loss), enter -0- in Part I, line 7	2	73,391
3	Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
	If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0- in Part I, line 8 ...................		3

Part V

Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income

SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE

1 Reserved

(a) Reserved	(b) Reserved	(c) Reserved	(d) Reserved

Reserved...........................

Reserved,..........................

Form 990-PF (2020)

Page 4

Part VI

Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)

1a	Exempt operating foundations described in section 4940(d)(2), check here and enter “N/A" on line 1.
	Date of ruling or determination letter: (attach copy of letter if necessary–see instructions)
b	Reserved................................	1	1,397
c	All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2	Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)	2	0
3	Add lines 1 and 2...........................	3	1,397
4	Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)	4	0
5	Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- .....	5	1,397
6	Credits/Payments:

a	2020 estimated tax payments and 2019 overpayment credited to 2020	6a	6,000
b	Exempt foreign organizations—tax withheld at source......	6b	0
c	Tax paid with application for extension of time to file (Form 8868)...	6c	0
d	Backup withholding erroneously withheld ...........	6d

7	Total credits and payments. Add lines 6a through 6d..............		7	6,000
8	Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached.		8	0
9	Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......		9
10	Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...		10	4,603
11	Enter the amount of line 10 to be: Credited to 2021 estimated tax1,400	Refunded	11	3,203

Part VII-A

Statements Regarding Activities

During the tax year, did the foundation attempt to influence any national, state, or local legislation or did

Yes

it participate or intervene in any political campaign? ....................

Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions

for the definition.................................

If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials

published or distributed by the foundation in connection with the activities.

Did the foundation file Form 1120-POL for this year?.....................

Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:

(1) On the foundation. bullet

$ (2) On foundation managers. bullet

Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed

on foundation managers. bullet

Has the foundation engaged in any activities that have not previously been reported to the IRS?.......

If "Yes," attach a detailed description of the activities.

Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles

of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....

Did the foundation have unrelated business gross income of $1,000 or more during the year?........

If "Yes," has it filed a tax return on Form 990-T for this year?...................

Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........

If "Yes," attach the statement required by General Instruction T.

Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:

By language in the governing instrument, or

By state legislation that effectively amends the governing instrument so that no mandatory directions

that conflict with the state law remain in the governing instrument?................

Yes

Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),

and Part XV..................................

Yes

Enter the states to which the foundation reports or with which it is registered (see instructions)

If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney

General (or designate) of each state as required by General Instruction G? If "No," attach explanation .

Yes

Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)

or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.

If "Yes," complete Part XIV .............................

Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names

and addresses. ...............................

Form 990-PF (2020)

Page 5

Part VII-A

Statements Regarding Activities (continued)

At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the

meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............

Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had

advisory privileges? If "Yes," attach statement. See instructions.................

Did the foundation comply with the public inspection requirements for its annual returns and exemption application?

Yes

Website address bullet

N/A

The books are in care of bullet

BANK OF AMERICA NA Telephone no. bullet

(888) 866-3275

Located at bullet

P O BOX 1802PROVIDENCERI ZIP+4 bullet

029011802

Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here ......... bullet

and enter the amount of tax-exempt interest received or accrued during the year ........ bullet

16 At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over YesNo

a bank, securities, or other financial account in a foreign country? .................

16 No

See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country bullet

Part VII-B

Statements Regarding Activities for Which Form 4720 May Be Required

File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.

Yes

During the year did the foundation (either directly or indirectly):

(1) Engage in the sale or exchange, or leasing of property with a disqualified person? YesNo

(2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)

a disqualified person?......................YesNo

(3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? YesNo

(4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? YesNo

(5) Transfer any income or assets to a disqualified person (or make any of either available

for the benefit or use of a disqualified person)?...............YesNo

(6) Agree to pay money or property to a government official? (Exception. Check "No"

if the foundation agreed to make a grant to or to employ the official for a period

after termination of government service, if terminating within 90 days.).......YesNo

If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations

section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ........

Organizations relying on a current notice regarding disaster assistance check here........ bullet

Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,

that were not corrected before the first day of the tax year beginning in 2020?.............

Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private

operating foundation defined in section 4942(j)(3) or 4942(j)(5)):

At the end of tax year 2020, did the foundation have any undistributed income (lines 6d

and 6e, Part XIII) for tax year(s) beginning before 2020?.............YesNo

If "Yes," list the years bullet

20, 20, 20, 20

Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)

(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)

to all years listed, answer "No" and attach statement—see instructions.) ..............

If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.

20, 20, 20, 20

Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at

any time during the year?......................YesNo

If "Yes," did it have excess business holdings in 2020 as a result of (1) any purchase by the foundation

or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved

by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)

the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine

if the foundation had excess business holdings in 2020.)..................

Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?

Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its

charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2020?

Form 990-PF (2020)

Page 6

Part VII-B

Statements Regarding Activities for Which Form 4720 May Be Required (continued)

During the year did the foundation pay or incur any amount to:

Yes

(1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? YesNo

(2) Influence the outcome of any specific public election (see section 4955); or to carry

on, directly or indirectly, any voter registration drive?.............YesNo

(3) Provide a grant to an individual for travel, study, or other similar purposes? YesNo

(4) Provide a grant to an organization other than a charitable, etc., organization described

in section 4945(d)(4)(A)? See instructions................YesNo

(5) Provide for any purpose other than religious, charitable, scientific, literary, or

educational purposes, or for the prevention of cruelty to children or animals?.....YesNo

If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in

Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ......

Organizations relying on a current notice regarding disaster assistance check here......... bullet

If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the

tax because it maintained expenditure responsibility for the grant?..........YesNo

If "Yes," attach the statement required by Regulations section 53.4945–5(d).

Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on

a personal benefit contract?.....................YesNo

Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....

If "Yes" to 6b, file Form 8870.

At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction? YesNo

If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? ....

Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or

excess parachute payment during the year? .................YesNo

Part VIII

Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors

1 List all officers, directors, trustees, foundation managers and their compensation. See instructions

(a) Name and address	(b) Title, and average hours per week devoted to position	(c) Compensation (If not paid, enter -0-)
BANK OF AMERICA	TRUSTEE 1	43,268
225 FRANKLIN ST BOSTON,MA02110	TRUSTEE 1	43,268
MICHAEL GARFIELD	CO-TRUSTEE 1	4,806
142 PELHAM ISLAND RD WAYLAND,MA017782508	CO-TRUSTEE 1	4,806

2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."


(a) Name and address of each employee paid more than $50,000	(b) Title, and average hours per week devoted to position	(c) Compensation	(d) Contributions to employee benefit plans and deferred compensation	(e) Expense account, other allowances
NONE









Total number of other employees paid over $50,000...................				0

Form 990-PF (2020)

Page 7

Part VIII

Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors (continued)

3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a) Name and address of each person paid more than $50,000	(b) Type of service	(c) Compensation
NONE

Total number of others receiving over $50,000 for professional services............. bullet

Part IX-A

Summary of Direct Charitable Activities

List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.	Expenses
1


2


3


4

Part IX-B

Summary of Program-Related Investments (see instructions)

Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.	Amount
1


2


All other program-related investments. See instructions.
3

Total. Add lines 1 through 3......................... bullet

Form 990-PF (2020)

Page 8

Part X

Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)

Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,

purposes:

Average monthly fair market value of securities...................

3,409,209

Average of monthly cash balances.......................

150,535

Fair market value of all other assets (see instructions)................

Total (add lines 1a, b, and c).........................

3,559,744

Reduction claimed for blockage or other factors reported on lines 1a and

1c (attach detailed explanation) .............

Acquisition indebtedness applicable to line 1 assets..................

Subtract line 2 from line 1d.........................

3,559,744

Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see

instructions) .............................

53,396

Net value of noncharitable-use assets. Subtract line 4 from line 3. Enter here and on Part V, line 4

3,506,348

Minimum investment return. Enter 5% of line 5..................

175,317

Part XI

Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow

and do not complete this part.)

Minimum investment return from Part X, line 6....................

175,317

Tax on investment income for 2020 from Part VI, line 5......

1,397

Income tax for 2020. (This does not include the tax from Part VI.)...

Add lines 2a and 2b............................

1,397

Distributable amount before adjustments. Subtract line 2c from line 1............

173,920

Recoveries of amounts treated as qualifying distributions................

Add lines 3 and 4............................

173,920

Deduction from distributable amount (see instructions).................

Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1 ...

173,920

Part XII

Qualifying Distributions (see instructions)

Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:

Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........

184,073

Program-related investments—total from Part IX-B..................

Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,

purposes...............................

Amounts set aside for specific charitable projects that satisfy the:

Suitability test (prior IRS approval required)....................

Cash distribution test (attach the required schedule) .................

Qualifying distributions. Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4

184,073

Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment

income. Enter 1% of Part I, line 27b. See instructions.................

Adjusted qualifying distributions. Subtract line 5 from line 4..............

184,073

Note: The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.

Form 990-PF (2020)

Page 9

Part XIII

Undistributed Income (see instructions)

		(a) Corpus	(b) Years prior to 2019	(c) 2019	(d) 2020
1 Distributable amount for 2020 from Part XI, line 7					173,920
2 Undistributed income, if any, as of the end of 2020:
a Enter amount for 2019 only.......				37,094
b Total for prior years:20, 20, 20			0
3 Excess distributions carryover, if any, to 2020:
a From 2015......	0
b From 2016......	0
c From 2017......	0
d From 2018......	0
e From 2019......	0
fTotal of lines 3a through e........		0
4Qualifying distributions for 2020 from Part
XII, line 4: $ 184,073
a Applied to 2019, but not more than line 2a				37,094
b Applied to undistributed income of prior years (Election required—see instructions).....			0
c Treated as distributions out of corpus (Election required—see instructions)........		0
d Applied to 2020 distributable amount.....					146,979
e Remaining amount distributed out of corpus		0
5 Excess distributions carryover applied to 2020.		0			0
(If an amount appears in column (d), the same amount must be shown in column (a).)
6Enter the net total of each column as indicated below:
a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5		0
b Prior years’ undistributed income. Subtract line 4b from line 2b ..........			0
c Enter the amount of prior years’ undistributed income for which a notice of deficiency has been issued, or on which the section 4942(a) tax has been previously assessed......			0
d Subtract line 6c from line 6b. Taxable amount —see instructions ...........			0
e Undistributed income for 2019. Subtract line 4a from line 2a. Taxable amount—see instructions .............				0
f Undistributed income for 2020. Subtract lines 4d and 5 from line 1. This amount must be distributed in 2021 ..........					26,941
7 Amounts treated as distributions out of corpus to satisfy requirements imposed by section 170(b)(1)(F) or 4942(g)(3) (Election may be required - see instructions) .......		0
8 Excess distributions carryover from 2015 not applied on line 5 or line 7 (see instructions) ...		0
9Excess distributions carryover to 2021. Subtract lines 7 and 8 from line 6a ......		0
10 Analysis of line 9:
a Excess from 2016....	0
b Excess from 2017....	0
c Excess from 2018....	0
d Excess from 2019....	0
e Excess from 2020....	0

Form 990-PF (2020)

Page 10

Part XIV

Private Operating Foundations (see instructions and Part VII-A, question 9)

1a If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2020, enter the date of the ruling....... bullet

b Check box to indicate whether the organization is a private operating foundation described in section4942(j)(3) or4942(j)(5)

2a Enter the lesser of the adjusted net income from Part I or the minimum investment return from Part X for each year listed ..........	Tax year	Prior 3 years			(e) Total
	(a) 2020	(b) 2019	(c) 2018	(d) 2017	(e) Total

b 85% of line 2a .........
c Qualifying distributions from Part XII, line 4 for each year listed .....
d Amounts included in line 2c not used directly for active conduct of exempt activities ..........
e Qualifying distributions made directly for active conduct of exempt activities. Subtract line 2d from line 2c ....
3 Complete 3a, b, or c for the alternative test relied upon:
a “Assets" alternative test—enter:
(1) Value of all assets ......
(2) Value of assets qualifying under section 4942(j)(3)(B)(i)
b “Endowment" alternative test— enter 2/3 of minimum investment return shown in Part X, line 6 for each year listed...
c “Support" alternative test—enter:
(1) Total support other than gross investment income (interest, dividends, rents, payments on securities loans (section 512(a)(5)), or royalties) ....
(2) Support from general public and 5 or more exempt organizations as provided in section 4942(j)(3)(B)(iii)....
(3) Largest amount of support from an exempt organization
(4) Gross investment income

Part XV

Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)

1Information Regarding Foundation Managers:

aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)

bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.

2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:

Check here bullet

if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions

aThe name, address, and telephone number or email address of the person to whom applications should be addressed:

bThe form in which applications should be submitted and information and materials they should include:

cAny submission deadlines:

dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:

Form 990-PF (2020)

Page 11

Part XV

Supplementary Information (continued)

3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient	If recipient is an individual, show any relationship to any foundation manager or substantial contributor	Foundation status of recipient	Purpose of grant or contribution	Amount
Name and address (home or business)		Foundation status of recipient	Purpose of grant or contribution	Amount
aPaid during the year
MAYO CLINIC ATTN BETHEL RUEST 200 1ST STREET SW ROCHESTER,MN559050001	N/A	PC	UNRESTRICTED GENERAL	164,308
Total ................................. 3a				164,308

bApproved for future payment

Total ................................. 3b

Form 990-PF (2020)

Page 12

Part XVI-A

Analysis of Income-Producing Activities

Enter gross amounts unless otherwise indicated.	Unrelated business income		Excluded by section 512, 513, or 514		(e) Related or exempt function income (See instructions.)
1Program service revenue:	(a) Business code	(b) Amount	(c) Exclusion code	(d) Amount	(e) Related or exempt function income (See instructions.)
a
b
c
d
e
f
gFees and contracts from government agencies
2 Membership dues and assessments....
3 Interest on savings and temporary cash investments ...........
4 Dividends and interest from securities....			14	57,510
5 Net rental income or (loss) from real estate:
aDebt-financed property......
bNot debt-financed property.....
6 Net rental income or (loss) from personal property
7 Other investment income.....
8 Gain or (loss) from sales of assets other than inventory ............			18	73,391
9 Net income or (loss) from special events:
10 Gross profit or (loss) from sales of inventory
11 Other revenue: a
b
c
d
e
12 Subtotal. Add columns (b), (d), and (e)..				130,901

13Total. Add line 12, columns (b), (d), and (e)..................

130,901

(See worksheet in line 13 instructions to verify calculations.)

Part XVI-B

Relationship of Activities to the Accomplishment of Exempt Purposes

Line No.	Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See instructions.)

Form 990-PF (2020)

Page 13

Part XVII

Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations

Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?

Yes

Transfers from the reporting foundation to a noncharitable exempt organization of:

(1) Cash...................................

1a(1)

(2) Other assets.................................

1a(2)

Other transactions:

(1) Sales of assets to a noncharitable exempt organization....................

1b(1)

(2) Purchases of assets from a noncharitable exempt organization..................

1b(2)

(3) Rental of facilities, equipment, or other assets.......................

1b(3)

(4) Reimbursement arrangements...........................

1b(4)

(5) Loans or loan guarantees.............................

1b(5)

(6) Performance of services or membership or fundraising solicitations................

1b(6)

Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............

If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.

(a) Line No.	(b) Amount involved	(c) Name of noncharitable exempt organization	(d) Description of transfers, transactions, and sharing arrangements

Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........Yes No

If "Yes," complete the following schedule.

(a) Name of organization	(b) Type of organization	(c) Description of relationship

Sign Here

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 taxpayer) is based on all information of which preparer has any knowledge.
				May the IRS discuss this return with the preparer shown below? See instructions. Yes No
	Signature of officer or trustee	Date	Title

Paid Preparer Use Only	Print/Type preparer's name	Preparer's Signature	Date	Check if self- employed	PTIN
	Firm's name				Firm's EIN
	Firm's address				Phone no.

Form 990-PF (2020)

Additional Data

Software ID:
Software Version:

Form 990PF - Special Condition Description:

Special Condition Description

- TIN:

TY 2020 AccountingFeesSchedule

Name:

ST MARY'S & ROCHESTER METH HOSP

EIN:

04-6788009

Category	Amount	Net Investment Income	Adjusted Net Income	Disbursements for Charitable Purposes
TAX PREPARATION FEE - BOA	1,250	750		500

- TIN:

TY 2020 CompensationExplanation

Name:

ST MARY'S & ROCHESTER METH HOSP

EIN:

04-6788009

Person Name	Explanation
BANK OF AMERICA	SEE FOOTNOTE

- TIN:

TY 2020 GeneralExplanationAttachment

Name:

ST MARY'S & ROCHESTER METH HOSP

EIN:

04-6788009

Identifier	Return Reference	Explanation
FEDERAL FOOTNOTE	PART VIII LIST OF OFFICERS AND DIRECTORS	THE COMPENSATION SHOWN ON THE RETURN THAT IS PAID TO BANK OF AMERICA, N.A. AS CORPORATE TRUSTEE IS NOT CALCULATED BASED UPON AN HOURLY RATE FOR THE TIME SPENT BY THE TRUSTEE; RATHER, BANK OF AMERICA'S COMPENSATION AS CORPORATE TRUSTEE IS CALCULATED USING A MARKET VALUE FEE SCHEDULE. THE TRUST OFFICER'S TIME SPENT PERFORMING ADMINISTRATIVE RESPONSIBILITIES FOR THIS FOUNDATION AVERAGES ONE HOUR PER WEEK. IN ADDITION, TIME IS SPENT BY OTHER STAFF MEMBERS FOR RECORDKEEPING, INVESTMENT MANAGEMENT, INCOME COLLECTION, RENDERING STATEMENTS AND ACCOUNTINGS, REGULATORY REPORTING, REGULATORY COMPLIANCE, AND TAX SERVICES.

- TIN:

TY 2020 InvestmentsCorpStockSchedule

Name:

ST MARY'S & ROCHESTER METH HOSP

EIN:

04-6788009

Name of Stock	End of Year Book Value	End of Year Fair Market Value
30231G102 EXXON MOBIL CORP COM	24,981	14,633
674599105 OCCIDENTAL PETE CORP
806857108 SCHLUMBERGER LTD COM
009158106 AIR PRODS & CHEMS IN	19,636	34,153
369550108 GENERAL DYNAMICS COR
88579Y101 3M CO COM	8,668	16,605
913017109 UNITED TECHNOLOGIES
437076102 HOME DEPOT INC COM	11,940	31,874
609207105 MONDELEZ INTL INC CO	21,736	28,650
713448108 PEPSICO INC COM	12,015	30,402
742718109 PROCTER & GAMBLE CO	11,505	25,741
478160104 JOHNSON & JOHNSON CO	8,398	20,459
717081103 PFIZER INC COM	29,961	34,233
09247X101 BLACKROCK INC CL A	14,636	28,862
46625H100 J P MORGAN CHASE & C	21,192	55,911
949746101 WELLS FARGO & CO NEW
037833100 APPLE INC COM	8,527	87,575
053015103 AUTOMATIC DATA PROCE
17275R102 CISCO SYS INC COM	12,112	27,074
594918104 MICROSOFT CORP COM	19,003	86,744
00206R102 AT&T INC COM	13,057	10,354
438516106 HONEYWELL INTL INC C	16,420	39,350
023135106 AMAZON COM INC COM	9,040	81,423
580135101 MCDONALDS CORP COM	12,348	19,312
00287Y109 ABBVIE INC COM	14,867	37,503
92826C839 VISA INC CL A COM	27,847	66,713
166764100 CHEVRON CORP COM	21,415	15,201
20825C104 CONOCOPHILLIPS COM	25,035	14,996
097023105 BOEING CO COM
20030N101 COMCAST CORP NEW CL	8,588	16,244
654106103 NIKE INC CL B	16,479	43,148
126650100 CVS HEALTH CORP COM	21,745	21,515
084670702 BERKSHIRE HATHAWAY I	15,752	25,506
902973304 US BANCORP DEL COM N
458140100 INTEL CORP COM	8,293	12,206
92343V104 VERIZON COMMUNICATIO	14,842	17,331
74253Q747 PRINCIPAL MIDCAP BLE	334,364	503,667
1261291M7 INTERMEDIATE AGGREGA	748,476	760,196
02079K107 ALPHABET INC CL C CO	7,575	26,278
02079K305 ALPHABET INC CL A CO	7,620	26,290
30303M102 FACEBOOK INC CL A CO	11,989	42,340
518439104 LAUDER ESTEE COS INC	11,033	33,274
91324P102 UNITEDHEALTH GROUP I	13,368	33,315
617446448 MORGAN STANLEY COM	24,310	43,174
872540109 TJX COS INC NEW COM	25,252	40,633
22160K105 COSTCO WHSL CORP NEW	9,851	24,491
19763T806 COLUMBIA INCOME OPPO	66,317	63,826
19765M213 COLUMBIA SHORT TERM
19766M824 COLUMBIA EMERGING MA	156,244	295,594
00846U101 AGILENT TECHNOLOGIES	18,155	31,400
101137107 BOSTON SCIENTIFIC CO	15,185	14,740
67066G104 NVIDIA CORP COM	15,307	52,220
G47791101 INGERSOLL-RAND CO LT
075887109 BECTON DICKINSON & C	31,444	31,278
883556102 THERMO FISHER SCIENT	14,714	23,289
172967424 CITIGROUP INC NEW CO	36,263	38,229
38141G104 GOLDMAN SACHS GROUP
00724F101 ADOBE INC COM	20,828	37,509
032654105 ANALOG DEVICES INC C	20,196	28,069
70450Y103 PAYPAL HOLDINGS INC	21,238	45,669
79466L302 SALESFORCE COM INC C	18,646	27,816
025537101 AMERICAN ELEC PWR IN	24,042	21,234
816851109 SEMPRA ENERGY COM	17,311	15,289
24610B826 DELAWARE SMALL CAP C	220,500	261,980
G8994E103 TRANE TECH PUB LTD C	12,143	18,145
773903109 ROCKWELL AUTOMATION	31,396	33,859
911312106 UNITED PARCEL SVC IN	15,917	16,840
92556V106 VIATRIS INC COM		2,162
11135F101 BROADCOM INC COM	12,811	18,390
641224811 NEUBERGER BERMAN INT	245,000	265,491

- TIN:

TY 2020 OtherExpensesSchedule

Name:

ST MARY'S & ROCHESTER METH HOSP

EIN:

04-6788009

Description	Revenue and Expenses per Books	Net Investment Income	Disbursements for Charitable Purposes
OTHER ALLOCABLE EXPENSE-PRINCI	274	274	0
OTHER ALLOCABLE EXPENSE-INCOME	274	274	0
STATE FILING FEE	35	0	35

- TIN:

TY 2020 OtherIncreasesSchedule

Name:

ST MARY'S & ROCHESTER METH HOSP

EIN:

04-6788009

Description	Amount
INCOME ADJUSTMENT	1,148
CTF ADJUSTMENT	37
ROUNDING	3

- TIN:

TY 2020 TaxesSchedule

Name:

ST MARY'S & ROCHESTER METH HOSP

EIN:

04-6788009

Category	Amount	Net Investment Income
EXCISE TAX - PRIOR YEAR	4,090	0
EXCISE TAX ESTIMATES	6,000	0
FOREIGN TAXES ON QUALIFIED FOR	227	227
FOREIGN TAXES ON NONQUALIFIED	53	53