Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and 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)
ST JOSEPH'S HOSPITAL |
590774199 | 3 | Yes | 2,814,417 | 0 | |
|
Total 1
|
2,814,417 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, 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 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART IV, SECTION B, QUESTION 1: | THE FILING ORGANIZATION EXISTS TO SUPPORT ST. JOSEPH'S HOSPITALS. THE FOUNDATION PRESIDENT REPORTS TO THE HOSPITAL PRESIDENT. ADDITIONALLY, THE HOSPITAL PRESIDENT IS A MEMBER OF THE FOUNDATION BOARD AND ITS EXECUTIVE COMMITTEE. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ST. JOSEPH'S HOSPITAL OF TAMPA FOUNDATION, INC. IS ST. JOSEPH'S HEALTH CARE CENTER, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | (A) THE PRESIDENT OF THE HOSPITAL SHALL SERVE AS A TRUSTEE OF THE CORPORATION. (B) ALL OTHER TRUSTEES SHALL BE APPOINTED (THE "APPOINTED TRUSTEES") BY THE BOARD OF TRUSTEES OF THE CORPORATE MEMBER AT AN ANNUAL MEETING OF SAID BOARD PURSUANT TO THE FOLLOWING PROCEDURE: (I) THE EXECUTIVE COMMITTEE SHALL IDENTIFY POTENTIAL TRUSTEES, PRESENT THE NAMES TO THE TRUSTEES, INTERVIEW THOSE CANDIDATES, CONSULT WITH THE TRUSTEES AND MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES. (II) THE BOARD OF TRUSTEES SHALL REVIEW THE RECOMMENDATIONS OF THE EXECUTIVE COMMITTEE AND EITHER APPOINT THE NEW TRUSTEES OR REQUEST ADDITIONAL RECOMMENDATIONS FROM THE EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING POWERS ARE RESERVED TO THE BOARD OF DIRECTORS OF THE CORPORATE MEMBER: (I) APPROVE THE AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION, IN WHOLE OR IN PART, AND RECOMMEND THE SAME TO TRINITY HEALTH FOR ADOPTION. (II) APPROVE THE AMENDMENT OR RESTATEMENT OF KEY BYLAWS PROVISIONS (AS DEFINED IN THE BYLAWS) OF THE CORPORATION, IN WHOLE OR IN PART, AND RECOMMEND THE SAME TO TRINITY HEALTH FOR ADOPTION. (III) APPROVE THE AMENDMENT OR RESTATEMENT OF NON-KEY BYLAWS PROVISIONS OF THIS CORPORATION, IN WHOLE OR IN PART. (IV) APPOINT AND REMOVE TRUSTEES OF THE CORPORATION, WITH OR WITHOUT CAUSE. (V) APPROVE THE OFFICIAL INTERPRETATION OF THE PHILOSOPHY AND MISSION OF THE CORPORATION. (VI) APPROVE THE STRATEGIC PLAN OF THE CORPORATION (VII) APPROVE THE ANNUAL OPERATING PLAN AND BUDGET FOR OF THE CORPORATION. (VIII) APPROVE SIGNIFICANT FINANCIAL TRANSACTIONS (AS DEFINED IN THE BYLAWS) AND SIGNIFICANT BUDGET VARIANCES OF THE CORPORATION, AND RECOMMEND THE SAME TO TRINITY HEALTH FOR ADOPTION AND AUTHORIZATION. (IX) APPROVE THE ESTABLISHMENT OR DISSOLUTION OF ORGANIZATIONAL RELATIONSHIPS BY THE CORPORATION, INCLUDING WITHOUT LIMITATION, SUBSIDIARY CORPORATIONS, AND SIGNIFICANT PARTNERSHIPS, JOINT VENTURES AND MERGERS AS DEFINED BY THE TRINITY HEALTH GOVERNANCE DOCUMENTS, AND RECOMMEND THE SAME TO TRINITY HEALTH FOR ADOPTION AND AUTHORIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, THE 990 FOR THE FOUNDATION EXCLUDING SCHEDULE B WAS MADE AVAILABLE TO ALL TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 12C | ST. JOSEPH'S HOSPITAL OF TAMPA FOUNDATION HAS TWO SEPARATE CONFLICT OF INTEREST PROCEDURES; ONE THAT RELATES TO BOARD MEMBERS AND ANOTHER THAT RELATES TO NON-BOARD MEMBER EMPLOYEES. BOTH GROUPS ARE REQUIRED ON AN ANNUAL BASIS TO COMPLETE, SIGN AND FILE AN ANNUAL DISCLOSURE STATEMENT DETAILING EXISTING OR POTENTIAL CONFLICTS OF INTERESTS. FOR BOARD MEMBERS, THE REVIEW OF CONFLICTS OR POTENTIAL CONFLICTS OCCURS AT THE BOARD OR COMMITTEE LEVEL AFTER EXCUSING THE MEMBER WITH THE CONFLICT. SHOULD IT BE DETERMINED THAT A BOARD MEMBER HAS AN ACTUAL CONFLICT, HE WOULD BE EXCLUDED FROM CONSIDERATION BY THE BOARD AS TO WHAT ACTION IT WILL TAKE. FOR EMPLOYEES, THE REVIEW OF CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS GOES BY THE BAYCARE'S CONFLICT OF INTEREST DETERMINATION COMMITTEE. THIS COMMITTEE CONSISTS OF BAYCARE CHIEF COMPLIANCE OFFICER, THE CORPORATE RESPONSIBILITY OFFICERS, AND THE BAYCARE VICE PRESIDENT OF TEAM RESOURCES. THIS COMMITTEE SHALL DETERMINE IF AN ACTUAL CONFLICT EXISTS AND ANY ACTION REQUIRED TO ADDRESS THE CONFLICT OF INTEREST SITUATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS OF DETERMINING THE COMPENSATION OF THE PRESIDENT IS CONDUCTED THROUGH ST. JOSEPH'S HOSPITAL AND ITS PARENT BAYCARE. AN INDEPENDENT COMPENSATION COMMITTEE, APPOINTED BY THE BOARD OF DIRECTORS, PROVIDES OVERSIGHT FOR THE ORGANIZATION'S EXECUTIVE COMPENSATION PROGRAM, REVIEW AND APPROVE COMPENSATION AND BENEFITS FOR ALL "DISQUALIFIED PERSONS" SUBJECT TO THE INTERMEDIATE SANCTIONS REGULATIONS ISSUED UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE (INCLUDING THE CHIEF EXECUTIVE OFFICER, CHIEF ADMINISTRATIVE OFFICER & CFO, OTHER SYSTEM AND ENTITY EXECUTIVES, AND OTHER DISQUALIFIED PERSONS AS DEFINED IN THE INTERMEDIATE SANCTIONS REGULATIONS (I.E., VOTING MEMBERS OF THE GOVERNING BODY, FAMILY MEMBERS, FORMER OFFICERS), AND ESTABLISH THE COMPENSATION PHILOSOPHY FOR ALL OTHER EXECUTIVES. THIS COMMITTEE ENGAGES COMPENSATION CONSULTANTS TO ASSIST THEM IN REVIEW OF EXECUTIVE COMPENSATION IN RELATION TO MARKET STANDARDS FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE ORGANIZATION KEEPS CONTEMPORANEOUS MINUTES OF THE COMPENSATION COMMITTEES MEETINGS AND DECISIONS. EXTERNAL CONSULTANTS REVIEW COMPENSATION EVERY OTHER YEAR. THE COMPENSATION COMMITTEE REGULARLY MONITORS COMPENSATION AND ALL OTHER PROCEDURES ARE FOLLOWED ANNUALLY. THE HOSPITAL'S PRESIDENT AND A BOARD COMMITTEE EVALUATES THE PERFORMANCE OF THE FOUNDATION PRESIDENT BASED ON PERFORMANCE GOALS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION PROVIDES COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. |
| PART XII LINE 2C | THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |
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