2014-08-11T13:03:26-05:00 2013-09-30 990 2012-10-01 042770980 EMERSON HEALTH CARE FOUNDATION INC EMER 9782873233 OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 ROBERT TREMBLAY 9782873233 2014-08-11 2012 2015-11-30 17:44:51Z ROBERT TREMBLAY OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 1709926 0 X EMERSONHOSPITAL.ORG X 1992 MA COORDINATE AND DEVELOP THE FUNDRAISING EFFORT FOR EMERSON HOSPITAL 25 22 0 0 0 0 1609114 1638011 0 0 2673 1770 0 0 1611787 1639781 0 0 0 0 476251 516491 0 0 801943 255986 285452 732237 801943 879550 837838 4130326 3800767 371283 368960 3759043 3431807 X EMERSON HEALTH CARE FOUNDATION INC PROVIDES PHILANTHROPIC RESOURCES TO ASSIST EMERSON HEALTH SYSTEM, INC AND EMERSON HOSPITAL IN FULFILLING THEIR MISSION OF IMPROVING THE HEALTH STATUS OF THE PEOPLE IN THE COMMUNITIES IT SERVES. THROUGH THE ON-GOING CULTIVATION OF RELATIONSHIPS, THE FOUNDATION LEADERSHIP WILL STRIVE TO CREATE THE WILLINGESS AS WELL AS THE MEANS THROUGH WHICH EMERSON HOSPITAL'S CONTITUENTS WILL FINANCIALLY SUPPORT THE FACILITY, EQUIPMENT, OPERATIONAL, EDUCATIONAL AND PROGRAMMATIC NEEDS OF THE HOSPITAL. THE FOUNDATION WILL STRIVE CONTINUALLY TO EXPAND THE BASE OF ANNUAL PHALANTHROPIC SUPPORT AND BUILD AN ENDOWMENT TO ENSURE THE COMMUNITY'S FUTURE HEALTH CARE NEEDS. 0 0 EMERSON HEALTH CARE FOUNDATION IS AN ORGANIZATION THAT SUPPORTS FUNDRAISING EFFORTS FOR EMERSON HOSPITAL. 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 25 22 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X ROBERT TREMBLAY 9782873233 OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 JOANNE ARMSTRONG 4.00 X 0 0 0 JEFFREY S CAMPBELL 4.00 X 0 0 0 PAUL BIRCH 4.00 X 0 0 0 WILLIAM P BOGER III MD 4.00 X 0 0 0 STEPHEN CARR 4.00 X X 0 0 0 RICHARD H CHURCHILL 4.00 X 0 0 0 GLORIA CLOUGH 4.00 X X 0 0 0 BYRON E WOODMAN JR 4.00 X 0 0 0 CYNTHIA DEYSHER 4.00 X X 0 0 0 MARTIN KAFINA MD 4.00 X 0 0 0 DENISE HAARTZ 4.00 X 0 0 0 HEIDI HARRING 4.00 X 0 0 0 JOHN HICKLING 4.00 X 0 0 0 WISNTON R HINDLE JR 4.00 X 0 0 0 RONALD JOHNSON 4.00 X 0 0 0 LYNN MARTIN 4.00 X 0 0 0 BETTY ANN KILLIAN 4.00 X X 0 0 0 JEANNE S KANGAS 4.00 X 0 0 0 BENJAMIN A TILLINGER MD 4.00 X 0 385132 19403 CHRISTINE SCHUSTER 4.00 X X 0 764586 41030 RODNEY G SPARROW 4.00 X 0 0 0 SALLY SAVELLE 4.00 X 0 0 0 CHARLES A DENAULT 4.00 X 0 0 0 ANNA WINTER RASMUSSEN 4.00 X 0 0 0 JOHN DRESSER 50.00 X 0 243047 30225 JOHN WILHELM 4.00 X 0 464724 18500 0 1857489 109158 0 0 1 0 0 95415 1542596 1638011 1770 1770 70145 95415 70145 0 1639781 0 0 1770 266450 266450 189267 189267 60774 60774 16807 16807 2453 2453 CONTRACTED SERVICES 113284 113284 FOOD & FUNCTION 58505 58505 OTHER ADMINISTRATIVE 40882 40882 PRINTING 29340 29340 24181 24181 801943 0 0 801943 1420650 1358550 848644 497090 1861032 1945127 4130326 3800767 371283 368960 371283 368960 X 894300 411990 1410143 1513428 1454600 1506389 3759043 3431807 4130326 3800767 X 837838 22816 -1187890 X 0 1 X 1 0 X X X 0 0 0 EMERSON HOSPITAL 042103565 3 1 1 1 705583 1 705583 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1454602 49197 55471 52881 1506389 1399339 45714 62557 53008 1454602 1322908 71732 67070 62371 1399339 1214920 105075 143410 140497 1322908 1101230 119654 67442 73406 1214920 1.00000 0 0 0 BENEFICIAL INTEREST IN SPLIT-INTEREST 217417 F UNRESTRICTED 63504 F TEMPORARILY RESTRICTED 157817 F PERMANENTLY RESTRICTED 1506389 F 1945127 X 1639781 0 1639781 0 1639781 801943 0 801943 0 801943 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE PRINCIPAL BALANCE OF THE ENDOWMENT FUND IS PERMANENTLY RESTRICTED FROM USE. INCOME ON THE ENDOWMENT FUND THAT HAS BEEN DESIGNATED FOR A SPECIFIC PURPOSE BY THE DONOR IS USED AS SPECIFIED. OTHERWISE, THE INCOME IS USED TO ADVANCE THE ORGANIZATION'S GENERAL CHARITABLE PURPOSE. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN FISCAL 2013 THERE WAS NO FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS REFERENCING FIN48 BECAUSE THE ORGANIZATION DID NOT FILE UNCERTAIN TAX POSITIONS. X X X X X 0 TELECOMP INC 3375 BRIGHTON HENRIETTA TOWNLINE RD ROCHESTER NY 14623 TELEMARKETING 0 51528 35472 16056 51528 35472 16056 MA +GOLF TOURNAMENT 127605 72922 54683 10011 26653 16704 1315 RUN WALK 37955 22493 15462 4925 10537 165560 95415 70145 10011 26653 21629 11852 70145 0 0 1 0 0 0 0 0 0 0 BENJAMIN A TILLINGER MD 0 340647 0 10000 0 34485 0 2500 0 16903 0 404535 0 0 CHRISTINE SCHUSTER 0 547712 0 183532 0 33342 0 18500 0 22530 0 805616 0 0 JOHN DRESSER 0 184267 0 49540 0 9240 0 5223 0 25002 0 273272 0 0 JOHN WILHELM 0 340315 0 106498 0 17911 0 18500 0 0 0 483224 0 0 PART I, LINE 4B JOHN DRESSER, CHRISTINE SCHUSTER AND JOHN WILHELM ARE PAID THROUGH EMERSON HOSPITAL AND ARE ELIGIBLE TO PARTICIPATE IN THE FOLLOWING NONQUALIFIED RETIREMENT PLAN. EMERSON HOSPITAL OFFERS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO A SELECT CLASS OF MANAGEMENT. SUPPLEMENTAL RETIREMENT INCOME IS ASSESSED BY AN INDEPENDENT ACTUARY TO DETERMINE ANNUAL CONTRIBUTION AMOUNTS BY EMERSON HOSPITAL. PLAN CONTRIBUTIONS BECOME INCOME TO THE PARTICIPANT BASED ON A CLIFF VESTING SCHEDULE, WHICH IS EVERY FIVE YEARS FROM THE DATE OF PLAN ENROLLMENT. THE FOLLOWING PERSONS PARTICIPATED IN A 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. CHRISTINE SCHUSTER JOHN O. WILHELM C. GREGORY MARTIN FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBERS DENISE HAARTZ AND GLORIA CLOUGH SERVE TOGETHER ON THE BOARD OF DIRECTORS OF THE LOUISA MAY ALCOTT ORCHARD HOUSE OF CONCORD. FORM 990, PART VI, SECTION A, LINE 6 EMERSON HEALTH SYSTEM, INC ACTING THROUGH ITS BOARD OF DIRECTORS, IS THE MEMBER FOR EMERSON HEALTH CARE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE NUMBER AND COMPOSITION OF THE BOARD OF DIRECTORS IS FIXED ANNUALLY BY THE MEMBER, EMERSON HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B THE NUMBER AND COMPOSITION OF THE BOARD OF DIRECTORS IS FIXED ANNUALLY BY THE MEMBER, EMERSON HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 WAS PRESENTED TO THE BOARD OF DIRECTORS DURING A REGULARLY SCHEDULED MEETING AND WAS OPEN FOR REVIEW, DISCUSSION, QUESTIONS AND COMMENTS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIERCTORS REQUIRES THAT ALL BOARD MEMBERS AND SENIOR MANAGERS COMPLETE AND SIGN THE CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. THE EXECUTIVE DIRECTOR REVIEWS THESE QUESTIONNAIRES AND SUMMARIZES ANY ISSUES THAT COULD CREATE A CONFLICT OF INTEREST. THIS SUMMARY IS REVIEWED BY THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS AND IS PRESENTED TO THE ENTIRE BOARD ANNUALLY SO THAT ALL BOARD MEMBERS ARE AWARE OF POTENTIAL CONFLICTS OF INTEREST AND HAVE INFORMATION THEY CAN RELY ON IF THEY FEEL AN INDIVIDUAL MAY HAVE DIVIDED LOYALTIES ON A DECISION COMING BEFORE THE BOARD OF DIRECTORS. THE BOARD CHAIR IS RESPONSIBLE FOR EVALUATING ANY CONFLICT OF INTEREST AND DETERMINING THE TREATMENT OF THE SITUATION ACCORDING TO BOARD POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND EXECUTIVE DIRECTOR OF EMERSON HEALTH CARE FOUNDATION ARE EMPLOYED BY EMERSON HOSPITAL. EMERSON HOSPITAL'S BOARD OF DIRECTORS HOLDS THE SOLE RESPONSIBILITY FOR ESTABLISHING THE COMPENSATION OF THE CEO. THE COMPENSATION COMMITTEE, A SUBCOMMITTEE OF THE BOARD OF DIRECTORS COMPRISED OF AT LEAST THREE INDEPENDENT BOARD MEMBERS, IS RESPONSIBLE FOR THE REVIEW AND RECOMMENDATION OF THE CEO'S COMPENSATION. THIS ANALYSIS INCLUDES AN ANNUAL INDEPENDENT REVIEW OF COMPARABLE INSTITUTIONS. THE VICE PRESIDENT OF HUMAN RESOURCES, ACTING AS STAFF SUPPORT FOR THE COMMITTEE, MAINTAINS WRITTEN RECORDS ON COMPENSATION AND THE COMMITTEE'S ACTIONS. MEETING MINUTES DOCUMENT THE COMMITTEE'S DECISION-MAKING PROCESS, THE TYPES OF COMPARABLE DATA THAT WAS USED TO DETERMINE THE FAIR MARKET VALUE FOR AN EXECUTIVE'S SERVICES AND THE NATURE OF ANY DECISIONS MADE SO AS TO ESTABLISH A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR COMPENSATION FOR A DISQUALIFIED INDIVIDUAL. THE COMPENSATION COMMITTEE ALSO REVIEWS AND APPROVES THE CEO'S RECOMMENDATION OF COMPENSATION FOR KEY EMPLOYEES INCLUDING OFFICERS AND VICE PRESIDENTS. THIS ANALYSIS INCLUDES AND INDEPENDENT REVIEW OF COMPARABLE INSTITUTIONS. THE VICE PRESIDENT OF HUMAN RESOURCES, ACTING AS STAFF SUPPORT FOR THE COMMITTEE, MAINTAINS WRITTEN RECORDS ON COMPENSATION AND THE COMMITTEE'S ACTIONS. MEETING MINUTES DOCUMENT THE COMMITTEE'S DECISION-MAKING PROCESS, THE TYPES OF COMPARABLE DATA THAT WAS USED TO DETERMINE THE FAIR MARKET VALUE FOR AN EXECUTIVE'S SERVICES AND THE NATURE OF ANY DECISIONS MADE SO AS TO ESTABLISH A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR COMPENSATION FOR A DISQUALIFIED INDIVIDUAL. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 990 IS AVAILABLE ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORMS 1023 AND 990 ARE ALSO AVAILABLE UPON REQUEST TO THE FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 EMERSON HEALTH CARE FOUNDATION'S BY-LAWS ARE AVAILABLE ON THE MASSACHUSETTS SECRETARY OF STATE'S WEBSITE. CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FOR PLANT AND EQUIPMENT -705,583. TRANSFER TO AFFILIATES -482,307. SALARIES/WAGES AND BENEFITS REPORTED ON STATEMENT OF FUNTIONAL EXPENSES FORM 990, PART IX, LINES 5, 7 AND 9 ALL PERSONNEL ARE EMPLOYEES OF EMERSON HOSPITAL, INC AND W-2S ARE ISSUED BY EMERSON HOSPITAL. THE EXPENSE FOR EMPLOYEES DOING THE WORK OF EMERSON HEALTH CARE FOUNDATION IS ALLOCATED TO EMERSON HEALTH CARE FOUNDATION VIA INTERCOMPANY ACCOUNTS. THE AMOUNTS ON LINES 5, 7, AND 9 REPRESENT THE EXPENSE ALLOCATED BY EMERSON HOSPITAL. EMERSON HEALTH SYSTEM INC 133 OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 042770977 PROVIDES ITS SUBSIDIARIES WITH A MANAGEMENT TEAM MA 501(C)3 509(A)(3) TYPE I N/A 0 EMERSON HOSPITAL INC 133 OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 042103565 ACUTE CARE COMMUNITY HOSPITAL MA 501(C)3 170(B)(1)(A)(III) EMERSON HEALTH SYSTEM INC 0 EMERSON PRACTICE ASSOCIATES 133 OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 043111240 HEALTH CARE SERVICES IN THE COMMUNITIES SERVED BY EMERSON HOSPITAL MA 501(C)3 170(B)(1)(A)(III) EMERSON HOSPITAL INC 0 EMERSON PRACTICE ASSOICATES II 133 OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 800482067 HEALTH CARE SERVICES IN THE COMMUNITIES SERVED BY EMERSON HOSPITAL MA 501(C)3 170(B)(1)(A)(III) EMERSON HOSPITAL INC 0 EMERSON OCCUPATIONAL HEALTH SERVICES INC 133 OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 042800607 HEALTH SERVICES MA EMERSON HEALTH SYSTEMS INC C 0 EMERSON PROPERTY DEVELOPMENT CORP 133 OLD ROAD TO NINE ACRE CORNER CONCORD MA 01742 042793599 PROPERTY MANAGEMENT MA EMERSON HEALTH SYSTEMS INC C 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 EMERSON HOSPITAL L 482307 REPORTED AT FAIR VALUE EMERSON HOSPITAL O 516492 REPORTED AT FAIR VALUE EMERSON HOSPITAL P 285452 REPORTED AT FAIR VALUE