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EMERSON HEALTH CARE FOUNDATION INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
EMERSON HEALTH CARE FOUNDATION INC (EIN 04-2770980)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-08
IRS object ID
201312209349300621
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-08T10:01:43-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042770980EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1EMERSON HEALTH CARE FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlEMERNameControl
Phone9782873226Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1OLD ROAD TO NINE ACRE CORNERAddressLine1
CityCONCORDCity
StateMAState
ZIP Code01742ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN O WILHELMName
TitleASSISTANT TREASURERTitle
Phone9782873226Phone
Date Signed2013-08-08DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN O WILHELMNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1OLD ROAD TO NINE ACRE CORNERAddressLine1
CityCONCORDCity
StateMAState
ZIP Code01742ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1865188GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteEMERSONHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionCOORDINATE AND DEVELOP THE FUNDRAISING EFFORT FOR EMERSON HOSPITALActivityOrMissionDescription
Nbr Voting Members Governing Body26NbrVotingMembersGoverningBody
Nbr Independent Voting Members24NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1378093ContributionsGrantsPriorYear
Contributions Grants Current Year1609114ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year2991InvestmentIncomePriorYear
Investment Income Current Year2673InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year1381084TotalRevenuePriorYear
Total Revenue Current Year1611787TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year468643SalariesEtcPriorYear
Salaries Etc Current Year476251SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year732237TotalFundrsngExpCurrentYear
Other Expense Prior Year343598OtherExpensePriorYear
Other Expenses Current Year255986OtherExpensesCurrentYear
Total Expenses Prior Year812241TotalExpensesPriorYear
Total Expenses Current Year732237TotalExpensesCurrentYear
Revenues Less Expenses Prior Year568843RevenuesLessExpensesPriorYear
Revenues Less Expenses CY879550RevenuesLessExpensesCY
Total Assets BOY4076070TotalAssetsBOY
Total Assets EOY4130326TotalAssetsEOY
Total Liabilities BOY386560TotalLiabilitiesBOY
Total Liabilities EOY371283TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3689510NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3759043NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionEMERSON 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionEMERSON HEALTH CARE FOUNDATION IS AN ORGANIZATION THAT SUPPORTS FUNDRAISING EFFORTS FOR EMERSON HOSPITAL.Description
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members26NbrVotingGoverningBodyMembers
Number Independent Voting Members24NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN WILHELMBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9782873226TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1OLD ROAD TO NINE ACRE CORNERAddressLine1
CityCONCORDCity
StateMAState
ZIP Code01742ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
JOANNE ARMSTRONG
DIRECTOR2.00X000
JEFFREY S CAMPBELL
DIRECTOR2.00X000
PAUL BIRCH
DIRECTOR2.00X000
WILLIAM P BOGER III MD
DIRECTOR2.00X000
STEPHEN CARR
TREASURER2.00X000X
RICHARD H CHURCHILL
DIRECTOR2.00X000
GLORIA CLOUGH
CHAIR2.00X000X
BYRON E WOODMAN JR
DIRECTOR2.00X000
CYNTHIA DEYSHER
VICE CHAIR2.00X000X
MARTIN KAFINA MD
DIRECTOR2.00X000
DENISE HAARTZ
DIRECTOR2.00X000
HEIDI HARRING
DIRECTOR2.00X000
JOHN HICKLING
DIRECTOR2.00X000
WISNTON R HINDLE JR
DIRECTOR2.00X000
RONALD JOHNSON
DIRECTOR2.00X000
LYNN MARTIN
DIRECTOR2.00X000
BETTY ANN KILLIAN
DIRECTOR2.00X000
JEANNE S KANGAS
DIRECTOR2.00X000
JACK MCGRATH MD
DIRECTOR2.00X000
KAREN MAINES
EX OFFICIO2.00X000
CHRISTINE SCHUSTER
PRESIDENT2.00X070358443362X
RODNEY G SPARROW
DIRECTOR2.00X000
DONAL G VOGHEL
DIRECTOR2.00X000
CHARLES A DENAULT
DIRECTOR2.00X000
CHARLES A ZIERING
SECRETARY2.00X000X
JOHN DRESSER
EXECUTIVE DIRECTOR50.00X023124724159
JOHN WILHELM
ASSISTANT TREASURER2.00044534622625X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1380177TotalReportableCompFrmRltdOrgs
Total Other Compensation90146TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events359449FundraisingEvents
All Other Contributions1249665AllOtherContributions
Total Contributions1609114TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2673TotalRevenueColumn
Exclusion$2,673ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events253401GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events359449CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses253401FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1611787TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,673ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total268631Total
Fundraising268631Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total153154Total
Fundraising153154Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total54466Total
Fundraising54466Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10116Total
Fundraising10116Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total12199Total
Fundraising12199Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1428Total
Fundraising1428Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalFundraisingFundraising
CONTRACTED SERVICES8780687806
OTHER ADMINISTRATIVE4804548045
FOOD & FUNCTION4581345813
PRINTING2620826208

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total24371Total
Fundraising24371Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total732237Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising732237Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1925643BOY
EOY1420650EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY524260BOY
EOY848644EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1626167BOY
EOY1861032EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4076070BOY
EOY4130326EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY386560BOY
EOY371283EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY386560BOY
EOY371283EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY574841BOY
EOY894300EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1715331BOY
EOY1410143EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1399338BOY
EOY1454600EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3689510BOY
EOY3759043EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4076070BOY
EOY4130326EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses879550ReconcilationRevenueExpenses
Reconcilation Other Changes-810017ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Written IRS DeterminationXWrittenIRSDetermination
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1EMERSON HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
EIN042103565EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$1,272,070Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts1272070SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1399339BeginningOfYearBalance
Contributions45714Contributions
Investment Earnings Or Losses62557InvestmentEarningsOrLosses
Other Expenditures53008OtherExpenditures
End Of Year Balance1454602EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1322908BeginningOfYearBalance
Contributions71732Contributions
Investment Earnings Or Losses67070InvestmentEarningsOrLosses
Other Expenditures62371OtherExpenditures
End Of Year Balance1399339EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1214920BeginningOfYearBalance
Contributions105075Contributions
Investment Earnings Or Losses143410InvestmentEarningsOrLosses
Other Expenditures140497OtherExpenditures
End Of Year Balance1322908EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1101230BeginningOfYearBalance
Contributions119654Contributions
Investment Earnings Or Losses67442InvestmentEarningsOrLosses
Other Expenditures73406OtherExpenditures
End Of Year Balance1214920EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
BENEFICIAL INTEREST IN SPLIT-INTEREST228990F
UNRESTRICTED51670F
TEMPORARILY RESTRICTED125770F
PERMANENTLY RESTRICTED1454602F
FieldValueIRS element (for citing)
Total Of Book Value Securities1861032TotalOfBookValueSecurities
Total Revenue1611787TotalRevenue
Total Expenses732237TotalExpenses
Excess Or Deficit For Year879550ExcessOrDeficitForYear
Net Unrealized GL On Investments142596NetUnrealizedGLOnInvestments
Other-$952,613OtherAmount
Total Adjustments-810017TotalAdjustments
Excess Or Deficit Per FS69533ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt1611787TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal1611787RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901611787TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt732237TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal732237ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990732237TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
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:IN FISCAL 2012 THERE WAS NO FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS REFERENCING FIN48 BECAUSE THE ORGANIZATION DID NOT FILE UNCERTAIN TAX POSITIONS.
PART XI, LINE 8 - OTHER ADJUSTMENTS:NET ASSETS RELEASED FOR PLANT AND EQUIPMENT -1,272,070. TRANSFER TO AFFILIATES 319,457. TOTAL TO SCHEDULE D, PART XI, LINE 8: -952,613.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1
Gross Receipts Event1120855GrossReceiptsEvent1
Charitable Contributions Event167243CharitableContributionsEvent1
Gross Revenue Event153612GrossRevenueEvent1
Non Cash Prizes Event12150NonCashPrizesEvent1
Rent Facility Costs Event126640RentFacilityCostsEvent1
Food And Beverage Event112960FoodAndBeverageEvent1
Other Direct Expenses Event111862OtherDirectExpensesEvent1
Name Of Event2CENTENNIEL BALLNameOfEvent2
Gross Receipts Event2428139GrossReceiptsEvent2
Charitable Contributions Event2246586CharitableContributionsEvent2
Gross Revenue Event2181553GrossRevenueEvent2
Non Cash Prizes Event233529NonCashPrizesEvent2
Rent Facility Costs Event23075RentFacilityCostsEvent2
Food And Beverage Event289874FoodAndBeverageEvent2
Entertainment Event29600EntertainmentEvent2
Other Direct Expenses Event245475OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events63856GrossReceiptsOtherEvents
Charitable Contrib Other Events45620CharitableContribOtherEvents
Gross Revenue Other Events18236GrossRevenueOtherEvents
Food And Beverage Other Events4435FoodAndBeverageOtherEvents
Other Direct Expenses Other Events13801OtherDirectExpensesOtherEvents
Gross Receipts Total612850GrossReceiptsTotal
Charitable Contributions Total359449CharitableContributionsTotal
Gross Revenue Total Events253401GrossRevenueTotalEvents
Non Cash Prizes Total Events35679NonCashPrizesTotalEvents
Rent Facility Costs Total Events29715RentFacilityCostsTotalEvents
Food And Beverage Total Events107269FoodAndBeverageTotalEvents
Entertainment Total Events9600EntertainmentTotalEvents
Other Direct Expenses Total Events71138OtherDirectExpensesTotalEvents
Direct Expense Summary Events253401DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CHRISTINE SCHUSTER
05027800168772032032022625020737074694600
JOHN DRESSER
017743903963201417601177022982025540600
JOHN WILHELM
0326209010196801716902262500046797100

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationJOHN 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 DURING FISCAL 2012, 208,397 WAS FUNDED TO THE 457(F) PLAN.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2BOARD 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 6EMERSON HEALTH SYSTEM, INC ACTING THROUGH ITS BOARD OF DIRECTORS, IS THE MEMBER FOR EMERSON HEALTH CARE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE NUMBER AND COMPOSITION OF THE BOARD OF DIRECTORS IS FIXED ANNUALLY BY THE MEMBER, EMERSON HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7BTHE NUMBER AND COMPOSITION OF HTE BOARD OF DIRECTORS IS FIXED ANNUALLY BY THE MEMBER, EMERSON HEALTH SYSTEM.
FORM 990, PART VI, SECTION B, LINE 11THE 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 12CTHE 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 15THE 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 18THE 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 19EMERSON 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.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 142,596. NET ASSETS RELEASED FOR PLANT AND EQUIPMENT -1,272,070. TRANSFER TO AFFILIATES 319,457. TOTAL TO FORM 990, PART XI, LINE 5: -810,017.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART IX, LINES 5, 7 AND 9ALL 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.SALARIES/WAGES AND BENEFITS REPORTED ON STATEMENT OF FUNTIONAL EXPENSES

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
EMERSON HEALTH SYSTEM INC
133 OLD ROAD TO NINE ACRE CORNERCONCORDMA01742042770977PROVIDES ITS SUBSIDIARIES WITH A MANAGEMENT TEAMMA501(C)3509(A)(3) TYPE IN/A0
EMERSON HOSPITAL INC
133 OLD ROAD TO NINE ACRE CORNERCONCORDMA01742042103565ACUTE CARE COMMUNITY HOSPITALMA501(C)3170(B)(1)(A)(III)0EMERSON HEALTH SYSTEM INC
EMERSON PRACTICE ASSOCIATES
133 OLD ROAD TO NINE ACRE CORNERCONCORDMA01742043111240HEALTH CARE SERVICES IN THE COMMUNITIES SERVED BY EMERSON HOSPITALMA501(C)3170(B)(1)(A)(III)0EMERSON HOSPITAL INC
EMERSON PRACTICE ASSOICATES II
133 OLD ROAD TO NINE ACRE CORNERCONCORDMA01742800482067HEALTH CARE SERVICES IN THE COMMUNITIES SERVED BY EMERSON HOSPITALMA501(C)3170(B)(1)(A)(III)0EMERSON HOSPITAL INC

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
EMERSON OCCUPATIONAL HEALTH SERVICES INC
133 OLD ROAD TO NINE ACRE CORNERCONCORDMA01742042800607HEALTH SERVICESMAEMERSON HEALTH SYSTEMS INCC
EMERSON PROPERTY DEVELOPMENT CORP
133 OLD ROAD TO NINE ACRE CORNERCONCORDMA01742042793599PROPERTY MANAGEMENTMAEMERSON HEALTH SYSTEMS INCC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
EMERSON HOSPITAL
K319457REPORTED AT FAIR VALUE
EMERSON HOSPITAL
N472252REPORTED AT FAIR VALUE
EMERSON HOSPITAL
O207941REPORTED AT FAIR VALUE