STRATEGY STUDIO / PUBLIC DATA EXPLORER

DIGNITY HEALTH FOUNDATION-EAST VALLEY: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
DIGNITY HEALTH FOUNDATION-EAST VALLEY (EIN 74-2418514)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-12
IRS object ID
201131329349303373
Schema version
2009v1.7
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)
Timestamp2011-05-12T15:29:03-04:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line155 SECOND STREET SUITE 1400AddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742418514EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHW Foundation East ValleyBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHWFNameControl
Phone4807283000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1475 South Dobson RoadAddressLine1
CityChandlerCity
StateAZState
ZIP Code85224ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK KEMName
TitleCFOTitle
Date Signed2011-05-11DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4159635100Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICHARD FRAZIERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1475 South Dobson RoadAddressLine1
CityChandlerCity
StateAZState
ZIP Code85224ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5070552GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.supportchweastvalley.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionTo support CHW healthcare facilities (CHW dba's, Chandler Regional Medical Center and Mercy Gilbert Medical Center) and programs in the Southeast Valley through philanthrophy.ActivityOrMissionDescription
Nbr Voting Members Governing Body23NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers7TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4266623ContributionsGrantsPriorYear
Contributions Grants Current Year4254176ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year-8461InvestmentIncomePriorYear
Investment Income Current Year88626InvestmentIncomeCurrentYear
Other Revenue Prior Year169370OtherRevenuePriorYear
Other Revenue Current Year-95939OtherRevenueCurrentYear
Total Revenue Prior Year4427532TotalRevenuePriorYear
Total Revenue Current Year4246863TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year2080020GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1747886GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year784413SalariesEtcPriorYear
Salaries Etc Current Year669351SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY5400TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year262912TotalFundrsngExpCurrentYear
Other Expense Prior Year407000OtherExpensePriorYear
Other Expenses Current Year717322OtherExpensesCurrentYear
Total Expenses Prior Year3271433TotalExpensesPriorYear
Total Expenses Current Year3139959TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1156099RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1106904RevenuesLessExpensesCY
Total Assets BOY7831662TotalAssetsBOY
Total Assets EOY8355623TotalAssetsEOY
Total Liabilities BOY88285TotalLiabilitiesBOY
Total Liabilities EOY323271TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7743377NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8032352NetAssetsOrFundBalancesEOY
Mission DescriptionTO SUPPORT CHW HEALTHCARE FACILITIES AND PROGRAMS IN THE SOUTHEAST VALLEY THROUGH PHILANTHROPY. THE FOUNDATION'S SUPPORT ALLOWS CHW DBA'S, CHANDLER REGIONAL MEDICAL CENTER AND MERCY GILBERT MEDICAL CENTER, FURTHER THEIR MISSION OF DELIVERING COMPASSIONATE, HIGH-QUALITY, AFFORDABLE HEALTH SERVICES, SERVING AND ADVOCATING FOR THE POOR AND DISENFRANCHISED, AND PARTNERING WITH OTHERS IN THE COMMUNITY TO IMPROVE QUALITY OF LIFE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2513046Expense
Grants1747886Grants
Revenue0Revenue
DescriptionThe Foundation is an IRC Sec 509(a)(3) supporting organization to Catholic Healthcare West, dba's Chandler Regional Medical Center and Mercy Gilbert Medical Center ("Hospitals"). As a supporting organization, the Foundation operates exclusively for the benefit of, to perform the function of, or to carry out the purposes of the Hospitals which include making payments directly to the Hospitals.Description
Total Program Service Expense2513046TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members23NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRANDY BRADLEYNamePerson
Telephone Number6023072546TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13033 N 3RD AVENUEAddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85013ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Timothy Baughman
Board Member1.0X000
Gale Brimhall
Board Member1.0X000
Laurie Eberst
Board Member1.0X050148655851
Connie Georghiou
Board Member1.0X000
Steve Gloyd
Board Member1.0X000
Deb Hoogestraat
Board Member1.0X000
Sandra Hudson
Board Member1.0X000
Dana Jones
Board Member1.0X000
Joan Krueger
Board Member2.0X000
Sherry Lund
Board Member1.0X000
Rodrick Miller
Board Member1.0X000
Howard Morrison
Board Member1.0X000
Mike Palermo
Board Member1.0X000
Tara Pauls
Board Member1.0X000
Larry Penley PhD
Board Member1.0X000
JW Rayhons
Board Member1.0X000
Ric Serrano
Board Member1.0X000
Dr Brian Tiffany
Board Member1.0X000
Terri Tobey
Board Member2.0X000
Mia Van Eken DO
Board Member1.0X000
Patty White
Board Member1.0X042678157417
James Wiley
Board Member1.0X000
Richard Frazier
Board Member/ Foundation CEO40.0X021031835825X
Jim Hayden
IMMEDIATE PAST CHAIR2.0X000X
Mark Kem
Board Member/ CFO1.0X041741846028X
Tom Marreel
Chairman2.0X000X
Richmond Vincent
Treasurer2.0X000X
MARY JANE CRIST
CEO/ FOUNDATION AREA PRESIDENT2.0027482441125X
Jeff Jackson
Controller40.0018931115824X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2020138TotalReportableCompFrmRltdOrgs
Total Other Compensation252070TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events357320FundraisingEvents
Related Organizations1438702RelatedOrganizations
Government Grants1064849GovernmentGrants
All Other Contributions1393305AllOtherContributions
Noncash Contributions46068NoncashContributions
Total Contributions4254176TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column49115TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$49,115ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities637640Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities598128Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities39512Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column39511TotalRevenueColumn
Exclusion$39,511ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events129622GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events357320CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses225561FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-95939TotalRevenueColumn
Exclusion-$95,939ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4246863TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$7,313ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1747886Total
Program Services1747886ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total559039Total
Program Services408099ProgramServices
Management And General78265ManagementAndGeneral
Fundraising72675Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total68384Total
Program Services49920ProgramServices
Management And General9574ManagementAndGeneral
Fundraising8890Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total41928Total
Program Services30607ProgramServices
Management And General5870ManagementAndGeneral
Fundraising5451Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total2150Total
Management And General2150ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total5400Total
Fundraising5400Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total17652Total
Management And General17652ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total198150Total
Program Services101834ProgramServices
Management And General96316ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total7997Total
Management And General6539ManagementAndGeneral
Fundraising1458Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total164522Total
Program Services86501ProgramServices
Management And General41591ManagementAndGeneral
Fundraising36430Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total8483Total
Management And General8483ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total77389Total
Management And General57184ManagementAndGeneral
Fundraising20205Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total23640Total
Management And General19220ManagementAndGeneral
Fundraising4420Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5563Total
Management And General5563ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServicesFundraisingFundraising
LICENSES & TAXES4343
DUES & SUBSCRIPTIONS47784778
DONOR RECOGNITION881997061917580
OTHER EXPENSES118756107731758090403

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3139959Total
Program Services2513046ProgramServices
Management And General364001ManagementAndGeneral
Fundraising262912Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2474636BOY
EOY1616866EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY4155960BOY
EOY3753176EOY
FieldValueIRS element (for citing)
Accounts ReceivableAccountsReceivable

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY13000BOY
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY972567BOY
EOY2455355EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY215499BOY
EOY530226EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7831662BOY
EOY8355623EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5145BOY
EOY5145EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY53020BOY
EOY286406EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY30120BOY
EOY31720EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY88285BOY
EOY323271EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2779646BOY
EOY3066933EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4591558BOY
EOY4593246EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY372173BOY
EOY372173EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7743377BOY
EOY8032352EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7831662BOY
EOY8355623EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTHCARE WEST (DBA CHANDLER REGIONAL MEDICAL CTR)BusinessNameLine1
FieldValueIRS element (for citing)
EIN941196203EIN
Type Of Organization0TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$3,139,959Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts3139959SumOfAmounts
General ExplanationThe Foundation provided or purchased for the benefit of Catholic Healthcare West dbas Chandler Regional Medical Center and Mercy Gilbert Medical Center, various services, facilities and goods. See Form 990, Part IX for further details.GeneralExplanation

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

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance421448BeginningOfYearBalance
Investment Earnings Or Losses13460InvestmentEarningsOrLosses
Other Expenditures42000OtherExpenditures
End Of Year Balance392908EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance422286BeginningOfYearBalance
Contributions18346Contributions
Investment Earnings Or Losses-3162InvestmentEarningsOrLosses
Grants Or Scholarships16022GrantsOrScholarships
End Of Year Balance421448EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionPOOLED INVSTMNTS NOT PUB TRADEDescription
Book Value530226BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities530226TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionANNUITY PAYABLEDescription
Amount$31,720Amount
FieldValueIRS element (for citing)
Total Of Amounts31720TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanation
FORM 990, PART X, LINE 25The consolidated audited financial statements did not include a FIN 48 footnote disclosure as the liability was determined not material for reporting purposes.
PART V, LINE 4The endowment funds are used to support the needs of those departments that are not covered under normal operational or capital budgets. The Cancer Patient Assistance fund is used to provide assistance to patients facing a financial hardship while undergoing treatments. Funds assist patients with daily expenses such as gas cards, transportation, utility bills, etc.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GALA 2009NameOfEvent1
Gross Receipts Event1351520GrossReceiptsEvent1
Charitable Contributions Event1260458CharitableContributionsEvent1
Gross Revenue Event191062GrossRevenueEvent1
Cash Prizes Event12400CashPrizesEvent1
Non Cash Prizes Event135621NonCashPrizesEvent1
Rent Facility Costs Event123634RentFacilityCostsEvent1
Food And Beverage Event135451FoodAndBeverageEvent1
Entertainment Event128200EntertainmentEvent1
Other Direct Expenses Event119078OtherDirectExpensesEvent1
Name Of Event2Golf TournamentNameOfEvent2
Gross Receipts Event2133471GrossReceiptsEvent2
Charitable Contributions Event294931CharitableContributionsEvent2
Gross Revenue Event238540GrossRevenueEvent2
Cash Prizes Event2460CashPrizesEvent2
Non Cash Prizes Event236936NonCashPrizesEvent2
Rent Facility Costs Event215148RentFacilityCostsEvent2
Food And Beverage Event211621FoodAndBeverageEvent2
Entertainment Event22524EntertainmentEvent2
Other Direct Expenses Event213544OtherDirectExpensesEvent2
Total Number Of Other Events4TotalNumberOfOtherEvents
Gross Receipts Other Events1951GrossReceiptsOtherEvents
Charitable Contrib Other Events1931CharitableContribOtherEvents
Gross Revenue Other Events20GrossRevenueOtherEvents
Non Cash Prizes Other Events944NonCashPrizesOtherEvents
Gross Receipts Total486942GrossReceiptsTotal
Charitable Contributions Total357320CharitableContributionsTotal
Gross Revenue Total Events129622GrossRevenueTotalEvents
Cash Prizes Total Events2860CashPrizesTotalEvents
Non Cash Prizes Total Events73501NonCashPrizesTotalEvents
Rent Facility Costs Total Events38782RentFacilityCostsTotalEvents
Food And Beverage Total Events47072FoodAndBeverageTotalEvents
Entertainment Total Events30724EntertainmentTotalEvents
Other Direct Expenses Total Events32622OtherDirectExpensesTotalEvents
Direct Expense Summary Events225561DirectExpenseSummaryEvents
Net Income Summary-95939NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Catholic Healthcare West dba Chandler Regional Med
1875 W Frye RoadChandlerAZ85224941196203501(c)(3)1427390550FMVMedical suppliesSupport Hospital Services
Catholic Healthcare West dba Mercy Gilbert Med Ctr
3555 S Val Vista DriveGilbertAZ85296941196203501(c)(3)3199460N/AN/ASuppport Hospital Services
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPART I, LINE 2Identifier
ExplanationAs a Sec. 509(a)(3) supporting organization, the Foundation operates exclusively for the benefit of, to perform the function of, or to carry out the purposes of the grantee listed in Part II, item 1 and 2 (Catholic Healthcare West), which include making payments directly to the beneficiary organization. As such, the Foundation does not monitor the Hospital's use of the grant funds.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 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
Laurie Eberst
02984250191849011212033011022840055733700
Patty White
0301606011852906646029361028056048419800
Richard Frazier
016396904501901330017742018083024614300
Mark Kem
02697520135770011896026971019057046344600
Jeff Jackson
0153201029487066230960706217020513500
MARY JANE CRIST
020876006140104663021529019596031594900

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierExplanationExplanation
PART I, LINE 3The Organization relied on a related organization, Catholic Healthcare West, that used one or more of the methods described in Schedule J, Part I, Line 3, to establish the Organization's top management official's compensation. See Schedule O disclosure for Form 990, Part VI, Section B, Line 15 for additional information.
PART I, LINE 4aThe organization's key employees and its highest compensated employees participate in a severance plan established by its supported organization. The plan provides fair compensation, ranging from payments of 10 weeks to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan.
PART I, LINE 4bCertain officers and key employees participate in the CHW Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the CHW retirement plan whose benefits are affected by the limitations imposed by Sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. No payments were made to any listed persons during 2009 pursuant to this plan. CHW's key employees and certain officers and highly compensated employees hired prior to June 30, 2006 are eligible to participate in the CHW Executive Deferred Compensation Plan, a nonqualified 457(f) plan which is intended to provide a benefit approximating the difference, if any, between the benefit provided under the CHW Excess Benefit Plan and the benefit provided under the qualified benefit plan that substantially replaced the Excess Plan. No benefit will vest under the 457(f) plan before the later of the attainment of age 62 while employed or the completion of 15 years of service. Certain listed persons participate in the CHW Key Employee Share Option Plan (KEYSOP), which was frozen in May 2002. The KEYSOP program was established in 2001 with the purpose of providing income deferral opportunities to employees eligible for the company's key employee retention program. No payments were made to any listed persons during 2009 pursuant to this plan.
PART II, SUPPLEMENTAL DISCLOSURESAlthough the organization does not directly employ any personnel, the supported organization's executive compensation philosophy is designed to assist in attracting and retaining the caliber of executives required to fulfill the organization's mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities the organization serves, promoting employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Compensation and Benefits Committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and the organization's commitment to serving the poor and disenfranchised in the communities it serves.

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest

Books And Publications BooksAndPublications

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F99059NoncashContribsRptdF990
Method Of Determining Revenuescomparable saleMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty
Securities Publicly TradedSecuritiesPubliclyTraded
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles

Food Inventory FoodInventory

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9902245NoncashContribsRptdF990
Method Of Determining Revenuescomparable saleMethodOfDeterminingRevenues

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions4NumberOfContributions
Noncash Contribs Rptd F99039010NoncashContribsRptdF990
Method Of Determining Revenuescomparable saleMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts

Other Non Cash Contributions Table OtherNonCashContributionsTable (7 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XGift certificates and tickets61600comparable sale
XFOOD AND WINE1100COMPARABLE SALE
XJEWELRY31250COMPARABLE SALE
XMEDICAL EQUIPMENT1800comparable sale
XOFFICE EQUIPMENT1135comparable sale
XTOYS120comparable sale
XBARBER TOOL, MAGNIFYING MIRRORS, WIGS & HATS3850comparable sale
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierSCH M, PART I, COLUMN BIdentifier
ExplanationTHE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierExplanationExplanation
PART VI - GOVERNANCE, MANAGEMENT, DISCLOSUREFORM 990, PART VI, SECTION A, LINE 6 The sole corporate member is Catholic Healthcare West, a 501(c)(3) exempt organization. FORM 990, PART VI, SECTION A, LINE 7a CHW, as the sole corporate member, ratifies the selection of members and the CHW Board approves new Board members of the foundation. FORM 990, PART VI, SECTION A, LINE 7b Reserved rights of the corporate member include adoption of mission and philosophy statements, amendment or restatement of articles of incorporation and bylaws, dissolution of the corporation, acquisition of another corporation, creation of a new subsidiary, merger or consolidation with another corporation, participation as a general or limited partner in any venture, incurring long-term indebtedness in excess of normal operating requirements, ratification of board member appointments and dismissals, selection and removal of independent auditors, and transactions outside the ordinary course of business. FORM 990, PART VI, SECTION B, LINE 11A The Board of Directors has delegated the review of the Form 990 to the Finance Committee. The supported organization's accounting department worked closely with AN INDEPENDENT accounting firm engaged to review the return and presented each section of the final draft of Form 990, excluding compensation information to the Finance Committee. Subsequent to its review, the Finance Committee reported back to the Board regarding its oversight of the Form 990 and the final draft was provided to the entire voting Board, again excluding compensation. FORM 990, PART VI, SECTION B, LINE 12C The Foundation has adopted CHW's Conflicts of Interest Policy. The Foundation's Board is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to the conflicts of interest policy, an annual conflict of interest disclosure statement, aimed at determining any family and business relationships and transactions, or other transactions that may pose a potential conflict, is distributed to all covered persons (e.g., board members, officers and executive leadership, key employees and all management personnel whose responsibilities include business decisions which may give rise to conflicts of interest). Covered persons are also required to disclose real or potential conflicts at the time such conflicts arise. When an individual becomes a covered person and annually thereafter, each covered person is required to submit an updated disclosure statement and to sign a statement affirming that he/she: (1) has received a copy of the conflicts of interest policy; (2) has read the policy and understands said policy; and (3) agrees to comply with all requirements of the policy, including completing the conflicts of interest disclosure statement. The completed questionnaires are reviewed by CHW's Legal Department and any persons with actual or potential conflicts are informed via written communication. The procedures for addressing any conflict of interest related to a proposed transaction include, but are not limited to, the following: (1) the conflicting interest is fully disclosed to the board; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the person with the conflict of interest is excluded from the discussion and approval of such transaction; (4) if warranted, alternatives to the proposed transaction are investigated, and competitive bids or comparable valuations are obtained; (5) any conflicting issues arising during the course of a board meeting which cannot be resolved are to be referred to an independent committee of the Board of Directors; and (6) the transaction or action must be approved by a majority of disinterested persons. All conflicts of interest, whether resolved or unresolved, are reported in the Foundation's Form 990. FORM 990, PART VI, SECTION B, LINE 15 FOR 2009 COMPENSATION, The supported organization's human resources department conductED an annual review and analysis to provide benchmarking data for the total compensation and benefits package of key executives. The compensation for these individuals were based on the qualification and experience of the candidates. Compensation is also reviewed annually as part of the merit increase process. FORM 990, PART VI, SECTION C, LINE 19 Federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection. The organization makes its financial statements available on CHW's website and upon request.
FORM 990, PART I, LINE 5 and PART V, LINE 2aThe organization does not have employees. As a supporting organization, the foundation operates for the benefit of the hospital and utilizes the employees of that hospital. The proportionate salaries and benefits for these individuals are allocated to the Foundation. The salaries of these employees are included in the hospital entity's Form W-3 and federal employment tax returns.
FORM 990, PART VII, SECTION AThe following individuals listed on Form 990 Part VII were compensated by Catholic Healthcare West, the supported organization. An estimate of their hours provided to the supported organization is provided: Laurie Eberst; 40 hours Patty White; 40 hours Mark Kem; 40 hours MARY JANE CRIST; 40 HOURS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Catholic Healthcare WestBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1185 Berry StreetAddressLine1
CitySan FranciscoCity
StateCAState
ZIP Code94107ZIPCode
FieldValueIRS element (for citing)
EIN941196203EIN
Primary ActivitiesHealthcarePrimaryActivities
Legal Domicile StateCALegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status3PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1NONEBusinessNameLine1