2011-05-12T15:29:03-04:00 2010-06-30 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2009-07-01 742418514 CHW Foundation East Valley CHWF 4807283000 475 South Dobson Road Chandler AZ 85224 MARK KEM 2011-05-11 4159635100 2009 2016-02-24 21:20:13Z RICHARD FRAZIER 475 South Dobson Road Chandler AZ 85224 5070552 false X www.supportchweastvalley.org X 1985 AZ To support CHW healthcare facilities (CHW dba's, Chandler Regional Medical Center and Mercy Gilbert Medical Center) and programs in the Southeast Valley through philanthrophy. 23 20 0 7 0 0 4266623 4254176 0 0 -8461 88626 169370 -95939 4427532 4246863 2080020 1747886 0 0 784413 669351 0 5400 262912 407000 717322 3271433 3139959 1156099 1106904 7831662 8355623 88285 323271 7743377 8032352 TO 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. false false 2513046 1747886 0 The 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. 2513046 true true false false false false false false true true false true false false false false false false true false false true false true false false false false false false false false true false false false false true false false false true 0 0 true 0 false false false false false true true false false false 23 20 false false false false true true true true true false false false true true true true true false false false AZ X RANDY BRADLEY 6023072546 3033 N 3RD AVENUE PHOENIX AZ 85013 X Timothy Baughman 1.0 X 0 0 0 Gale Brimhall 1.0 X 0 0 0 Laurie Eberst 1.0 X 0 501486 55851 Connie Georghiou 1.0 X 0 0 0 Steve Gloyd 1.0 X 0 0 0 Deb Hoogestraat 1.0 X 0 0 0 Sandra Hudson 1.0 X 0 0 0 Dana Jones 1.0 X 0 0 0 Joan Krueger 2.0 X 0 0 0 Sherry Lund 1.0 X 0 0 0 Rodrick Miller 1.0 X 0 0 0 Howard Morrison 1.0 X 0 0 0 Mike Palermo 1.0 X 0 0 0 Tara Pauls 1.0 X 0 0 0 Larry Penley PhD 1.0 X 0 0 0 JW Rayhons 1.0 X 0 0 0 Ric Serrano 1.0 X 0 0 0 Dr Brian Tiffany 1.0 X 0 0 0 Terri Tobey 2.0 X 0 0 0 Mia Van Eken DO 1.0 X 0 0 0 Patty White 1.0 X 0 426781 57417 James Wiley 1.0 X 0 0 0 Richard Frazier 40.0 X X 0 210318 35825 Jim Hayden 2.0 X X 0 0 0 Mark Kem 1.0 X X 0 417418 46028 Tom Marreel 2.0 X X 0 0 0 Richmond Vincent 2.0 X X 0 0 0 MARY JANE CRIST 2.0 X 0 274824 41125 Jeff Jackson 40.0 X 0 189311 15824 0 2020138 252070 0 false true false 0 357320 1438702 1064849 1393305 46068 4254176 0 49115 0 0 49115 0 0 637640 598128 39512 39511 39511 129622 357320 225561 -95939 -95939 0 0 0 4246863 0 0 -7313 1747886 1747886 0 0 0 0 0 559039 408099 78265 72675 0 68384 49920 9574 8890 41928 30607 5870 5451 0 0 2150 2150 0 5400 5400 17652 17652 198150 101834 96316 7997 6539 1458 164522 86501 41591 36430 8483 8483 0 77389 57184 20205 23640 19220 4420 0 5563 5563 0 0 0 0 LICENSES & TAXES 43 43 DUES & SUBSCRIPTIONS 4778 4778 DONOR RECOGNITION 88199 70619 17580 OTHER EXPENSES 118756 17580 10773 90403 3139959 2513046 364001 262912 2474636 1616866 4155960 3753176 13000 0 972567 2455355 215499 530226 7831662 8355623 5145 5145 53020 286406 30120 31720 88285 323271 X 2779646 3066933 4591558 4593246 372173 372173 7743377 8032352 7831662 8355623 X false true true X false X X X false false false CATHOLIC HEALTHCARE WEST (DBA CHANDLER REGIONAL MEDICAL CTR) 941196203 0 true true true 3139959 1 3139959 The 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 421448 13460 42000 392908 422286 18346 -3162 16022 421448 1.00000 false false POOLED INVSTMNTS NOT PUB TRADE 530226 F 530226 0 ANNUITY PAYABLE 31720 31720 FORM 990, PART X, LINE 25 The 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 4 The 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. GALA 2009 351520 260458 91062 2400 35621 23634 35451 28200 19078 Golf Tournament 133471 94931 38540 460 36936 15148 11621 2524 13544 4 1951 1931 20 944 486942 357320 129622 2860 73501 38782 47072 30724 32622 225561 -95939 true Catholic Healthcare West dba Chandler Regional Med 1875 W Frye Road Chandler AZ 85224 941196203 501(c)(3) 1427390 550 FMV Medical supplies Support Hospital Services Catholic Healthcare West dba Mercy Gilbert Med Ctr 3555 S Val Vista Drive Gilbert AZ 85296 941196203 501(c)(3) 319946 0 N/A N/A Suppport Hospital Services 1 0 PART I, LINE 2 As 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. false true false false false false false false false Laurie Eberst 0 298425 0 191849 0 11212 0 33011 0 22840 0 557337 0 0 Patty White 0 301606 0 118529 0 6646 0 29361 0 28056 0 484198 0 0 Richard Frazier 0 163969 0 45019 0 1330 0 17742 0 18083 0 246143 0 0 Mark Kem 0 269752 0 135770 0 11896 0 26971 0 19057 0 463446 0 0 Jeff Jackson 0 153201 0 29487 0 6623 0 9607 0 6217 0 205135 0 0 MARY JANE CRIST 0 208760 0 61401 0 4663 0 21529 0 19596 0 315949 0 0 PART I, LINE 3 The 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 4a The 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 4b Certain 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 DISCLOSURES Although 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. X 59 comparable sale X 1 2245 comparable sale X 4 39010 comparable sale X Gift certificates and tickets 6 1600 comparable sale X FOOD AND WINE 1 100 COMPARABLE SALE X JEWELRY 3 1250 COMPARABLE SALE X MEDICAL EQUIPMENT 1 800 comparable sale X OFFICE EQUIPMENT 1 135 comparable sale X TOYS 1 20 comparable sale X BARBER TOOL, MAGNIFYING MIRRORS, WIGS & HATS 3 850 comparable sale 0 false true false SCH M, PART I, COLUMN B THE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. PART VI - GOVERNANCE, MANAGEMENT, DISCLOSURE FORM 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 2a The 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 A The 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 Catholic Healthcare West 185 Berry Street San Francisco CA 94107 941196203 Healthcare CA 501(C)(3) 3 NA false true false false false false false false false false false false true true false true false false NONE