TY 2013 Form 990 Schedule O

efile Public Visual Render ObjectId: 201502299349304210 - Submission: 2015-08-17 TIN: 56-0845796

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Cumberland County Hospital System Inc

Employer identification number

56-0845796

Return Reference	Explanation
Form 990, Part VI, Section A, line 7a	The Board of Trustees of Cumberland County Hospital System shall be comprised of seven trustees who are the seven members of the Cumberland County Board of Commissioners. The Board of Trustees will also have eight at large trustees who are appointed by the Board of Commissioners. The remaining five at large members are appointed by the Board of Trustees.
Form 990, Part VI, Section B, line 11	The process the organization uses to review the Form 990 consists of providing the Form 990 to the Cumberland County Hospital System's Board of Trustees by electronic copy. Board Members will be given time to do a review before the filing date of August 15, 2015.
Form 990, Part VI, Section B, line 12c	Cumberland County Hospital System, Inc. regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Section B, line 15	A human resources consulting firm is retained by Cumberland County Hospital Systems, Inc. to review the competitiveness and reasonableness of the compensation provided to the CEO and other top management personnel.
Form 990, Part VI, Section C, line 19	Provided upon request.

Return Reference

Explanation

Form 990, Part VI, Section A, line 7a

The Board of Trustees of Cumberland County Hospital System shall be comprised of seven trustees who are the seven members of the Cumberland County Board of Commissioners. The Board of Trustees will also have eight at large trustees who are appointed by the Board of Commissioners. The remaining five at large members are appointed by the Board of Trustees.

Form 990, Part VI, Section B, line 11

The process the organization uses to review the Form 990 consists of providing the Form 990 to the Cumberland County Hospital System's Board of Trustees by electronic copy. Board Members will be given time to do a review before the filing date of August 15, 2015.

Form 990, Part VI, Section B, line 12c

Cumberland County Hospital System, Inc. regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.

Form 990, Part VI, Section B, line 15

A human resources consulting firm is retained by Cumberland County Hospital Systems, Inc. to review the competitiveness and reasonableness of the compensation provided to the CEO and other top management personnel.

Form 990, Part VI, Section C, line 19

Provided upon request.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

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