TY 2022 Form 990 Schedule O

efile Public Visual Render ObjectId: 202420939349301667 - Submission: 2024-04-02 TIN: 04-3344288

SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

COYNE ROAD INC

Employer identification number

04-3344288

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	THE COMPLETED INFORMATIONAL RETURN IS REVIEWED BY THE EXECUTIVE DIRECTOR, FISCAL OFFICER, TREASURER, MEMBERS OF THE FINANCE COMMITTEE, AND MEMBERS OF THE EXECUTIVE COMMITTEE ON BEHALF OF THE ENTIRE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUAL STATEMENTS: EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; 2. HAS READ AND UNDERSTANDS THE POLICY; 3. HAS AGREED TO COMPLY WITH THE POLICY; AND 4. UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PERIODIC REVIEWS: TO ENSURE THAT THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1. WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE ORGANIZATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE BENEFIT. 2. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE ORGANIZATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION HAS A PERSONNEL COMMITTEE THAT ONLY REVIEWS THE EXECUTIVE DIRECTOR SALARY. THE DIRECTOR OF HUMAN RESOURCES OVERSEES AN ORGANIZATION-WIDE EVALUATION PROCESS FOR ALL EMPLOYEES ANNUALLY AND REVIEWS SALARY COMPARISONS AND MAKES RECCOMENDATIONS TO THE EXECUTIVE DIRECTOR TO SET EMPLOYEE SALARIES
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION PROVIDES ITS FINANCIAL STATEMENTS THROUGH THE OFFICIAL WEBSITE OF THE ATTORNEY GENERAL OF MASSACHUSETTS AND GUIDESTAR.ORG. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO THE EXECUTIVE DIRECTOR.

Return Reference

Explanation

FORM 990, PART VI, SECTION B, LINE 11B

THE COMPLETED INFORMATIONAL RETURN IS REVIEWED BY THE EXECUTIVE DIRECTOR, FISCAL OFFICER, TREASURER, MEMBERS OF THE FINANCE COMMITTEE, AND MEMBERS OF THE EXECUTIVE COMMITTEE ON BEHALF OF THE ENTIRE BOARD OF DIRECTORS.

FORM 990, PART VI, SECTION B, LINE 12C

ANNUAL STATEMENTS: EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; 2. HAS READ AND UNDERSTANDS THE POLICY; 3. HAS AGREED TO COMPLY WITH THE POLICY; AND 4. UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PERIODIC REVIEWS: TO ENSURE THAT THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1. WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS AND PHYSICIAN HOSPITAL ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE ORGANIZATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE BENEFIT. 2. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES, AND THIRD PARTY PAYORS FURTHER THE ORGANIZATION'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT.

FORM 990, PART VI, SECTION B, LINE 15

THE ORGANIZATION HAS A PERSONNEL COMMITTEE THAT ONLY REVIEWS THE EXECUTIVE DIRECTOR SALARY. THE DIRECTOR OF HUMAN RESOURCES OVERSEES AN ORGANIZATION-WIDE EVALUATION PROCESS FOR ALL EMPLOYEES ANNUALLY AND REVIEWS SALARY COMPARISONS AND MAKES RECCOMENDATIONS TO THE EXECUTIVE DIRECTOR TO SET EMPLOYEE SALARIES

FORM 990, PART VI, SECTION C, LINE 19

THE ORGANIZATION PROVIDES ITS FINANCIAL STATEMENTS THROUGH THE OFFICIAL WEBSITE OF THE ATTORNEY GENERAL OF MASSACHUSETTS AND GUIDESTAR.ORG. GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO THE EXECUTIVE DIRECTOR.

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

Cat. No. 51056K

Schedule O (Form 990) 2022

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