Pyramid. Innovator Fosters Compassionate Healthcare. Former Chief of Staff and Wife Support Humanistic Medicine

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1 Ideas on financial, estate and gift planning for Legacy Society Members Pyramid Spring 2007 Innovator Fosters Compassionate Healthcare Former Chief of Staff and Wife Support Humanistic Medicine Shattuck Hartwell, M.D., and his wife Mary Jane established an estate gift to support patient care and research at Cleveland Clinic The years have not slowed retired plastic surgeon Shattuck Hartwell, Jr., M.D. He walks briskly and speaks with careful emphasis about the future of medicine at Cleveland Clinic. Dr. Hartwell helped shape the direction of Cleveland Clinic as Chief of Staff from 1974 to 1987 and as a member of the Board of Governors and Board of Trustees. An innovator, he founded the Page Center for Creative Thinking in Medicine to encourage intellectual discussions or what he calls meetings of the mind among physicians and researchers. Today, Dr. Hartwell and his wife Mary Jane are particularly interested in fostering compassion among young doctors. It s important for doctors to not only practice quantitative medicine, in terms of science and technique, but also humanistic or qualitative medicine, he says, adding that engaging the creative imaginations of young physicians is important to their training. Rapid Change and Growth This latest endeavor follows a prestigious career at Cleveland Clinic. Dr. Hartwell s multifaceted role included editing a history of Cleveland Clinic called, To Act as a Unit: The Story of The Cleveland Clinic. The phrase, to act as a unit comes from a journal entry of one of Cleveland Clinic s founders, George W. Crile Sr., referring to the cooperative spirit of group practice. Continued on page 2 Inside this Issue A Letter From the Senior Director Former Physician Leaves a Legacy Realize Philanthropic Objectives with Flexible Options Complimentary Booklet: Charitable Planning That Keeps Your Options Open Charitable IRA Rollover Campaign for Cleveland Clinic: Philanthropy at Work New Members

2 Innovator Fosters Compassionate Healthcare Continued from page 1 Dr. Hartwell saw rapid changes, not only in Cleveland Clinic s growth, but also in his specialty of plastic surgery, which he practiced for many years. Letter from the Senior Director Greetings! It has been my pleasure to work with many of you over the years to fulfill your philanthropic goals. Your commitment to supporting world-class patient care and research while creating a legacy for your families is inspiring, not only to me but to the entire gift planning staff. In case you have not had the opportunity to personally meet our team, I would like to introduce my gift planning colleagues in the next few newsletters. Their enthusiasm and expertise serves as a foundation for all the services we offer. We are always happy to help answer any questions you may have. Nelson J. Wittenmyer, Jr., Esq. Senior Director of Gift Planning As manager of gift planning since March 2005, Anne Corrette (pictured) brings a financial background that has been so valuable to our department these past two years. She has been a loyal Cleveland Clinic employee for 25 years and has worked in treasury, research accounting and general accounting. The Fun of Giving Back After such a long, rewarding career at Cleveland Clinic, Dr. Hartwell says it feels good to give back. He and his wife Mary Jane decided to arrange an estate gift with hopes to perpetuate a new liberal artsbased lecture series for Cleveland Clinic clinicians. (For more on estate gifts, see story Realize Philanthropic Objectives with Flexible Options on page 4). This institution is a great place to give. It s been a wonderful place for my profession. I ve grown and developed at this place and now, toward the end of my life, I owe it back, he says. While a sense of duty is a good reason to support a cause, Dr. Hartwell says it also gives him great pleasure. Giving away money should be fun. Even if you don t have a lot. It s nice to support something you believe in and I find it enormously satisfying, he adds. Caring for the Community Dr. Hartwell knows what it is like to be both a Cleveland Clinic doctor and patient. The fruits of a career that began at Cleveland Clinic in 1963 and his care for Parkinson s disease have influenced his views on charitable giving. Philanthropy is a state of mind that is much influenced by your environment, your background, and your heritage and traditions, Dr. Hartwell says. Families Perpetuate Charitable Giving As a child, Dr. Hartwell says he learned from his family s generosity, and from other influences later in life. I think that the real tutor in giving would be my wife, Mary Jane, he says. She gets our kids involved in philanthropy and has a charitable fund. Mrs. Hartwell notes how satisfying it is to offer support, by volunteering both her time and financial resources. She and Dr. Hartwell believe in conserving the environment, supporting cultural organizations and improving healthcare for all. I receive great satisfaction in being able to help. I very firmly believe that those who can should work to make other people s lives better, Mrs. Hartwell says. Anne Corrette, Manager of Gift Planning Giving away money should be fun, even if you don t have a lot. It s nice to support something you believe in and I find it enormously satisfying. Shattuck Hartwell, M.D., former Cleveland Clinic Chief of Staff 2

3 Former Physician Leaves a Legacy Dr. Nousek and His Family Grew With Cleveland Clinic Sally Nousek remembers Cleveland Clinic when it barely filled three buildings on Euclid Avenue and E. 93rd St. There were about 78 staff members and we all knew each other. The elevator operators knew our names, she recalls. It was at Cleveland Clinic in the summer of 1954 that she met her late husband, respected ophthalmologist James Nousek, M.D., who later became known for expanding the ophthalmology department as well as training many physicians. At that time, Mrs. Nousek was a laboratory technician. She remembers the day when three new residents, including Dr. Nousek, were shown around the surgical pathology lab at the beginning of a three-month rotation. I don t have a romantic story about the day we met, she says, smiling. We got to know each other by working together. Then, around Christmas time, he invited me to a St. Louis University Alumni dance. It did not take them long to realize they belonged together. They were engaged the following spring and married in October. Over the years, as Cleveland Clinic grew, so did the Nousek family. Four of the Nouseks five children were delivered at Cleveland Clinic. Dr. Nousek s department, which began with only four physicians fifty years ago, expanded and eventually became the Cleveland Clinic Cole Eye Institute, which retains more than 50 physicians and researchers. Fondly Remembered Cancer claimed Dr. Nousek s life this past year. He is fondly remembered by family and many former patients and friends. Mrs. Nousek describes the many condolence cards she received. They wrote to me, most of all, about his kindness, she says. That s what came through in all the letters. He treated every person the same way, with respect. She recalls how he would arrive early for surgery to give patients and families time to ask any questions about a procedure. When he was on call, she says they always stayed home to make sure Dr. Nousek could get to Cleveland Clinic at a moment s notice. The late James E. Nousek, M.D., met his wife Sally at Cleveland Clinic fifty years ago. They shared philanthropic interests, particularly when it came to advancing healthcare at Cleveland Clinic. Leaving a Legacy When Dr. Nousek became ill, he focused on making sure his family would be taken care of after his passing. He and Mrs. Nousek discussed options that would include support for Cleveland Clinic, where Dr. Nousek built his career and turned for treatment in his own fight against cancer. They chose to make Cleveland Clinic the income beneficiary of a lead trust with the remainder benefiting his children. A lead trust allows individuals to meet their philanthropic goals while supporting future generations, usually at a significant tax savings. Sometimes a medical problem comes up and suddenly you realize it would be a good time to do something to help others, especially when you are receiving the benefits of such good care. Jim always wanted to do something for Cleveland Clinic, Mrs. Nousek says. Next Generation Today, the family s connection to Cleveland Clinic continues. Two of Dr. and Mrs. Nousek s sons work at Cleveland Clinic, one in informational technology and the other in medical records and data entry. Mrs. Nousek also volunteers with the Cleveland Clinic Ambassadors at the Cleveland Clinic Center for ALS and Related Disorders. I m involved because my mother died of ALS, Mrs. Nousek says. I think a lot of volunteers have personal experience with an illness. They know what it s like and they want to help others. Philanthropy can take on many forms, she adds, whether a person is generous by volunteering their time or through charitable giving. 3

4 Realize Philanthropic Objectives with Flexible Options When weighing a decision to support Cleveland Clinic and leave a legacy with a planned gift, it is important to understand the options. Perhaps you have a desire to make a gift but must determine when the time is appropriate for you and your family. Testamentary commitments, in particular, are an attractive option. They are flexible enough to allow for revision should your circumstances change. They also offer other advantages to those who wish to fulfill their philanthropic objectives without affecting their current finances. Bequests An outright bequest is still the most common form of testamentary commitment. You simply direct in your will that a portion, or all, of your estate be transferred to a designated charity such as Cleveland Clinic. Your estate will be entitled to a charitable deduction for the full fair market value of your gift. An outright bequest can take various forms: A general bequest is probably the most popular type of charitable bequest. You simply leave a specified dollar amount to Cleveland Clinic. For example, a bequest of $10,000 is a general bequest. A specific bequest is another popular way to benefit a charity. You designate specific property that you want Cleveland Clinic to receive. For example, a bequest of specified stock or a vacation home is a specific bequest. A residuary bequest is used to give a charity all, or a portion, of one s property after all debts, taxes, expenses and all other bequests have been paid. For example, giving Cleveland Clinic the rest of the property that I own at my death is a residuary bequest. A percentage bequest can be expressed as a percentage of an estate or a residuary estate. For example, you might leave Cleveland Clinic 50 percent of the residuary estate. If fortune changes the size of the estate over the years, this bequest will change in the same proportion. A contingent bequest is important to provide for the situation in which a beneficiary dies before you, or the beneficiary disclaims the property. To prepare for such an occurrence, consider naming a charity such as Cleveland Clinic as the contingent beneficiary. This will ensure that the property will pass to the designated charity rather than to unintended beneficiaries. Example of a Bequest Provision I bequeath to The Cleveland Clinic Foundation, Cleveland, Ohio, (the sum of $ or %) to support (medical research and education). Insurance or a Retirement Plan Asset Beneficiary Designation Forms Make Giving Easy: Life insurance policies and tax-deferred retirement plan assets are two of the simplest assets to give away. You may direct that we receive all or a portion of the asset simply by adding Cleveland Clinic to the form and signing your name. Just contact the administrator of your retirement plan or your insurance carrier and request a beneficiary designation form. If you change your mind about the gift, simply request a new beneficiary designation form. It s that easy! Life Insurance: Why would you consider making a charitable gift of life insurance by naming Cleveland Clinic as either beneficiary or owner and beneficiary of a policy? Consider these benefits: Proceeds paid to Cleveland Clinic are not subject to estate tax. In addition, when you assign ownership of a policy to Cleveland Clinic, you receive an income tax deduction for the value of the policy and for any premiums you subsequently pay. Retirement Plan Assets: While funds in qualified retirement plans grow on a tax-deferred basis, when they are distributed they are subject to income tax. This tax is paid by the recipient by you while you are receiving payments, by your beneficiaries following your death. 4

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6 Retain Control and Receive Income for Life: The Living Trust Although many people view the will as the final say on their lives and estates, the revocable living trust provides for quicker and easier asset transfers and is gaining in popularity. Example Upon the death of her husband, Jane Brown, 65, wants some help with financial management responsibilities. She also wants to plan a major gift to Cleveland Clinic but is uncertain about her financial situation and does not want to make an irrevocable commitment. After consulting with her advisors, Jane decides to create a $500,000 living trust that will pay her the trust income and principal as needed each year for her life. We are fortunate to have many generous friends who support our work with annual gifts. With creative planning, you can ensure that your annual gift will continue perpetually. At her death, the remaining principal will pass to Cleveland Clinic if Jane has not revoked or modified the trust. Benefits Establishing the trust has several positive results for Jane: She acquires sound professional management by placing the assets in the hands of an experienced trustee. She receives all of the income and as much of the principal as she needs. She avoids probate delay and costs, and also retains privacy regarding the extent, nature and value of her assets and beneficiaries. She provides a significant gift to Cleveland Clinic, unless unforeseen circumstances arise. She retains the right to modify or revoke the trust if necessary. Since her gift can be revoked or the trust principal extended, Jane does not take a current income tax deduction; but the amount passing to Cleveland Clinic at her passing will not be subject to federal estate tax. Endow Your Annual Gift: Leave a Permanent Legacy We are fortunate to have many generous friends who support our work with annual gifts. With creative planning, you can ensure that your annual gift will continue perpetually. An endowed fund can both ensure the continuation of your current giving level and provide for increases in that amount to account for inflation. Here s how: if an endowed fund can earn more than it distributes, it, and its annual distribution, will continue to grow. Example David Smith faithfully contributes $5,000 to Cleveland Clinic each year. He has decided that he doesn t want his annual support to stop when he dies, so he has named us as the beneficiary of a $100,000 life insurance policy to fund an endowment. Each year the endowed fund will distribute to Cleveland Clinic an amount close to or perhaps exceeding David s typical annual fund support. Testamentary Backed Pledge You may have made a pledge to Cleveland Clinic and would like to make sure it is fulfilled in the event it is not paid off during your lifetime. A testamentary backed pledge will ensure the distribution of any remaining amount due. Simply add the appropriate language in your will to make sure your wishes are carried out. 6

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