Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ROSALIND FRANKLIN UNIVERSITY HEALTH SYSTEM
Employer identification number
77-0691998
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
(1)
ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE
362181973
2
Yes
Yes
Yes
0
Total
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
SCHEDULE A, PART I, LINE 11H (VII), AMOUNT OF SUPPORT, ROSALIND FRANKLIN UNIVERSITY HEALTH SYSTEM IS ORGANIZED AS A 509(A)(3) SUPPORTING ORGANIZATION TO ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE. RFUHS PROVIDES SUPPORT TO RFUMS THROUGH VARIOUS PROGRAMS WHICH INCLUDE CLINICAL, RESEARCH, PATIENT EDUCATION, AND STUDENT HEALTH CARE ACTIVITIES. CLINICAL ACTIVITIES - RFUHS PROVIDES DIRECT TRAINING TO STUDENTS THROUGH INTERACTION WITH PATIENTS UNDER THE SUPERVISION AND GUIDANCE OF FACULTY CLINICAL SERVICE PROVIDERS. RESEARCH ACTIVITIES - RFUHS SUPPORTS AND ENHANCES THE UNIVERSITY'S RESEARCH ACTIVITIES BY PROVIDING CLINICAL RESOURCES AND INFRASTRUCTURE TO UNIVERSITY RESEARCHERS. PATIENT EDUCATION ACTIVITIES - RFUHS EDUCATES PATIENTS THROUGH ONE ON ONE CONSULTATION, THROUGH RESOURCES MADE AVAILABLE ON THE WEBSITE AS WELL AS PATIENT EDUCATIONAL SESSIONS. STUDENT HEALTH CARE ACTIVITIES - RFUHS OPERATES THE RFUMS STUDENT HEALTH CENTER, PROVIDING MEDICAL CARE DIRECTLY TO UNIVERSITY STUDENTS TO PROMOTE GOOD PHYSICAL AND MENTAL HEALTH. ,
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000128
Software Version:
v2010.1.0
-
TIN:
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.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ROSALIND FRANKLIN UNIVERSITY HEALTH SYSTEM
Employer identification number
77-0691998
Identifier
Return Reference
Explanation
Classes of members or stockholders
Form 990, Part VI, Section A, Line 6
ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE (RFUMS), A RELATED TAX-EXEMPT ORGANIZATION, IS THE SOLE CORPORATE MEMBER OF ROSALIND FRANKLIN UNIVERSITY HEALTH SYSTEM. AS THE SOLE CORPORATE MEMBER, RFUMS HAS THE POWER AND AUTHORITY TO ELECT AND REMOVE DIRECTORS OF THE ORGANIZATION, AND TO FILL VACANCIES IN SUCH DIRECTOR'S POSITIONS. ADDITIONALLY, RFUMS HAS THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY. THESE DECISIONS INCLUDE, BUT ARE NOT LIMITED TO, THE RIGHT TO ADOPT CAPITAL AND OPERATING BUDGETS, ADOPT A STRATEGIC PLAN, AND AUTHORIZE CAPITAL EXPENDITURES.
Members or stockholders electing members of governing body
Form 990, Part VI, Section A, Line 7a
SEE NARRATIVE FOR PART VI, LINE 6
Decisions requiring approval by members or stockholders
Form 990, Part VI, Section A, Line 7b
SEE NARRATIVE FOR PART VI, LINE 6
Review of form 990 by governing body
Form 990, Part VI, Section B, Line 11b
THE CHIEF FINANCIAL OFFICER OF ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE, A RELATED TAX-EXEMPT ORGANIZATION, CONDUCTS A DETAILED REVIEW OF THE FORM 990 IN CONJUNCTION WITH RFUHS' OUTSIDE INDEPENDENT TAX PREPARER. A FORMAL REVIEW OF THE FULL FORM 990 IS THEN CONDUCTED BY THE ORGANIZATION'S OFFICERS, MEMBERS OF MANAGEMENT AND THE INDEPENDENT AUDIT COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. SUBSEQUENT TO THIS REVIEW, A COPY OF THE FULL FORM 990 IS DISTRIBUTED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
Conflict of interest policy
Form 990, Part VI, Section B, Line 12c
RFUHS HAS WRITTEN CONFLICT OF INTEREST POLICIES FOR MEMBERS OF THE BOARD OF DIRECTORS AND OFFICERS OF THE CORPORATION. IN ADDITION, CONFLICT OF INTEREST POLICIES AND DISCLOSURE REQUIREMENTS COVER EXECUTIVE ADMINISTRATION AND PROVIDERS. ON AN ANNUAL BASIS, MEMBERS OF ANY OF THE GROUPS NOTED ARE REQUIRED TO DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO ANY CONFLICTS AND PROVIDE A LIST OF ANY POTENTIAL OR ACTUAL CONFLICTS. BOARD OF DIRECTORS AND ADMINISTRATION DISCLOSURE DOCUMENTS ARE MONITORED BY THE BOARD OF DIRECTORS AND BY THE RELATED ORGANIZATION'S CHIEF COMPLIANCE OFFICER. A DIRECTOR MAY NOT PARTICIPATE IN OR BE PRESENT DURING THE DELIBERATIONS REGARDING ANY MATTER WHERE THERE IS A PERCEIVED CONFLICT OF INTEREST. THE REMAINING DIRECTORS DETERMINE THE PROPER COURSE OF ACTION. MINUTES OF THE MEETING REFLECT BOTH THE NAME AND THE NATURE OF THE CONFLICT.
Process used to establish compensation of top management official
Form 990, Part VI, Section B, Line 15a
THE COMPENSATION OF HEALTH SYSTEM'S OFFICERS AND KEY EMLOYEES IS DETERMINED UNDER THE PROCEDURES USED BY THE PARENT ORGANIZATION. THE FOLLOWING IS THE PROCESS USED FOR DETERMINING COMPENSATION BY THE PARENT ORGANIZATION: THE TOTAL COMPENSATION PACKAGE OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, OTHER OFFICERS OR KEY EMPLOYEES IS ESTABLISHED, APPROVED AND REVIEWED EACH YEAR BY THE ORGANIZATION'S INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES AND REPORTED TO THE FULL BOARD OF TRUSTEES. THE ORGANIZATIONAL COMPENSATION PHILOSOPHY IS TO COMPENSATE TOP MANAGEMENT AT THE 75TH PERCENTILE OR BELOW THE MARKET. TO ENSURE THAT COMPENSATION IS BOTH REASONABLE AND COMPETITIVE, THE BOARD RETAINS THE SERVICES OF AN OUTSIDE INDEPENDENT CONSULTING FIRM WITH EXPERTISE IN ACADEMIC HEALTHCARE WHEN ANNUAL INCREASES ARE AWARDED. THE INDEPENDENT CONSULTANT CONDUCTS AN ANNUAL MARKET SURVEY THAT PROVIDES THE BOARD WITH COMPARABILITY DATA FOR COMPENSATION FOR SIMILARLY QUALIFIED PERSONS AT SIMILAR ORGANIZATIONS. THE DECISIONS AND DELIBERATIONS REGARDING THE REVIEW AND APPROVAL OF THE TOP MANAGEMENT OFFICIAL'S COMPENSATION ARE DOCUMENTED IN THE BOARD MINUTES. THIS PROCESS WAS LAST UNDERTAKEN FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IN JANUARY, 2011.
Process used to establish compensation of other officers/key employees
Form 990, Part VI, Section B, Line 15b
SEE NARRATIVE FOR PART VI, LINE 15A
Public Disclosure
Form 990, Part VI, Section C, Line 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
HOURS DEVOTED TO RELATED ORGANIZATIONS
FORM 990, PART VII
MARGOT A. SURRIDGE, PRESIDENT, DEVOTES APPROXIMATELY 30 HRS A WEEK TO ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE, A RELATED TAX-EXEMPT ORGANIZATION. KATHLEEN M. STONE, BOARD CHAIR, DEVOTES APPROXIMATELY 1 HR A WEEK TO ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE, A RELATED TAX-EXEMPT ORGANIZATION. JOAN CUMMINGS, BOARD SECRETARY, DEVOTES APPROXIMATELY 1 HR A WEEK TO ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE, A RELATED TAX-EXEMPT ORGANIZATION. WILFRED J. LUCAS, BOARD TREASURER, DEVOTES APPROXIMATELY 1 HR A WEEK TO ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE, A RELATED TAX-EXEMPT ORGANIZATION. MICHAEL J. HRILJAC, TRUSTEE, DEVOTES APPROXIMATELY 1 HR A WEEK TO ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE, A RELATED TAX-EXEMPT ORGANIZATION.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.