Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 4,271,795 | 28,600,762 | 46,053,320 | 15,060,110 | 14,346,788 | 108,332,775 |
| 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...... | 82,550,213 | 71,443,978 | 80,241,886 | 81,080,802 | 78,542,665 | 393,859,544 |
| 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. | 86,822,008 | 100,044,740 | 126,295,206 | 96,140,912 | 92,889,453 | 502,192,319 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support (Subtract line 7c from line 6.) | 502,192,319 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 86,822,008 | 100,044,740 | 126,295,206 | 96,140,912 | 92,889,453 | 502,192,319 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 29,159 | 32,794 | 81,721 | 218,427 | 203,199 | 565,300 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 29,159 | 32,794 | 81,721 | 218,427 | 203,199 | 565,300 |
| 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 VI.) .. | 289,860 | 356,229 | 642,955 | 2,142,375 | 2,410,931 | 5,842,350 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 87,141,027 | 100,433,763 | 127,019,882 | 98,501,714 | 95,503,583 | 508,599,969 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE BOARD MEMBERS DR. JO ANN SMOAK (MOTHER) AND RAYMOND BUSH (SON) HAVE A FAMILIY RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11 | A MEETING IS SCHEDULED WITH THE CHIEF FINANCIAL OFFICER (CFO), CHIEF EXECUTIVE OFFICER (CEO) AND THE EXECUTIVE COMMITTEE OF THE BOARD TO REVIEW THE FORM 990 BEFORE IT IS FILED WITH THE IRS. AT THE MEETING, THE CFO CONDUCTS A DETAILED REVIEW OF THE FORM 990 AND ANSWERS ANY QUESTIONS ASKED. AFTER THE MEETING, THE FORM 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENTS. ANY COMMENTS OR QUESTIONS FROM BOARD MEMBERS ARE INCORPORATED INTO THE FORM 990 PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | UNITY HEALTH CARE INC. REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH EDUCATION, DISCLOSURE AND INVESTIGATION IN ACCORDANCE WITH ITS CORPORATE OMPLIANCE PROGRAM. UNITY'S CONFLICT OF INTEREST POLICY IS ENCOMPASSED WITHIN ITS STANDARDS OF CONDUCT. THE STANDARDS OF CONDUCT ARE PART OF UNITY HEALTH CARE'S EMPLOYEE HANDBOOK. OFFICERS, DIRECTORS, BOARD MEMBERS, KEY EMPLOYEES AND NEW EMPLOYEES OF UNITY HEALTH CARE ARE TRAINED ON THE EXISTENCE OF THE CONFLICT OF INTEREST POLICY AS PART OF THEIR TRAINING ON UNITY HEALTH CARE'S STANDARDS OF CONDUCT. EMPLOYEES ARE ALSO TRAINED TO REFER ANY CONCERNS REGARDING A VIOLATION OF THE STANDARDS OF CONDUCT TO UNITY'S CORPORATE COMPLIANCE PROGRAM VIA THE CORPORATE COMPLIANCE HOTLINE OR OTHERWISE. AT THE TIME OF EACH EMPLOYEE'S ANNUAL PERFORMANCE VALUATION, THE EMPLOYEE IS REQUIRED TO SIGN AN ACKNOWLEDGMENT THAT HE/SHE IS AWARE THAT ANY POTENTIAL VIOLATION SHOULD BE REFERRED TO THE CORPORATE COMPLIANCE PROGRAM AND IS AGAIN INSTRUCTED ON HOW TO MAKE SUCH A REFERRAL. ON AN ANNUAL BASIS, UNITY HEALTH CARE REQUIRES OFFICERS, DIRECTORS, BOARD MEMBERS, AND KEY EMPLOYEES TO COMPLETE A DISCLOSURE FORM CONCERNING BOARD MEMBER CONFLICT OF INTEREST. IN THIS FORM, OFFICERS, DIRECTORS, BOARD MEMBERS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST THAT EACH RESPECTIVE OFFICER, DIRECTOR, BOARD MEMBES, AND KEY EMPLOYEE (OR MEMBER OF SUCH PERSON'S IMMEDIATE FAMILY) MAY HAVE WITH SUCH PERSON'S DUTIES TO UNITY HEALTH CARE. THE DISCLOSURE FORM ALSO CONTAINS A CERTIFICATION THAT EACH OFFICER, DIRECTOR, BOARD MEMBER, AND KEY EMPLOYEE MUST COMPLETE. IF ANY CONFLICT OF INTEREST CONCERN ARISES AT UNITY HEALTH CARE REGARDING ANY OFFICER, DIRECTOR, BOARD MEMBER, OR KEY EMPLOYEE, THE CONCERN IS IMMEDIATELY REFERRED TO UNITY'S CORPORATE COMPLIANCE OFFICER AND INVESTIGATED. IF, UPON INVESTIGATION, IT IS DETERMINED THAT AN EMPLOYEE OR BOARD MEMBER HAS ENGAGED IN AN ACTIVITY THAT REPRESENTS A CONFLICT OF INTEREST THAT HAS NOT BE OTHERWISE DISCLOSED AND MANAGED BY THE ORGANIZATION, UNITY HEALTH CARE WILL TAKE ACTION AGAINST SUCH PERSON UP TO AND INCLUDING TERMINATION FROM EMPLOYMENT OR REMOVAL FROM THE BOARD OF DIRECTORS, AS NECESSARY. |
| FORM 990, PART VI, SECTION B, LINE 15 | UNITY CONTRACTS WITH AN INDEPENDENT CONSULTANT WHO PERFORMS A MARKET SURVEY/STUDY OF SIMILAR ORGANIZATIONS IN SIZE, REGION, AND SECTOR AS UNITY. UPON COMPLETION OF THE SURVEY/STUDY, THE ANALYSIS AND RECOMMENDATION IS PRESENTED TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN DELIBERATE AND AGREE ON THE CEO'S COMPENSATION AND AN EMPLOYMENT CONTRACT IS DRAWN. AS A FEDERALLY QUALIFIED HEALTH CENTER, ALL OF THE BOARD MEMBERS OF THE ORGANIZATION, WHICH AGREE TO THE CEO'S COMPENSATION, ARE INDEPENDENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | MEDICAL CONSULTANTS: PROGRAM SERVICE EXPENSES 5,386,193. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,386,193. SOFTWARE/NETWORK CONSULTANTS: PROGRAM SERVICE EXPENSES 110,427. MANAGEMENT AND GENERAL EXPENSES 1,169,066. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,279,493. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 1,285,542. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,285,542. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 10,227. MANAGEMENT AND GENERAL EXPENSES 15,743. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,970. PAYROLL PROCESSING FEES: PROGRAM SERVICE EXPENSES 216,657. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 216,657. OTHER CONTRACT PAYMENTS: PROGRAM SERVICE EXPENSES 449,196. MANAGEMENT AND GENERAL EXPENSES 2,075,215. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,524,411. |
| FORM 990, PART XI, LINE 9: | DECREASE IN TEMP RESTRICTED NET ASSETS -529,845. |
| PART X, LINE 7 | DURING 2012, UNITY-PARKSIDE PROPERTY, INC. (PARKSIDE) WAS ESTABLISHED TO PARTICIPATE IN THE INTERNAL REVENUE SERVICE'S NEW MARKET TAX CREDIT (NMTC) PROGRAM IN ORDER TO FINANCE CONSTRUCTION OF A NEW HEALTH CARE FACILITY FOR A "LOW-INCOME COMMUNITY" IN WASHINGTON D.C., AS DEFINED UNDER SECTION 45D(E)(1) OF THE INTERNAL REVENUE CODE. PARKSIDE IS A NON-PROFIT CORPORATION THAT IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3), WHICH IS WHOLLY-CONTROLLED BY UNITY HEALTH CARE. PURSUANT TO THE NMTC FINANCING PROGRAM ENTERED INTO BY PARKSIDE, USB NMTC FUND 2011-3, LLC (THE INVESTOR) MADE A $6,975,150 CAPITAL CONTRIBUTION TO D.C. UNITY INVESTMENT FUND, LLC (THE CDE) DURING 2012, WHICH REPRESENTS A 100% MEMBERSHIP INTEREST IN THE CDE. IN ADDITION, DURING 2012, UNITY HEALTH CARE MADE AN $18,300,000 LOAN TO THE CDE. THE CDE THEN MADE A CAPITAL CONTRIBUTION THAT QUALIFIED AS A QUALIFIED EQUITY INVESTMENT (QEI) INTO CITY FIRST CAPITAL 30, LLC (SUB-CDE) OF $24.5 MILLION, THEREBY OBTAINING A 99.99% OWNERSHIP IN THE SUB-CDE. THIS QEI ENTITLES THE INVESTOR, AS THE 100% MEMBER OF THE CDE TO CLAIM UP TO $24.5 MILLION NMTCS OVER A SEVEN YEAR PERIOD. THE SUB-CDE HAD BEEN ALLOCATED $24.5 MILLION NMTCS BY CITY FIRST NEW MARKETS FUND II, LLC (AS ALLOCATE WITH THE CDFI FUND OF THE UNITED STATES DEPARTMENT OF TREASURY). THE SUB-CDE IS UTILIZING $23,765,000 MILLION OF THE PROCEEDS OF THE CDE CAPITAL CONTRIBUTION TO MAKE QUALIFIED LOW-INCOME COMMUNITY INVESTMENTS (QLICI) IN AND TO PARKSIDE, THE QUALIFIED ACTIVE-LOW INCOME COMMUNITY BUSINESS (QALICB). THE QLICI ARE IN THE FORM OF A LOAN, WHICH CONSISTS OF TWO TRANCHES, LOAN A ($18,267,350) AND LOAN B ($5,497,650), BOTH OF WHICH HAVE AN ANNUAL INTEREST RATE OF 1.321%. |
| Software ID: | |
| Software Version: |