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.") . | ||||||
| 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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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. |
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| 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 |
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| Return Reference | Explanation |
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| 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 1 | THE BOARD OF DIRECTORS CONSISTS OF 21 VOTING MEMBERS, 20 OF WHICH ARE CONSIDERED INDEPENDENT. THE CHIEF EXECUTIVE OFFICER IS A MEMBER OF THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS COMPOSED OF BUSINESS PROFESSIONALS, CIVIC AND COMMUNITY LEADERS AND EDUCATORS DRAWN FROM THE COMMUNITIES AND AREAS SERVED BY MARY BIRD PERKINS CANCER CENTER. ALL MEMBERS OF THE BOARD OF DIRECTORS ARE ACTIVELY ENGAGED IN THE GOVERNANCE OF MBPCC AND AWARE OF ITS ACTIVITIES THROUGH THEIR ASSIGNMENT TO CERTAIN BOARD AUTHORIZED COMMITTEES. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO TRANSACT ANY AND ALL BUSINESS OF MBPCC BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONTRAVENE SPECIFICALLY ADOPTED POLICIES OF THE BOARD OF DIRECTORS OR THE ARTICLES OF INCORPORATION. THE FINANCE COMMITTEE SHALL REVIEW THE ANNUAL BUDGET PREPARED BY THE PRESIDENT AND RECOMMEND TO THE BOARD OF DIRECTORS AN ANNUAL BUDGET FOR THE OPERATION OF MBPCC. IT SHALL SUPERVISE INVESTMENTS, IF ANY, AND ATTEND TO ALL FISCAL MATTERS, AND SHALL CAUSE THE ANNUAL AUDIT TO BE CONDUCTED. THE PROFESSIONAL AFFAIRS COMMITTEE SHALL ADDRESS, AT LEAST, THE FOLLOWING AREAS: THE QUALITY IMPROVEMENT PROGRAM; CONTRACTUAL RELATIONSHIPS WITH PHYSICIANS; DENTISTS AND OTHER MEDICAL SUPPORT PERSONNEL; MEDICAL/PHYSICS/DENTAL STAFF BYLAWS; STAFFING PRIVILEGES; MEMBERSHIP AND CREDENTIALING; OUTSIDE REVIEW AND ACCREDITATION; MEDICAL EDUCATION; BASIC AND CLINICAL RESEARCH; AND RADIATION SAFETY. THE COMPENSATION COMMITTEE SHALL ANNUALLY REVIEW THE SALARY AND WAGE ADMINISTRATION PROGRAM AND BENEFITS PACKAGE FOR MBPCC'S STAFF TO ENSURE THAT A COMPETITIVE POSITION IS MAINTAINED IN EMPLOYMENT AND THAT THE COMPENSATION PROGRAM CONTINUES TO ENABLE THE ATTRACTION OF HIGH QUALITY PERSONNEL TO MEET THE GOALS OF MBPCC. |
| FORM 990, PART VI, SECTION A, LINE 2 | BRETT FURR IS A PARTNER OF TAYLOR PORTER AND HAS BUSINESS RELATIONSHIPS WITH OTHER BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11 | INFORMATION FOR THE FORM 990 IS GATHERED BY MBPCC'S ACCOUNTING DEPARTMENT AND PROVIDED TO POSTLETHWAITE & NETTERVILLE, ITS INDEPENDENT PROFESSIONAL ACCOUNTING FIRM, FOR PREPARATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA OF THE ORGANIZATION AND A COMPLETE DRAFT IS PROVIDED TO MBPCC'S CHIEF FINANCIAL OFFICER. PROPOSED CHANGES TO THE DRAFT ARE DISCUSSED WITH REPRESENTATIVES OF POSTLETHWAITE & NETTERVILLE. AFTER THE CHIEF FINANCIAL OFFICER CONSIDERS THE RETURN TO BE IN FINAL FORM, AND BEFORE ITS FILING, THE FINANCE AND AUDIT COMMITTEE OF THE BOARD OF DIRECTORS IS PRESENTED WITH A COPY FOR THEIR REVIEW AND APPROVAL. ANY CHANGES PROPOSED BY THE FINANCE AND AUDIT COMMITTEE ARE DIRECTED TO THE CHIEF FINANCIAL OFFICER, THE APPROPRIATE SENIOR MANAGER OF THE FUNCTIONAL AREA, AND WHERE NECESSARY, POSTLETHWAITE & NETTERVILLE FOR CONSIDERATION. THE RETURN IS ONLY FILED AFTER EACH OF THE STEPS IN THE REVIEW PROCESS IS COMPLETE. A FINAL VERSION OF THE FORM IS MADE AVAILABLE TO THE ENTIRE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | MBPCC HAS A CONFLICT OF INTEREST POLICY AND CONSISTENTLY MONITORS AND ENFORCES ITS PROVISIONS. ANNUALLY, ALL DIRECTORS AND KEY MANAGEMENT PERSONNEL SUBMIT TO THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND CONFLICTING INTERESTS AND AMENDMENTS THERETO DURING THE YEAR AS ANY ADDITIONAL FINANCIAL OR CONFLICTING INTERESTS ARISE. THE STATEMENT INCLUDES AN ACKNOWLEDGEMENT THAT THE PERSON SIGNING THE FORM: I) RECEIVED A COPY OF THE POLICY AND BY LAWS; II) HAS READ AND UNDERSTANDS THIS ARTICLE; III) AGREES TO COMPLY WITH THE PROVISIONS OF THIS ARTICLE; IV) UNDERSTANDS THAT THIS ARTICLE APPLIES TO THE BOARD AND ALL BOARD COMMITTEES; AND V) UNDERSTANDS THAT THIS CORPORATION AND ITS AFFILIATES ARE ORGANIZED TO ADVANCE CHARITABLE PURPOSES AND THAT IN ORDER TO MAINTAIN TAX-EXEMPT STATUS, THEY MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF THEIR TAX-EXEMPT PURPOSES. THE BYLAWS FURTHER STATE THAT WHERE A MATTER BROUGHT BEFORE THE BOARD, OR BOARD COMMITTEE, GIVES RISE TO A POTENTIAL CONFLICT OF INTEREST, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD: I) THE AFFECTED PERSON, AFTER THE DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANSWERING ANY QUESTIONS THAT MIGHT BE ASKED OF HER/HIM, SHALL WITHDRAW FROM THE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON; II) IF A CONFLICT EXISTS, THE INTERESTED PERSON SHALL REMAIN OUT OF THE MEETING FOR SO LONG AS THE BOARD, OR COMMITTEE CHAIRMAN, SHALL DETERMINE; III) THE INTERESTED PERSON SHALL NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM, NOR ALLOWED TO PARTICIPATE IN THE DELIBERATIONS OR VOTE ON THE ITEM THAT CREATED THE CONFLICT; IV) THE BOARD, OR BOARD COMMITTEE, SHALL DETERMINE BY A MAJORITY VOTE OF THE NON-INTERESTED PERSONS PRESENT, THAT THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT; IS FAIR AND REASONABLE TO THE CORPORATION; AND, AFTER EXERCISING DUE DILIGENCE, SHALL DETERMINE THAT THE CORPORATION CANNOT OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORT UNDER THE CIRCUMSTANCES; V) IN THE EVENT THAT A MEMBER OF THE BOARD OF DIRECTORS DEVELOPS A FINANCIAL OR CONFLICTING INTEREST THAT IS INSURMOUNTABLE, S/HE SHALL RESIGN FROM HIS / HER POSITION ON THE BOARD OF DIRECTORS. PROCEDURES FOR ADEQUATE RECORD KEEPING DIRECT THAT THE MINUTES OF THE BOARD MEETINGS AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL INCLUDE: 1. THE NAMES OF THE PERSONS WHO DISCLOSED FINANCIAL OR CONFLICTING INTERESTS, THE NATURE OF THE FINANCIAL OR CONFLICTING INTERESTS AND WHETHER THE BOARD DETERMINED THERE WERE FINANCIAL OR CONFLICTING INTERESTS; AND 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THESE DISCUSSIONS, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF THE VOTE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, WHOSE ENTIRE COMPOSITION CONSISTS OF ENTIRELY INDEPENDENT DIRECTORS, CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY MANAGMENT PERSONNEL, INCLUDING THE CHIEF EXECUTIVE OFFICER. THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO THE SENIOR MANAGEMENT TEAM, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF THE VICE PRESIDENT-HUMAN RESOURCES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CHIEF EXECUTIVE OFFICER. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE INTERNAL REVENUE CODE, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. |
| FORM 990, PART VI, SECTION C, LINE 18 | AVAILABLE UPON REQUEST |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON REQUEST |
| FORM 990, PART XI, LINE 9: | EARNINGS FROM SUBSIDIARY 363,437. TRANSFER TO MARY BIRD PERKINS CANCER CENTER FOUNDATION -42,632. ROUNDING 3. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. |
| Software ID: | |
| Software Version: |