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 I, LINE 1 | ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES: ST. ANTHONY'S PHYSICIAN ORGANIZATION, IN CONJUNCTION WITH ST. ANTHONY'S MEDICAL CENTER, CARRIES OUT ITS HEALING MISSION BY RESPONDING TO THE DIVERSE NEEDS OF THE PEOPLE OF OUR COMMUNITY WITH CONCERN FOR THE POOR. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS AND STOCKHOLDERS: THE CORPORATE MEMBER IS ST. ANTHONY'S MEDICAL CENTER, A MISSOURI NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS AND STOCKHOLDERS: THE MEMBER HAS THE POWER TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE MEMBERS OF THE BOARD THROUGH THE ACTION OF THE PRESIDENT / CEO OF THE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | MEMBERS AND STOCKHOLDERS: THE MEMBER HAS THE FOLLOWING POWERS: - AMENDMENT OF THE MISSION, VISION AND OPERATING VALUES PURSUANT TO WHICH THE CORPORATION WILL OPERATE -AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS AND ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF ANY AFFILIATE OF THE CORPORATION - APPOINTMENT AND REMOVAL, WITH OR WITHOUT CAUSE, OF MEMBERS OF THE BOARD THROUGH THE ACTION OF THE PRESIDENT/CEO OF THE CORPORATE MEMBER - ADOPTION OR AMENDMENT OF THE STRATEGIC PLAN, GOALS, AND OBJECTIVES OF THE CORPORATION AND OF ANY AFFILIATE OF THE CORPORATION - ADOPTION OR AMENDMENT OF THE OPERATING, CAPITAL, CONSTRUCTION AND ALL OTHER BUDGETS FOR THE CORPORATION - ASSIGNMENT, TRANSFER, SALE OR LEASE OF ANY OF THE ASSETS OF THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS ($100,000) IN ANY ONE OR SERIES OF RELATED TRANSACTIONS OCCURRING WITHIN ANY TWELVE (12) MONTH PERIOD - AUTHORIZATION AND APPROVAL OF THE INCURRENCE OF DEBT BY THE CORPORATION OR ANY AFFILIATE OF THE CORPORATION (OTHER THAN DEBT INCURRED FOR THE ACQUISITION OF GOODS THAT ARE ACQUIRED IN THE ORDINARY COURSE OF BUSINESS) AND TO GRANT ANY SECURITY INTERESTS, PLACE ANY ENCUMBRANCES, ENTER INTO ANY COVENANTS, AND EXECUTE ANY DOCUMENTS AND TAKE ANY ACTIONS NECESSARY OR APPROPRIATE IN CONNECTION WITH THE INCURRENCE OF SUCH DEBT - APPROVAL OF A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION - APPROVAL OF THE LEASE, MANAGEMENT OR PURCHASE OF, OR AFFILIATION WITH, ANOTHER HOSPITAL OR HOSPITAL SYSTEM, OR HEALTH CARE FACILITY OR HEALTH CARE SYSTEM BY THE CORPORATION - APPROVAL OF THE CREATION OR DISSOLUTION OF ANY AFFILIATE OF THE CORPORATION - APPROVAL OF THE CREATION OF OR WITHDRAWAL FROM ANY JOINT VENTURE INVOLVING THE CORPORATION - APPROVAL OF ANY CONTRACTS TO BE ENTERED INTO BY THE CORPORATION REQUIRING A FINANCIAL COMMITMENT IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS ($100,000), UNLESS SUCH CONTRACT OR EXPENDITURE WAS CONTAINED IN A PREVIOUSLY AUTHORIZED BUDGET OF THE CORPORATION, AND APPROVAL OF ANY ACTIONS OF ANY AFFILIATE OF THE CORPORATION WHICH, IF SUCH ACTION WAS TAKEN BY THE CORPORATION, WOULD BE SUBJECT TO THE APPROVAL OF THE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW PROCESS: RETURNS ARE PREPARED AND INITIALLY REVIEWED BY ST ANTHONY'S FINANCE STAFF AND PREPARER BKD. AFTER THESE REVIEWS ARE COMPLETED, THE RETURNS ARE THEN REVIEWED WITH THE CHIEF FINANCIAL OFFICER (CFO) BY FINANCE STAFF. ONCE THIS REVIEW OCCURS, RETURNS ARE MAILED TO BOARD / FINANCE COMMITTEE MEMBERS FOR REVIEW, QUESTIONS, AND COMMENTS DIRECTED TO THE CFO OR THEIR DESIGNEE. COPIES OF THE RETURNS ARE PROVIDED TO ST. ANTHONY'S PHYSICIAN ORGANIZATION'S BOARD AND THE ST. ANTHONY'S MEDICAL CENTER BOARD. ONCE ALL REVIEWS HAVE TAKEN PLACE, THE RETURNS ARE FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST: To ensure that all affiliates operate in a manner that is consistent with their charitable purposes and that they engage only in transactions that are reasonable and the result of arm's length bargaining, St. Anthony's Medical Center has adopted and enforces compliance with a conflict of interest policy for all of its affiliates, including St. Anthony's Physician Organization. The policy requires disclosure of any actual or potential conflict of interest. Individual directors, officers and key employees are surveyed annually concerning their relationships to determine whether conflicts of interest might exist. If the St. Anthony's Medical Center board of directors or any committee or administrator has reasonable cause to believe that an individual has failed to disclose actual or potential conflicts of interest, the individual must be informed and afforded the opportunity to explain the alleged failure to disclose. If, after hearing the response of the individual and making such further investigation as may be warranted in the circumstances, the St. Anthony's Medical Center board of directors, or any committee or administrator determines that the individual has, in fact, failed to disclose an actual or potential conflict of interest, appropriate disciplinary and corrective action shall be taken against the individual. |
| FORM 990, PART VI, SECTION B, LINE 15A & 15B | PROCESS FOR DETERMINING COMPENSATION: COMPENSATION FOR THE PHYSICIAN EMPLOYEES OF THE CORPORATION IS DETERMINED IN ACCORDANCE WITH A COMPENSATION PLAN APPROVED BY THE COMPENSATION COMMITTEE OF THE ST. ANTHONY'S MEDICAL CENTER BOARD OF DIRECTORS. THE COMPENSATION PLAN IN EFFECT SINCE JANUARY 1, 2014, WAS DETERMINED TO BE REASONABLE AND CONSISTENT WITH FAIR MARKET VALUE BY AN INDEPENDENT COMPENSATION CONSULTANT. COMPENSATION FOR THE FORMER CFO WAS DETERMINED TO BE REASONABLE AND CONSISTENT WITH FAIR MARKET VALUE BY AN INDEPENDENT COMPENSATION CONSULTANT FOR THE FISCAL YEAR ENDING JUNE 30, 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABILITY OF DOCUMENTS TO THE PUBLIC: THE ORGANIZATION CONSIDERS ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO BE PROPRIETARY. ACCORDINGLY THEY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. |
| FORM 990, PART VI, SECTION A, LINE 3 | DELEGATION OF CONTROL TO A MANAGEMENT COMPANY OR OTHER PERSON: DAN MCCORMICK WAS A CONTRACTED COO OF ST. ANTHONY'S PHYSICIAN ORGANIZATION. HE WORKED FOR THE ADVISORY BOARD COMPANY, WHICH WAS PAID BY ST. ANTHONY'S MEDICAL CENTER, A RELATED ENTITY. ST ANTHONY'S MEDICAL CENTER PAID THE ADVISORY BOARD COMPANY $859,159 WHICH INCLUDES THE SERVICES OF THE ST. ANTHONY'S PHYSICIAN ORGANIZATION'S COO AND OTHER CONTRACTED SERVICES FOR ST. ANTHONY'S MEDICAL CENTER AND ST. ANTHONY'S PHYSICIAN ORGANIZATION. |
| FORM 990, PART XII, LINE 2C | OVERSIGHT COMMITTEE: RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT IS ASSUMED BY THE FINANCE AND AUDIT COMMITTEE OF THE GOVERNING BODY OF ST. ANTHONY'S MEDICAL CENTER, THE PARENT ORGANIZATION. |
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