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. |
||||
| 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 III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS IN JULY 2014, EISENHOWER MEDICAL CENTER IS NAMED FOR THE THIRD CONSECUTIVE YEAR AS ONE OF THE NATION'S MOST WIRED HOSPITALS IN THE 2014 MOST WIRED SURVEY BENCHMARKING STUDY RELEASED IN THE JULY ISSUE OF HOSPITALS & HEALTH NETWORKS, THE JOURNAL OF THE AMERICAN HOSPITAL ASSOCIATION. IN SEPTEMBER 2014, EISENHOWER LUCY CURCI CANCER CENTER HOSTS THE SEVENTH ANNUAL ARNOLD PALMER PROSTATE CENTER SYMPOSIUM, A SERIES OF WEEKLY LECTURES REGARDING THE PREVENTION, DIAGNOSIS AND TREATMENT OF PROSTATE CANCER IN RECOGNITION OF NATIONAL PROSTATE CANCER AWARENESS MONTH. IN OCTOBER 2014, EISENHOWER IS RECOGNIZED AS A LEADER IN LGBT HEALTHCARE EQUALITY IN THE HEALTHCARE EQUALITY INDEX 2014, AN ANNUAL SURVEY CONDUCTED BY THE HUMAN RIGHTS CAMPAIGN (HRC) FOUNDATION. EISENHOWER EARNS TOP MARKS FOR ITS COMMITMENT TO EQUITABLE, INCLUSIVE CARE FOR LGBT PATIENTS AND THEIR FAMILIES FOR THE SECOND CONSECUTIVE YEAR. IN OCTOBER 2014, EISENHOWER SCHNITZER/NOVACK BREAST CENTER HOSTS A SERIES OF LECTURES TO EDUCATE THE COMMUNITY ABOUT BREAST CANCER PREVENTION, SCREENING, DIAGNOSIS AND TREATMENT IN RECOGNITION OF NATIONAL BREAST CANCER AWARENESS MONTH. IN NOVEMBER 2014, EISENHOWER IS HONORED WITH AN "A" RATING - THE TOP GRADE IN PATIENT SAFETY - IN THE HOSPITAL SAFETY SCORE ADMINISTERED BY THE LEAPFROG GROUP. THE FIRST AND ONLY HOSPITAL SAFETY RATING TO BE PEER-REVIEWED IN THE JOURNAL OF PATIENT SAFETY, THE SCORE IS FREE TO THE PUBLIC AND DESIGNED TO GIVE CONSUMERS INFORMATION THEY CAN USE TO PROTECT THEMSELVES AND THEIR FAMILIES WHEN FACING A HOSPITAL STAY. IN NOVEMBER 2014, BNP PARIBAS OPEN EXECUTIVES PRESENT EISENHOWER SCHNITZER/NOVACK BREAST CENTER WITH A DONATION IN HONOR OF BREAST CANCER AWARENESS MONTH. FOR EACH TICKET SOLD IN THE MONTH OF OCTOBER TO THE TENNIS EVENT, $1 WAS DONATED TO EISENHOWER'S BREAST CENTER. IN FALL 2014, EISENHOWER ADDS TWO NEW INFUSION CENTERS TO EXPAND ACCESS TO PATIENTS WITH ACUTE AND CHRONIC CONDITIONS THAT REQUIRE IV THERAPY AT THE EISENHOWER BIGHORN INFUSION CENTER LOCATED IN THE EISENHOWER GEORGE AND JULIA ARGYROS HEALTH CENTER IN LA QUINTA AND AT THE EISENHOWER HEALTH CENTER AT YUCCA VALLEY. IN FALL 2014, EISENHOWER RENAMES ITS ADULT DAY CARE CENTER. FORMERLY KNOWN AS THE FIVE STAR CLUB, THE EISENHOWER MEMORY CARE CENTER - ADULT DAY CENTER CONTINUES TO SERVE MEMBERS OF THE COMMUNITY WITH ALZHEIMER'S AND OTHER DEMENTIAS, PROVIDING A SUPPORTING AND CARING ENVIRONMENT. IN FALL 2014, EISENHOWER OPENS THE VALLEY'S FIRST GENERAL PHYSICAL MEDICINE AND REHABILITATION CLINIC FOR ONGOING STROKE AND OTHER NEUROLOGICAL CARE AFTER A PATIENT HAS HAD INPATIENT CARE AND REHABILITATION. IN FALL 2014, EISENHOWER LAUNCHES A PILOT STUDY OF A SMARTPHONE APPLICATION CALLED MOBILE HEARTBEAT TO PROVIDE ELECTRONIC COMMUNICATION AMONG CLINICAL TEAM MEMBERS IN THE CARE OF HOSPITAL PATIENTS. THE APPLICATION ALLOWS HIPAA COMPLIANT TEXTS AS WELL AS ACCESS TO PATIENT DATA THAT PROTECTS PATIENT PRIVACY WHILE ALLOWING MORE EFFICIENT RESPONSE TIME TO PATIENT NEEDS. IN DECEMBER 2014, EISENHOWER OPENS ITS FOURTH PALM SPRINGS LOCATION TO BETTER SERVE THE COMMUNITY. EISENHOWER HEALTH CENTER AT SOUTH PALM CANYON (415 SOUTH PALM CANYON DRIVE) OFFERS A VARIETY OF SPECIALTIES INCLUDING PAIN MANAGEMENT, CARDIOLOGY, NEUROLOGY, GASTROENTEROLOGY, GYNECOLOGY, ENDOCRINOLOGY, UROLOGY, AND PULMONOLOGY. ON FEBRUARY 13, 2015, EISENHOWER CELEBRATES THE GRAND OPENING OF THIS LOCATION WITH A RIBBON CUTTING AND THE UNVEILING OF THE PATTISON BRONZE, A MID-CENTURY MODERN SCULPTURE DONATED BY THE AGUA CALIENTE BAND OF INDIANS. IN WINTER 2015, EISENHOWER IS THE FIRST AND ONLY HEALTH CENTER IN THE VALLEY TO UTILIZE TRANSCRANIAL MAGNETIC STIMULATION (TMS) FOR THE TREATMENT OF SEVERE DEPRESSION THAT IS NOT SUCCESSFULLY TREATED WITH MEDICATION AND TALK THERAPY. THE FDA-APPROVED DEVICE USES MAGNETIC FIELDS TO STIMULATE NERVE CELLS IN THE REGIONS OF THE BRAIN INVOLVED IN MOOD CONTROL AND DEPRESSION. ON JANUARY 10, 2015, EISENHOWER HOSTS ITS FIRST TRANSGENDER SYMPOSIUM IN PALM SPRINGS. PHYSICIAN EXPERTS FROM UNIVERSITY OF CALIFORNIA, SAN FRANCISCO AND CHILDREN'S HOSPITAL LOS ANGELES PROVIDE CONTINUING EDUCATION TO PHYSICIANS, NURSES, OTHER CLINICAL STAFF AND THE COMMUNITY TO BROADEN THE UNDERSTANDING OF TRANSGENDER PATIENTS' HEALTH NEEDS. ON JANUARY 13, 2015, EISENHOWER COMPLETES THE FUNDRAISING CAMPAIGN FOR THE SEISMIC RETROFIT OF THE ORIGINAL HOSPITAL BUILDING, KNOWN AS THE IKE WING. THE CAMPAIGN IS COMPLETED AT A FUNDRAISING EVENT HOSTED BY DENNIS AND PHYLLIS WASHINGTON, WHOSE FOUNDATION GAVE THE INITIAL $12.5 MILLION GIFT WITH A CHALLENGE TO RAISE THE $12.5 MILLION BALANCE. ON MARCH 5, 2015, EISENHOWER LUCY CURCI CANCER CENTER HOSTS THE 12TH ANNUAL COMMUNITY CANCER AWARENESS DAY WITH A FOCUS ON COLON CANCER. ON MARCH 28, 2015, EISENHOWER HOSTS THE 19TH ANNUAL JIM COOK DAY OF HOPE FOR DIABETES, FEATURING AWARD-WINNING ACTOR/DANCER/SINGER BEN VEREEN, AT THE ANNENBERG CENTER FOR HEALTH SCIENCES AT EISENHOWER. IN MARCH 2015, EISENHOWER MEDICAL CENTER'S RESIDENCY PROGRAM FILLS ALL OF ITS AVAILABLE SLOTS IN THE PROGRAM'S THIRD YEAR. EISENHOWER IS THE FIRST HOSPITAL IN THE VALLEY TO OFFER AN ACCREDITED RESIDENCY PROGRAM. IN MARCH 2015, EISENHOWER MEDICAL CENTER ACHIEVES MAGNET RECOGNITION AS A REFLECTION OF ITS NURSING PROFESSIONALISM, TEAMWORK AND EXCELLENCE IN PATIENT CARE. MAGNET RECOGNITION IS DETERMINED BY THE AMERICAN NURSES CREDENTIALING CENTER (ANCC) MAGNET RECOGNITION PROGRAM, WHICH ENSURES THAT RIGOROUS STANDARDS FOR NURSING EXCELLENCE ARE MET. IN APRIL 2015, EISENHOWER IS HONORED WITH AN "A" RATING - THE TOP GRADE IN PATIENT SAFETY - IN THE HOSPITAL SAFETY SCORE ADMINISTERED BY THE LEAPFROG GROUP. IN APRIL 2015, EISENHOWER IS THE FIRST HOSPITAL IN RIVERSIDE COUNTY TO PERFORM THE TRANSCATHETER AORTIC HEART VALVE REPLACEMENT PROCEDURE (TAVR). |
| FORM 990, PART VI, LINE 2 | FAMILY OR BUSINESS RELATIONSHIPS KATHRYN B. SAMPLE AND STEVEN B. SAMPLE HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, LINE 6 | MEMBERS OR STOCKHOLDERS THE BOARD OF TRUSTEES ARE MEMBERS OF EISENHOWER MEDICAL CENTER. |
| FORM 990, PART VI, LINE 7A | POWER TO ELECT OR APPOINT MEMBERS TRUSTEES HAVE THE RIGHT TO ELECT THE GOVERNING BOARD MEMBERS OF THE EISENHOWER MEDICAL CENTER BOARD OF DIRECTORS. |
| FORM 990, PART VI, LINE 7B | DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS MEMBERS HAVE THE RIGHT TO VOTE ON THE FOLLOWING MAJOR DECISIONS: ANY MATERIAL CHANGE IN THE MISSION OF EMC; THE MERGER OF EMC WITH ANY OTHER BUSINESS ENTITY; THE DISSOLUTION OF EMC; THE SALE OF ALL OR SUBSTANTIALLY ALL OF EMC'S ASSETS; AND ANY MATTER ON WHICH A MEMBER OF A CALIFORNIA NON-PROFIT CORPORATION IS REQUIRED TO BE PERMITTED TO VOTE ON UNDER APPLICABLE LAW. |
| FORM 990, PART VI, LINE 11B | PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND SUBSEQUENTLY REVIEWED BY MANAGEMENT. AFTER MANAGEMENT'S REVIEW, THE FORM 990 IS PRESENTED TO THE BOARD AFTER FILING. |
| FORM 990, PART VI, LINE 12C | MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST ANNUALLY, RELATED PARTIES INCLUDING OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE SURVEYED FOR TRANSACTIONS THAT COULD GIVE RISE TO CONFLICTS. WRITTEN QUESTIONNAIRES ARE REVIEWED BY LEGAL AND FINANCE TO DETERMINE IF ADDITIONAL QUESTIONS OR INFORMATION SHOULD BE DOCUMENTED REGARDING SPECIFIC TRANSACTIONS. ALL NEW CONTRACTS ARE REVIEWED BY EXECUTIVE MANAGEMENT FOR CONFLICT CONSIDERATIONS. GENERAL COUNSEL REVIEWS ALL STATEMENTS SUBMITTED BY BOARD MEMBERS WHO INDICATE A POTENTIAL CONFLICT. GENERAL COUNSEL ADVISES THE CEO AND CHAIRMAN OF THE BOARD OF ANY MATERIAL CONFLICTS SO THAT THE INDIVIDUAL CAN BE RECUSED FROM ANY DISCUSSION OR DELIBERATION PERTAINING TO THE CONFLICT. |
| FORM 990, PART VI, LINE 15A & 15B | PROCESS FOR DETERMINING COMPENSATION EISENHOWER MEDICAL CENTER ENGAGES AN INDEPENDENT CONSULTING FIRM TO PROVIDE THE BOARD'S COMPENSATION COMMITTEE BENCHMARKED SURVEY DATA FOR THE EXECUTIVE LEADERSHIP TEAM IN THE ORGANIZATION. THE CONSULTANT PROVIDES ANALYSIS OF SALARIES (ON AN ANNUAL BASIS), INCENTIVE PLANS AND BENEFITS (ON A BIANNUAL BASIS) AS COMPARED TO PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS. THIS REVIEW WAS COMPLETED AND PRESENTED TO THE COMPENSATION COMMITTEE IN FEBRUARY 2015. THIS PROCESS WAS CONTEMPORANEOUSLY SUBSTANTIATED IN THE MEETING MINUTES OF THE COMPENSATION COMMITTEE. |
| FORM 990, PART VI, LINE 19 | PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC EISENHOWER MEDICAL CENTER RELEASES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC UPON REQUEST. THAT REQUEST MAY BE EITHER VERBAL OR WRITTEN. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICES REPRESENTS PURCHASED SERVICES: PHYSICIAN SERVICES $48,294,004 PURCHASED SERVICES - OTHER $17,169,416 OTHER MEDICAL SERVICES $ 4,960,653 COLLECTION SERVICES $ 3,541,067 PROFESSIONAL FEES $19,566,919 ----------- TOTAL $93,532,059 |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN FUND BALANCE PENSION RELATED CHANGES ($27,269,568) CHANGE IN NPV OF PLEDGES $ 22,405 CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS $ 17,077 ----------- TOTAL ($27,230,086) |
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