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.") . | 423,224 | 185,751 | 162,643 | 35,154 | 0 | 806,772 |
| 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...... | 152,114,133 | 150,430,135 | 290,937,187 | 317,186,494 | 385,360,095 | 1,296,028,044 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 152,537,357 | 150,615,886 | 291,099,830 | 317,221,648 | 385,360,095 | 1,296,834,816 |
| 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.) | 1,296,834,816 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 152,537,357 | 150,615,886 | 291,099,830 | 317,221,648 | 385,360,095 | 1,296,834,816 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 362,081 | 525,837 | 441,183 | 387,321 | 343,424 | 2,059,846 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 362,081 | 525,837 | 441,183 | 387,321 | 343,424 | 2,059,846 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 152,899,438 | 151,141,723 | 291,541,013 | 317,608,969 | 385,703,519 | 1,298,894,662 |
| 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 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 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) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
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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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 6 | CLASSES OF MEMBERS OR STOCKHOLDERS DRISCOLL CHILDREN'S HOSPITAL IS THE SOLE MEMBER OF DRISCOLL CHILDREN'S HEALTH PLAN. |
| FORM 990, PART VI, SECTION A, LINE 7A | CLASS OF PERSONS AND NATURE AND THEIR RIGHTS ANY VACANCY OCCURRING IN THE BOARD OF DIRECTORS SHALL BE FILLED IN ACCORDANCE WITH THE FOLLOWING PROCEDURE: THE MEMBER SHALL ELECT AND APPOINT A CANDIDATE TO FILL THE VACANCY. |
| FORM 990, PART VI, SECTION A, LINE 7B | CLASS OF THE PERSON, DECISIONS THAT REQUIRE APPROVAL, AND VOTING RIGHTS THE FOLLOWING MATTERS ARE RESERVED TO THE MEMBER AND SHALL REQUIRE THE AFFIRMATIVE ACTION OF THE MEMBER TO BE EFFECTIVE: A. ANNUAL OPERATING & CAPITAL BUDGETS OF THE CORPORATION; B. MERGER, ACQUISITION OR CONSOLIDATION OF THE CORPORATION; C. BORROWING OR LENDING OF MONEY OR THE CREATION OF INDEBTEDNESS THROUGH THE GUARANTEE OF ANOTHER DEBT OR SIMILAR ACTION; AND D. APPOINTMENT & REMOVAL OF DIRECTORS IN ACCORDANCE WITH THE BY-LAWS. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 PROVIDED TO GOVERNING BODY THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS AND DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ORGANIZATION'S PRACTICE FOR MONITORING COMPLIANCE WITH POLICY ANNUALLY, ALL DIRECTORS, OFFICERS, AND KEY PERSONNEL FILL OUT A CONFLICT OF INTEREST FORM. THE COMPLIANCE OFFICER MAKES SURE ALL CONFLICT OF INTEREST FORMS ARE TURNED IN AND REVIEWED ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW OF OFFICERS OR KEY EMPLOYEES THE BOARD OF DIRECTORS REVIEW THE APPLICABLE MARKETING DATA PROVIDED BY A THIRD PARTY COMPENSATION FIRM AND MATCHES THE PRESIDENT/CEO SALARY TO THE APPROPRIATE MARKET RATE FOR THE DUTIES. SULLIVAN COTTER REVIEWED 2014. |
| FORM 990, PART VI, SECTION B, LINE 15B | COMPENSATION REVIEW OF OFFICERS OR KEY EMPLOYEES THE BOARD OF DIRECTORS REVIEW THE APPLICABLE MARKETING DATA PROVIDED BY A THIRD PARTY COMPENSATION FIRM AND MATCHES THE PRESIDENT/CEO SALARY TO THE APPROPRIATE MARKET RATE FOR THE DUTIES. SULLIVAN COTTER REVIEWED 2014. |
| FORM 990, PART VI, SECTION C, LINE 19 | ORGANIZATIONAL DOCUMENTS MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VI, SECTION A, LINE 4 | SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS THE ORGANIZATION AMENDED ITS BYLAWS EFFECTIVE DECEMBER 8, 2014. THE GOVERNING BOARD OF DRISCOLL CHILDREN'S HOSPITAL (DCH) APPOINTED A BYLAWS COMMITTEE TO REVIEW AND MAKE PROPOSED RECOMMENDATIONS TO THE BYLAWS OF DRISCOLL HEALTH PLAN (DHP) FOR THE PURPOSE OF ENSURING PROPER OVERSIGHT OF THE CORPORATION AND ITS RELATED ENTITIES AND DELEGATION OF AUTHORITY AS APPROPRIATE. THE DHP BYLAWS WERE REFORMATTED TO MAINTAIN CONSISTENCY WITH THE 2013 REVISED DCH BYLAWS. THE FOLLOWING IS A SUMMARY OF THE MAJOR CHANGES: ARTICLE II. MEMBER THE RESERVED POWERS OF DCH WERE EXPANDED TO REFLECT ACTUAL PRACTICE AND CONSISTENCY AMONG THE SUBSIDIARIES ARTICLE III. BOARD OF DIRECTORS COMPOSITION OF THE BOARD WAS CLARIFIED. - NUMBER AND QUALIFICATION OF THE DIRECTORS DEFINED. - PREVIOUS BYLAWS DO NOT DEFINE STATUS OF EX-OFFICIO MEMBERS, SUCH AS THE PRESIDENT OF DHP, PRESIDENT AND EXECUTIVE VICE PRESIDENT OF DCH. - THERE WAS NO CHANGE IN THE NUMBER OF VOTING MEMBERS (7) WHICH INCLUDES THE 3 LISTED ABOVE PLUS 4 ADDITIONAL DIRECTORS. - CMO WAS ADDED EX-OFFICIO WITHOUT VOTE, WHICH REFLECTS CURRENT PRACTICE. ARTICLE IV. BOARD CHAIR AND OFFICERS SIMPLE CLARIFICATIONS WERE MADE TO THE DESCRIPTIONS. THE DUTIES OF THE DHP PRESIDENT WERE EXPANDED. AUTHORITY FOR VICE PRESIDENTS ADDED. CLARIFIED THE ROLE OF TREASURER VERSUS THE CORPORATION'S FINANCIAL OFFICER. ARTICLE V. COMMITTEES STANDING COMMITTEES OF THE BOARD WERE ADDED TO THE BYLAWS TO MEET BEST PRACTICES FOR BOARD DELEGATED AUTHORITY. THESE INCLUDE THE QUALITY MANAGEMENT COMMITTEE AND IT SUBCOMMITTEES AND THE WASTE, FRAUD AND ABUSE COMMITTEE. COMPOSITION, TERMS AND VOTING RIGHTS OF COMMITTEES ADDED. ARTICLE VI. CONFLICTS OF INTEREST THIS SECTION WAS COMPLETELY REWRITTEN TO BRING THE LANGUAGE UP TO DATE BASED UPON LEGAL AND REGULATORY REQUIREMENTS. PREVIOUS BYLAWS CONTAINED ONLY ONE SMALL AND INADEQUATE SECTION ON CONFLICTS OF INTEREST. ARTICLE VII. INDEMNIFICATION AND INSURANCE INDEMNIFICATION LANGUAGE WAS UPDATED AND BROADENED TO ALLOW FOR THE ADVANCE REIMBURSEMENT OF EXPENSES INCURRED BY BOARD MEMBERS PRIOR TO FINAL RESOLUTION OF THE MATTER. |
| AMENDED RETURN | RETURN IS BEING AMENDED TO CORRECT THE COMPENSATION REPORTING ON FORM 990, PART VII AND SCHEDULE J, PART II. ON THE ORIGINALLY FILED FORM SOME ELEMENTS OF COMPENSATION WERE INADVERTENTLY EXCLUDED FOR SOME OF THE INDIVIDUALS LISTED. |
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