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 (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 | |||||
| (A)
VIRTUA - WEST JERSEY HEALTH SYSTEM INC |
210634532 | 3 | Yes | 0 | 0 | |
| Total 1 | 0 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 | ||||
| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART VI, SECTION B, LINE 1 | ALL OF THE TRUSTEES OF THE SUPPORTED ORGANIZATIONS SERVE AS THE BOARD OF VIRTUA HEALTH, INC. |
| 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 B, LINE 11 | THE FORM 990 IS REVIEWED BY IN-HOUSE COUNSEL, EXTERNAL TAX CONSULTANTS AND THE BOARD OF TRUSTEES. A FINAL COPY OF FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH TRUSTEE, OFFICER, KEY EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT IN WHICH THEY AGREE TO COMPLY WITH THE CONFLICT-OF-INTEREST POLICY. THE BOARD OF TRUSTEES IS RESPONSIBLE FOR ENSURING THAT PERIODIC REVIEWS OF OPERATIONS ARE CONDUCTED SO THAT THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT-OF-INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING TRUSTEES OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | EXECUTIVE COMPENSATION IS DETERMINED USING MARKET DATA AND PERFORMANCE CRITERIA. THE COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPOSED ENTIRELY OF INDEPENDENT TRUSTEES WITH NO CONFLICTS OF INTEREST, REVIEWS DATA FROM AN INDEPENDENT HUMAN RESOURCES CONSULTING FIRM, INCLUDING BENCHMARKS BY JOB TITLE, MARKET TRENDS, AND COMPETITIVE ANALYSIS. THE COMMITTEE ESTABLISHES THE SALARIES FOR THE CEO AND EXECUTIVE VICE PRESIDENTS. IT ALSO REVIEWS AND APPROVES THE SALARY RECOMMENDATION BY THE CEO FOR ALL VICE PRESIDENTS. EACH YEAR THE COMMITTEE RECEIVES A REASONABLENESS OPINION CONFIRMING THE APPROPRIATENESS OF THE SALARY RECOMMENDATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WERE NOT MADE AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE REPOSITORY WEBSITES EMMA (ELECTRONIC MUNICPAL MARKET ACCESS SYSTEM) AND DAC (DIGITAL ASSURANCE CERTIFICATION), OR UPON REQUEST. |
| FORM 990. PART VII, SECTION A, COLUMN B | SOME OFFICERS AND KEY EMPLOYEES DEVOTE 40 HOURS A WEEK TO VIRTUA HEALTH, INC. THE AMOUNT OF TIME DEVOTED TO RELATED ORGANIZATIONS IS DEPENDENT UPON THEIR INVOLVEMENT IN THOSE ORGANIZATIONS. AS A RESULT, THE TOTAL AVERAGE HOURS PER WEEK FOR EACH OFFICER AND KEY EMPLOYEES MAY VARY. |
| FORM 990, PART IX, LINE 24E | EDUCATION & DEVELOPMENT: PROGRAM SERVICE EXPENSES 319,653. MANAGEMENT AND GENERAL EXPENSES 103,661. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 423,314. RECRUITMENT: PROGRAM SERVICE EXPENSES 359,751. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 359,751. RECOGNITION: PROGRAM SERVICE EXPENSES 306,885. MANAGEMENT AND GENERAL EXPENSES 4,069. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 310,954. LEGAL SETTLEMENTS: PROGRAM SERVICE EXPENSES 189,009. MANAGEMENT AND GENERAL EXPENSES 47,252. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 236,261. SPEAKER FEES: PROGRAM SERVICE EXPENSES 86,543. MANAGEMENT AND GENERAL EXPENSES 127,225. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 213,768. MEDICAL SUPPLIES: PROGRAM SERVICE EXPENSES 187,768. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 187,768. JCAHO FEES: PROGRAM SERVICE EXPENSES 179,692. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 179,692. LABOR/UNION: PROGRAM SERVICE EXPENSES 136,017. MANAGEMENT AND GENERAL EXPENSES 34,004. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 170,021. CORP CONTINGENCY: PROGRAM SERVICE EXPENSES 97,172. MANAGEMENT AND GENERAL EXPENSES 24,293. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 121,465. CANCER GRANT SCREENINGS: PROGRAM SERVICE EXPENSES 58,254. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,254. CONTINUING EDUCATION: PROGRAM SERVICE EXPENSES 47,187. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,187. LICENSES: PROGRAM SERVICE EXPENSES 2,277. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,277. |
| FORM 990, PART XI, LINE 9: | PENISON ADJUSTMENT -6,365,396. NET ASSET TRANSFER - VIRTUA SURGICAL GROUP -2,699,225. NET ASSET TRANSFER - COMMUNITY NURSING SERVICES -49,624. NET ASSET TRANSFER - VIRTUA RETAIL -639,185. NET ASSET TRANSFER - VHRCMH -596,090. NET ASSET TRANSFER - VMG -17,155,389. NET ASSET TRANSFER - VHRCB 423,707. NET ASSET TRANSFER - SUMMIT ACO -2,434,859. NET ASSET TRANSFER - VHF 10,000. NET ASSET TRANSFER - WJHS -196,054. NET ASSET TRANSFER - MHBC -26,057. NET ASSET TRANSFER - LIFEWELL WT -9,615. NET ASSET TRANSFER - WT FITNESS CENTER -1,818. NET ASSET TRANSFER - MOORESTOWN FITNESS CENTER -2,283. INVESTMENT IN SUB 1,947,606. |
| FORM 990, PART XII , LINE 2C | THE ORGANIZATION HAS AN AUDIT AND COMPLIANCE COMMITTEE TO PROVIDE OVERSIGHT OF VIRTUA HEALTH'S FINANCIAL, OPERATIONAL AND COMPLIANCE EFFORTS WITH QUARTERLY REPORTS TO THE VIRTUA HEALTH BOARD OF TRUSTEES. THE COMMITTEE REVIEWS AND APPROVES FINANCIAL INFORMATION PRESENTED BY THE EXTERNAL AUDITORS, INTERNAL AUDIT PLANS, AND SYSTEMS OF INTERNAL CONTROLS IMPLEMENTED BY MANAGEMENT. THE COMMITTEE IS RESPONSIBLE FOR ENGAGING EXTERNAL AUDITORS. THE COMMITTEE ALSO PROVIDES OVERSIGHT OF VIRTUA HEALTH'S COMPLIANCE PROGRAM. |
| FORM 990, PART V, LN 1A & PART VII SEC B | ALL ACCOUNTS PAYABLE TRANSACTIONS ARE PAID BY VIRTUA - WEST JERSEY HEALTH SYSTEM, INC. (21-0634532) |
| Software ID: | |
| Software Version: |