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 | |||||
| (A)
CONNECTICUT CHILDREN'S MEDICAL CENTER |
060646755 | Yes | 0 | 0 | ||
| (B)
CONNECTICUT CHILDREN'S MEDICAL CENTER FOUNDATION INC |
222619869 | No | 0 | 0 | ||
| (C)
CCMC AFFILIATES INC |
222619870 | No | 0 | 0 | ||
| (D)
CONNECTICUT CHILDREN'S SPECIALTY GROUP INC |
061446900 | No | 0 | 0 | ||
| (E)
CHILDREN'S HEALTH & DEVELOPMENT INSTITUTE INC |
061504725 | No | 0 | 0 | ||
Total 5
|
0 | |||||
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 |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART IV, SECTION A, QUESTION 1 | CCMC CORPORATION WAS INCORPORATED ON JUNE 1, 1985, AS A NOT-FOR-PROFIT ORGANIZATION UNDER THE NON-STOCK CORPORATION ACT OF THE STATE OF CONNECTICUT. IT IS THE TAX-EXEMPT PARENT ENTITY OF CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CCMC CORPORATION IS THE SOLE MEMBER OF CONNECTICUT CHILDREN'S MEDICAL CENTER ("CONNECTICUT CHILDREN'S"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. CCMC CORPORATION WAS ORGANIZED FOR THE PURPOSE OF BENEFITING, CARRYING OUT THE PURPOSES OF, AND UPHOLDING, PROMOTING AND FURTHERING THE WELFARE, PROGRAMS AND ACTIVITY OF CONNECTICUT CHILDREN'S. IN SECTION 2(A), PURPOSE, OF THE ORGANIZATION'S AMENDED AND RESTATED CERTIFICATE OF INCORPORATION IT STATES THAT THE NATURE OF THE ACTIVITIES TO BE CONDUCTED, OR THE PURPOSES TO BE PROMOTED AND FURTHER THE GOALS, WELFARE, PROGRAMS AND ACTIVITIES OF CONNECTICUT CHILDREN'S. ALL OF CCMC CORPORATION'S SUPPORTED ORGANIZATIONS ARE NOT LISTED BY NAME IN THE ORGANIZATION'S GOVERNING DOCUMENTS. IN ACCORDANCE WITH EACH SUBSIDARY ORGANIZATION'S MISSION, THE PURPOSES OF EACH IS TO SUPPORT THE OVERALL MISSION OF CONNECTICUT CHILDREN'S IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY, IN VARIOUS WAYS. CCMC CORPORATION SUPPORTS ALL OF ITS SUBSIDARIES BY VIRTUE OF THE FACT THAT IT ACTS AS THE PARENT ENTITY OF THE HEALTHCARE SYSTEM AND THE SOLE MEMBER OF CONNECTICUT CHILDRENS. CCMC CORPORATION SUPPORTS ALL AFFILIATES INCLUDED IN SCHEDULE A, PART I, LINE 11G REGARDLESS OF WHETHER THEY ARE INCLUDED IN CCMC CORPORATION'S ORGANIZING DOCUMENTS AS A SUPPORTED ORGANIZATION. |
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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 |
|---|---|
| CORE FORM, PART V, QUESTION 34 | ON JULY 30, 2015 THE GOVERNING BODY OF THIS ORGANIZATION, ITS BOARD OF DIRECTORS, APPROVED THE AMENDEDMENT AND RESTATMENT OF THE ORGANIZATION'S BYLAWS TO ADDRESS THE FOLLOWING: - THE CHAIRMAN OF THE BOARD SHALL BE AN EX-OFFICIO MEMBER OF THE NOMINATING COMMITTEE, FINANCE AND AUDIT COMMITTEE, STRATEGIC PLANNING COMMITTEE, DEVELOPMENT COMMITTEE AND THE MARKETING COMMUNICATIONS AND PUBLIC POLICY COMMITTEE; - THE MARKETING COMMUNICATIONS AND PUBLIC RELATIONS COMMITTEE CHANGED IT'S NAME TO THE MARKETING COMMUNICATIONS AND PUBLIC POLICY COMMITTEE; AND - THE MARKETING COMMUNICATIONS AND PUBLIC POLICY COMMITTEE'S MISSION WAS UPDATED TO STATE THE FOLLOWING: THE COMMITTEE SHALL REPRESENT AND REPORT TO THE BOARD AS FOLLOWS (I) PROVDE ADVICE AND GUIDENCE RELATING TO CONNECTICUT CHILDREN'S MARKETING, PUBLIC RELATIONS AND SOCIAL MEDIA STRATEGIES; (II) PROVIDE ADVICE AND GUIDANCE TO ADVANCE CONNECTICUT CHILDREN'S PUBLIC POLICY PRIORITIES; AND (III) PROVIDE PERSPECTIVE ON THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. |
| CORE FORM, PART IV | THIS ORGANIZATION IS THE TAX-EXEMPT PARENT ENTITY OF CCMC CORPORATION AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CERTAIN BOARD OF DIRECTOR MEMBERS AND OFFICERS INCLUDED ON CORE FORM, PART IV OF THIS FORM 990-EZ MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990-EZ, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS ARE APPROXIMATELY THE SAME AS REFLECTED ON PART IV OF THIS FORM 990-EZ. THE HOURS REFLECTED ON PART IV OF THIS FORM 990-EZ, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY AND PAID OFFICERS, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. AS PER INTERNAL REVENUE SERVICE RULES, REGULATIONS AND INSTRUCTIONS COMPENSATION PAID BY RELATED ORGANIZATIONS TO INDIVIDUALS INCLUDED IN PART IV OF THIS FORM 990-EZ ARE NOT INCLUDED ON THIS FORM 990-EZ. MARTIN J. GAVIN AND PATRICK J. GARVEY, CPA, CHFP, BOTH RECEIVE TAXABLE COMPENSATION, RETIREMENT BENEFITS AND HEALTH AND WELFARE BENEFITS FROM CONNECTICUT CHILDREN'S MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PLEASE REFER TO THE CONNECTICUT CHILDREN'S MEDICAL CENTER FORM 990 FOR THIS INFORMATION. |
| FORM 990EZ PART I LINE 16 | Description:ALLOCATION OF EXECUTIVE COMPENSATION & BENEFITS |
| FORM 990EZ PART I LINE 16 | Description:FROM CONNECTICUT CHILDREN'S FOR TIME DEVOTED |
| FORM 990EZ PART I LINE 16 | Description:TOWARD THIS ORGANIZATION BY THE PRESIDENT/CEO Amount:71691 |
| FORM 990EZ PART I LINE 20 | Description:TRANSFER FROM CCMC Amount:909390 |
| FORM 990EZ PART II LINE 24 | Description:OTHER ASSETS BOY Amount:1000 EOY Amount:1000 |
| FORM 990EZ PART II LINE 24 | Description:DUE FROM AFFILIATED ENTITIES BOY Amount:EOY Amount:434326 |
| FORM 990EZ PART II LINE 26 | Description:DUE TO AFFILIATED ENTITIES BOY Amount:432734 EOY Amount: |
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