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 | |||||
| Total | ||||||
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 |
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| Return Reference | Explanation |
|---|
| Software ID: | 15000352 |
| Software Version: | v1.00 |
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 1 | Our mission at East Jefferson General Hospital, a nonprofit community health system is to provide personalized and dependable health care and health related services to individuals, physicians and businesses consistent with quality medical and ethical standards to improve the health status of those we serve in the east bank of Jefferson Parish and surrounding communities. We practice a holistic approach to health care that recognizes each person's need for physical, emotional, and spiritual well-being. We deliver our care to all races, creeds, nationalities, sexes, ages, and socio-economic groups. In pursuing our mission, we commit to these guiding principles: 1) To deliver quality care and services at a price which represents value to our customers; 2) To uphold the basic rights and responsibilities of patients and to encourage active participation in their care; 3) To work in harmony with physicians, recognizing our mutual responsibility to meet the needs of our patients; 4) To treat each other, as members of the EJGH family, with fairness and dignity and to strive to achieve the highest level of personal growth and development in an atmosphere that recognizes creativity and innovation; 5) To fulfill our civic responsibility by participating in community activities and by supporting local commerce as a major employer and health resource; and 6) To manage, individually and collectively, our time, equipment and supplies to assure fulfillment of our mission. All revenues generated by the Hospital are in furtherance of our exempt purpose. In addition, EJGH provides a free and below cost care program on its own, ambulance service at no charge, various contributions to parish programs such as prison medical unit, community education, comprehensive early detection programs, facilities for various community groups, and numerous other services to the community. The program service revenue generated allows us to provide quality, dependable health care in our community. |
| Form 990, Part VI, Section A, Line 1a | EJGH has 10 positions on it's governing board. As of December 31, 2015, one position remainied vacant due to the death of a member of the Board of Directors. |
| Form 990, Part VI, Section A, Line 7a | Members of the Jefferson Parish Council appoint or approve each of the 10 members of the Board of Directors. |
| Form 990, Part VI, Section A, Line 7b | The Jefferson Parish Council shall, by ordinance or resolution, enter into all contracts with all architects, engineers and contractors in connection with plant alterations of or additions to the hospital, provided, however, that nothing herein to the contrary shall prevent the board from recommending to the council the engagement of an architect, engineer or contractor for the performance of professional services as defined in the code of the Parish, so long as such recommendation is in accordance with the Parish contract procedures set forth in the code or ordinance; and the Jefferson Parish Council shall by ordinance or resolution, enter into contracts for special counsel, financial consultants, economic or financial managers for and/or involving the hospital, investment teams in conjunction with any bond issue of the hospital, and investment managers for the hospital provided however, that the Board may select and execute contracts with consultants as it deems appropriate; and each insurance policy governing the Hospital, its properties and activities shall comply with the requirements of the program of insurance adopted by the Jefferson Parish Council; and the Board may, with the approval of the Jefferson Parish Council, enter into such contracts and agreements with the United States of America or with Louisiana or any state or any agency or instrumentality thereof necessary to procure aids or grants to assist in carrying out the purposes of the Board; and any agreement, memorandum of understanding, and/or contract that binds the Hospital to any future action, the effect of which shall constitute a merger, sale or consolidation of the Hospital and its property and/or equipment or that would effect a similar change in the operations of the Hospital shall require the prior approval of the Jefferson Parish Council. |
| Form 990, Part VI, Section B, Line 11b | The Form 990 was distributed to member of the Board of Directors for questions and comments prior to filing of the form. The return was submitted for ratification by the Board at the first meeting of the Directors following the filing deadline. |
| Form 990, Part VI, Section B, Line 12c | EJGH requires board members and officers of the organization to complete a conflict of interest form on an annual basis. The form is monitored, updated, and revised on a yearly basis by the internal auditor. Monitoring and enforcing the conflict of interest statement is performed by the internal auditing department. They monitor the statements and enforce the rules related to the conflict of interest statements. |
| Form 990, Part VI, Section B, Line 15 | EJGH's Human Resources department conducts comparability surveys on a periodic basis and uses third-party independent data to set levels of the all top managers and key employees. The results of the process are presented to the Board of Directors which determines the appropriate level of compensation for the Chief Executive Officer. All other officers and key employees are not presented to the Board, but follow the same process for determining reasonableness. Surveys were last performed in July, 2011. |
| Form 990, Part VI, Section C, Line 19 | EJGH makes its governing documents, conflict of interest policy, and financial statements available to the public on a request basis. When a request is made for one or more of the above policies, they are provided to the individual making the request. |
| Form 990, Part IX, Line 11g | Other Fees for Service (non-employees) include the following: Contract Labor $2,280,364 (Program Services - $1,824,291; Management & General - $456,073) / Medical Director Fees $1,116,946 (Program Services - $1,116,946; Management & General - $0) / Purchased Medical Services $16,706,928 (Program Services - $16,706,928; Management & General - $0) / Maintenance Contracts $3,110,286 (Program Services - $2,488,229; Management & General - $622,057) / Rental Expenses $1,763,386 (Program Services - $1,410,709; Management & General - $352,677) /Purchased Services $20,865,374 (Program Services - $16,684,299; Management & General - $4,171,075) / Utilities $4,279,043 (Program Services - $3,423,234; Management & General - $855,809) / Intergovernmental Transfers $13,088,198 (Program Services - $13,088,198; Management & General - $0) / Other $2,035,345 (Program Services - $1,628,276; Management & General - $407,069) / |
| Form 990, Part XI, Line 9 | Other changes in Net Asset is comprised of Tranfers to Jefferson Parish $-1,323,011 and the adoption of GASB No. 68 $-29,082,781 . |
| Software ID: | 15000352 |
| Software Version: | v1.00 |