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)
ARKANSAS CHILDREN'S HOSPITAL |
710236857 | Yes | 0 | 0 | ||
Total 1
|
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. |
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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 7A | THE BOARD OF DIRECTORS OF ACHRI ARE ELECTED BY THE BOARD OF DIRECTORS OF ARKANSAS CHILDREN'S HOSPITAL, WHO ALSO RETAIN THE POWER TO REMOVE ANY OR ALL OF THE ACHRI BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 2: ALTHOUGH NOT CONSIDERED COVERED RELATIONSHIPS AS NOTED IN PART VI, SECTION A, LINE 2, THE FOLLOWING DIRECTORS WERE ALL EMPLOYEES OF THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS) DURING THE TAX YEAR: RICHARD JACOBS, M.D.; DANIEL RAHN, M.D.; JOSE ROMERO, M.D.; KARTIK SHANKAR, PH.D.; AND RICHARD SMITH, M.D. |
| FORM 990, PART VI, SECTION A, LINE 7B | ANY CHANGES TO ACHRI'S ARTICLES OF INCORPORATION MUST BE RATIFIED BY THE ARKANSAS CHILDREN'S HOSPITAL BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE DRAFT FORM 990, WHICH IS RECONCILED TO THE ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE'S (ACHRI) INTERNAL FINANCIAL STATEMENTS AND THE ARKANSAS CHILDREN'S HOSPITAL CONSOLIDATED AUDIT REPORT, IS INITIALLY REVIEWED IN DETAIL WITH ACHRI'S PRESIDENT AND VICE PRESIDENT. THE DRAFT IS ALSO REVIEWED IN DETAIL WITH BOTH THE SVP/CFO AND THE VP OF FINANCIAL OPERATIONS OF ARKANSAS CHILDREN'S HOSPITAL. IF THE REVIEW BY ACHRI'S MANAGEMENT RESULTS IN REVISIONS TO THE DRAFT FORM 990, THOSE REVISIONS ARE MADE, AND THE FORM 990 TO BE FILED IS PROVIDED TO THE ACHRI BOARD OF DIRECTORS PRIOR TO THE RETURN BEING FILED. IN ADDITION, THE FORM 990 IS PROVIDED TO BOTH THE CHAIRMAN OF THE BOARD AND THE TREASURER OF ARKANSAS CHILDREN'S HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL DISCLOSURE OF CONFLICTS IS REQUIRED OF ALL BOARD MEMBERS IN ACCORDANCE WITH THE ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY. THE ANNUAL DISCLOSURES ARE REVIEWED AND APPROVED BY A MAJORITY OF THE DISINTERESTED DIRECTORS OF THE ACHRI EXECUTIVE COMMITTEE. DISCLOSURES ARE ALSO RECEIVED BY BOTH THE SVP/CFO AND VP OF FINANCIAL OPERATIONS OF ARKANSAS CHILDREN'S HOSPITAL FOR REPORTING PURPOSES. DURING THE YEAR, WHILE BOARD MEMBERS MAY PARTICIPATE IN INITIAL DISCUSSIONS, BOARD MEMBERS WHO HAVE A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISIONS IN THE RELATED TRANSACTION AND ABSTAIN FROM VOTING, WHICH IS NOTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR THE TAX YEAR 2014 (FISCAL YEAR 2015), THE ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE'S (ACHRI) PRESIDENT WAS AN EMPLOYEE OF THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS) AND COMPENSATION FOR HIS ROLE AS THE ACHRI PRESIDENT WAS PAID THROUGH A CONTRACT WITH UAMS. HIS COMPENSATION, PRIMARILY BASED ON NATIONAL BENCHMARKING DATA, WAS INITIALLY DETERMINED BY UAMS AND SUBSEQUENTLY REVIEWED BY THE ACHRI EXECUTIVE COMMITTEE BEFORE RENEWING THE ANNUAL CONTRACT. COMPENSATION FOR ANY ACHRI SENIOR OFFICER (PRESIDENT; SENIOR VICE PRESIDENT) WHO IS NOT A CONTRACTED UAMS EMPLOYEE IS REVIEWED BY THE ARKANSAS CHILDREN'S HOSPITAL BOARD COMPENSATION COMMITTEE WHICH IS ESTABLISHED THROUGH THE BYLAWS OF ARKANSAS CHILDREN'S HOSPITAL TO DISCHARGE THE DUTY OF THE BOARD IN FULFILLING ITS OVERSIGHT RESPONSIBILITIES FOR DETERMINING THE ADEQUACY AND REASONABLENESS OF THE COMPENSATION PAID THE CEO AND OTHER EMPLOYEES THAT THE COMMITTEE BELIEVES ARE IN A POSITION TO EXERCISE A SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE HOSPITAL AND ITS RELATED ORGANIZATIONS. THE COMMITTEE IS COMPOSED OF MEMBERS WHO PERSONALLY RECEIVE NO COMPENSATION, FEES, OR OTHER BENEFITS FROM THE HOSPITAL OR RELATED ORGANIZATIONS. THE COMMITTEE MAY RELY UPON REASONED WRITTEN OPINIONS OF QUALIFIED LEGAL, ACCOUNTING, VALUATION AND EXECUTIVE COMPENSATION EXPERTS. THE COMMITTEE HAS THE SOLE AUTHORITY TO RETAIN AND TERMINATE ANY SPECIAL ADVISORS USED TO ASSIST IN THE EVALUATION OF COMPENSATION. THE COMMITTEE CONTEMPORANEOUSLY, WITH MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION OF DISQUALIFIED PERSONS, DOCUMENTS IN A WRITTEN REPORT TO THE EXECUTIVE COMMITTEE AND THE BOARD, THE BASIS FOR ITS DECISIONS. SALARY RANGES FOR THE NOTED POSITIONS WERE REVIEWED IN DETAIL WITH EXTERNAL COMPENSATION CONSULTANTS IN A PRIOR FISCAL YEAR. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE'S FORM 990 AND FORM 990-T ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AS REQUIRED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AS REQUIRED. |
| FORM 990, PART VI, SECTION A, LINE 1: | DURING THE INTERVALS BETWEEN THE MEETINGS OF THE ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE (ACHRI) BOARD OF DIRECTORS, THE ACHRI EXECUTIVE COMMITTEE POSSESSES AND EXERCISES ALL POWERS AND FUNCTIONS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT AND DIRECTION OF THE AFFAIRS OF ACHRI IN ALL CASES IN WHICH SPECIFIC DIRECTION HAS NOT BEEN GIVEN BY THE BOARD OF DIRECTORS. ALL ACTIONS BY THE EXECUTIVE COMMITTEE ARE REPORTED TO THE BOARD OF DIRECTORS AT ITS NEXT MEETING SUCCEEDING SUCH ACTION. THE EXECUTIVE COMMITTEE IS COMPRISED OF THE FOLLOWING: THE CHAIRMAN OF THE ACHRI BOARD OF DIRECTORS, THE CHAIRMAN OF THE DEPARTMENT OF PEDIATRICS AT UAMS, THE CHIEF EXECUTIVE OFFICER OF ARKANSAS CHILDREN'S HOSPITAL, AND THE DEAN OF THE UAMS COLLEGE OF MEDICINE, THE ACHRI PRESIDENT SERVES AS A NONVOTING MEMBER. IF ONE PERSON HOLDS MORE THAN ONE OF THESE POSITIONS, HE/SHE WILL HAVE ONLY ONE VOTE ON THE COMMITTEE. |
| FORM 990, PART XII, LINE 3B: | THE CONSOLIDATED ORGANIZATION IS REQUIRED TO UNDERGO AN AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AND DID UNDERGO THAT REQUIRED AUDIT. |
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