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)
Renown Health Foundation |
942972749 | Yes | 0 | 1,007,133 | ||
| (B)
Renown Regional Medical Center |
880213754 | Yes | 0 | 56,540,991 | ||
| (C)
Hometown Health Plan Inc |
880231433 | No | 0 | 2,406,913 | ||
| (D)
Renown Network Services |
880231828 | No | 0 | 918,156 | ||
| (E)
Renown South Meadows Medical Center |
460517825 | No | 0 | 9,762,837 | ||
| (F)
Renown Skilled Nursing |
201347269 | No | 0 | 298,103 | ||
Total 6
|
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 I, Line 11g, Column vi: | Renown Health provides centralized management, control, oversight, and other support services for the supported organizations. Amounts reported here are for the allocation of the following services: Administration and payroll for all employees, information resource systems & support, purchasing and procurement of supplies, marketing and communication services, accounting, billing and collection services, insurance and legal services. |
| Schedule A, Part IV, Section A, Line 1: | Two of the six supported organizations are listed by name in the governing documents: Renown Health Foundation and Renown Regional Medical Center. The remaining supported organizations have a historic and continuing relationship with Renown Health. Renown Health is the parent organization within the health system and provides centralized management, control, oversight, and other support services for the system. As the health system has grown, additional entities have been formed to carry out the overall tax-exempt purpose of making a genuine difference in the health and well-being of the people and communities the system serves. Renown Health controls all supported organizations through its power as the sole member to appoint and remove members of the governing body of each supported organization. |
| Schedule A, Part IV, Section A, Line 3b: | Hometown Health Plan is tax-exempt under IRC Section 501(c)(4) and operates a health maintenance organization and health insurance services to commercial enrollees and to those eligible for Medicare through its Medicare Advantage plan Senior Care Plus. Hometown Health Plan has more than 15,000 members in its commercial HMO and more than 17,000 in its Medicare Advantage HMO. Hometown Health Plan satisfies the public support test under section 509(a)(2) by receiving payments for services from its tens-of-thousands of members and by keeping its overall investment income within the required limit. As such, Hometown Health Plan is reported as a 509(a)(2) tax-exempt organization in Schedule A, Part I, Line 11g, column (iii). |
| Schedule A, Part IV, Section A, Line 3c: | Renown Health provides centralized management, control, oversight, and other support services to Hometown Health Plan. Renown Health is the sole member of Hometown Health Plan and through its power as the sole member it appoints and removes members of the governing body of Hometown Health Plan. Through this control and relationship, Renown Health ensures all support provided is used exclusively for charitable purposes. |
| Schedule A, Part IV, Section A, Line 6: | Renown Health also provides centralized management, control, oversight, and other support services to various related for-profit subsidiaries within the health system. Provision of these services furthers the overall tax-exempt purpose of making a genuine difference in the health and well-being of the people and communities the system serves. |
| Schedule A, Part IV, Section D, Line 3: | Renown Health is responsive to the needs and demands of its supported organizations. Each supported organization has officers and directors who also serve as officers and directors of Renown Health. Due to this close and continuous working relationship, the officers and directors of the supported organizations have the ability to influence Renown Health's decisions regarding the use of its income and assets. |
| Schedule A, Part IV, Section E, Line 3a: | Renown Health controls all supported organizations through its power as the sole member to appoint and remove members of the governing body of each supported organization. |
| Schedule A, Part IV, Section E, Line 3b: | Through its power as the sole member and through the continuous working relationship between the organizations, Renown Health exercises substantial direction over the policies, programs, and activities of each of its supported organizations. In addition, Renown Health reserves the authority to approve certain governance decisions of the supported organizations. |
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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 1 | The governing documents allow for an Executive Committee. The Executive Committee consists of the President and CEO of the Corporation, Chairman, Vice Chair, Secretary, and Treasurer and up to 2 "at-large" members of the Board of Directors who are appointed by the Chairman. The Executive Committee shall act in the interval between meetings of the board in emergency or time-sensitive situations. All decisions are submitted for final ratification at the next scheduled board meeting. |
| Form 990, Part VI, Section A, line 2 | Bernard Carter had a business relationship with David Line. Rob Winkel and G. Blake Smith had a business relationship. Anthony Slonim, David Line, Dawn Ahner, Donald Sibery and Allan Hanssen have a business relationship. |
| Form 990, Part VI, Section A, line 3 | Renown Health paid Decisive Consulting Solutions, LLC for Donald Sibery's services as the Interim CEO for all the Renown entities. Renown Health paid $412,000 for fiscal year ending June 30, 2015 for the Interim CEO services and reimbursed travel and business expenses. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared by the organization's tax department with support from a certified tax preparer. The form is reviewed by the organization's current CFO and current EVP and Chief Administrative Officer prior to the final Form 990 being sent to the board. The IRS Form 990, as filed with the IRS, is sent to each voting member of the Renown Health Board prior to filing. Along with the forms, the Renown Health board is provided with a narrative that explains the various parts of the Form and their content. |
| Form 990, Part VI, Section B, line 12c | On an annual basis at or prior to the first regular meeting following the election of new board members, the members of the Renown Health Board are given an Annual Disclosure Statement. They are expected to perform a reasonable investigation into their business, financial, family or significant personal relationships to disclose any actual or potential conflicts of interest. If, in connection with a proposed transaction or arrangement involving a Renown Health entity, a board member discovers that an actual or possible conflict of interest has arisen that was not disclosed on the Annual Statement, then the board member must disclose the existence and nature of his or her financial interests to the remaining directors that are considering the proposed transaction or arrangement in a timely manner. If a board member discloses an actual or possible conflict of interest, the board member shall leave the board or committee meeting while the remaining board members discuss the financial interest. The remaining board members shall vote upon and decide whether a conflict of interest actually exists. If the remaining board members determine that a conflict does exist, then appropriate measures are taken to ensure the issue is addressed. |
| Form 990, Part VI, Section B, line 15a | Renown Health's executive compensation, including compensation for the CEO and certain executives, is reviewed and approved by the Renown Health Executive Committee. All decisions are submitted for final ratification at the next scheduled board meeting. The discussion is documented in the Executive Committee minutes and Board minutes. The Executive Committee is comprised of members of the Renown Health Board of Directors unrelated to and not subject to the control or undue influence of executives, with no material financial interest in transactions of the Company or any other perceived or actual conflicts of interest. Total cash compensation for the organization's executives is targeted at competitive compensation levels, relative to market surveys of comparable healthcare organizations, based upon the level of performance required to achieve the targeted compensation levels. Base compensation and total cash compensation is reviewed at a minimum of every two years in comparison to the surveys for comparable businesses and responsibilities and adjusted as to maintain equity with the survey information. The Executive Committee undertook the process outlined above for the fiscal year 2015 executive compensation. |
| Form 990, Part VI, Section C, line 19 | Renown Health does not make its governing documents, conflict of interest policy, or financial statements available to the general public. |
| Form 990, Part XI, line 9: | Changes in Post Retirement Obligation -1,463,352. Change in Market Value of NSDC Investment 2,748,848. Investment in Subsidiaries 12,802. Intercompany Settlements 89,107,514. NHI Dissolution -39,940,388. |
| Form 990, Part XII, Line 2B, Audit Committee | Renown Health has an audit committee that assumes responsibility for the consolidated audit and selection of the independent accountant. |
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