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 | |||||
| Total | ||||||
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 |
|---|
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| SCH E, PART I, LINE 3 | RACIALLY NONDISCRIMINATORY POLICY --------------------------------- ON AN ANNUAL BASIS, A NEWS RELEASE IS PUBLISHED WITH THE LOCAL NEWSPAPER AND THE LOCAL HEALTH DEPARTMENT DESCRIBING THE ORGANIZATION'S NONDISCRIMINATORY POLICY. |
| SCH E, PART I, LINE 6A | GOVERNMENTAL AID OR ASSISTANCE ------------------------------ THE ORGANIZATION RECEIVES ASSISTANCE FROM THE FEDERAL CACSP AND KY CHILD CARE ASSISTANCE PROGRAM. |
| 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 | PROCESS TO REVIEW FORM 990 -------------------------- COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12B AND 12C | MONITORING THE CONFLICT OF INTEREST POLICY ------------------------------------------ Annually, Board of Directors, Senior Leadership and Medical Staff Leaders complete a conflict of interest questionnaire. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY GENERAL COUNSEL AND Ephraim McDowell's CORPORATE COMPLIANCE OFFICER. The completed questionnaires are reviewed by the Senior Leadership and the Corporate Compliance officer. The Chairman of the Board of Directors is made aware of conflicts which have been disclosed on annual statements. If conflicts exist, the conflict is disclosed and the individual with the conflict does not participate or vote on activities where a conflict of interest is present. |
| FORM 990, PART VI, SECTION B, LINE 15A AND 15B | PROCESS FOR DETERMINING COMPENSATION ------------------------------------ A CHILDREN'S PLACE IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS EPHRAIM MCDOWELL HEALTH, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEeN AND COORDINATED THROUGH EPHRAIM MCDOWELL HEALTH, INC. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW AND PROVIDED MARKET DATA IN 2015 FOR ESTABLISHING REASONABLE COMPENSATION OF OFFICERS AND KEY EMPLOYEES FOR THE SYSTEM. THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE EPHRAIM MCDOWELL HEALTH, INC. BOARD OF DIRECTORS. THE DECISION AND PROCESS IS DOCUMENTED BY THE COMMITTEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | MAKING FORMS AVAILABLE TO THE PUBLIC ------------------------------------ THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART V, LINE 2A | COMMON PAYMASTER ---------------- EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS THE COMMON PAYMASTER FOR JOHN HILL BAILEY CHILDREN'S LEARNING CENTER. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 61-0492356. |
| FORM 990, PART III, LINE 4 | PROGRAM SERVICE ACCOMPLISHMENTS ------------------------------- A Children's Place (ACP), a service of Ephraim McDowell Health since 1992, is a handicapped accessible early learning and development center that provides year-round care to a monthly average (FY15) of 151 children, from age 6 weeks through 10 years old; Monday through Friday from 6:00am to 6:00pm. This service has contributed to Ephraim McDowell Health's longstanding programmatic efforts to positively influence childhood obesity and related risk factors. Approximately 107 families from Anderson, Boyle, Casey, Fayette, Mercer, Lincoln and Pulaski counties utilize ACP services, including some children with special needs. Children's programs are organized into three divisional units--Infants and Toddlers, Early Childhood, and School-age Child Care, maximizing age appropriate services throughout the continuum of development. Approximately 24 families using ACP services receive child care assistance and all receive free (23) or reduced cost (1) benefits. To ensure the children comprising this at risk age group receive proper nutrition, breakfast, lunch and an afternoon snack are provided to all of the children. Age appropriate activities are part of their daily routine to ensure the children stay active and that the benefits of physical activity are reinforced at all ages. Infant/Toddler Unit ------------------- The Infant/Toddler Unit includes two nurseries and individual, age-based classrooms. The activities in each classroom vary according to the developmental levels of the children. Staff members use activities such as singing, reading, crafts, art and the introduction of colors to focus on the child's physical, intellectual, emotional and social development. Infants in the Nursery I classroom spend most of their day eating and sleeping, according to each child's needs. When the children are awake, staff members interact with them and make them feel comforted and loved. The Nursery II classroom adapts schedules to the children's needs but introduce more activities to stimulate their interest. Toddlers and older children begin a structured schedule that includes creative activities, exercise, singing, reading, identifying colors and numbers, and practicing the letters of the alphabet. Early Childhood Unit -------------------- The Early Childhood Unit has separate classrooms for children ages 3 - 5. In each room the curriculum focuses on preparing each child socially and academically for starting school. Each teacher organizes and follows a monthly lesson plan. Activities include reading a daily calendar that introduces the days of the week and the months of the year. Staff members also review colors, numbers and the letters of the alphabet. Activity centers utilize blocks, puzzles, art and other creative play activities to encourage children to socialize and play with each other at scheduled times as well as during free play time. School-Age Child Care Program ----------------------------- The School-Age Child Care Program is for children age 6 - 10 years old. Services are available both before and after school, and all-day services are available during the summer, school holidays and school cancellation days. After school, the children are allowed a period of time to unwind from the structured school environment. Activities are planned each day as well as time scheduled where students may choose from several centers of learning, including a science center, a dramatic play area or a center of puzzles and games. A homework area is also available, and group projects are planned regularly. Summer programs follow a specific theme each year, and include activities and weekly field trips. Parents are engaged in their child's care and development through direct access to their child's caregiver, special events and activities. Parent/Teacher conferences are readily available in addition to normal daily communications. Activities such as the Mother's Day Brunch, Donuts with Daddy, Grandparent's Day Brunch, the Preschool Graduation Ceremony, Winter Programs, and the Easter Egg Hunt, all encourage active participation and engagement in the child's care and development. More formalized feedback is provided through the Parent Satisfaction Surveys. The center's services are more than day-care services to the community's youth. A Children's Place is a 2 star member of the "STARS for KIDS NOW" program, Kentucky's voluntary quality rating system for licensed Type I and Type II child care centers and certified family child care homes. "STARS for KIDS NOW" represents a collaborative effort to ensure that young children in Kentucky are in early care and education settings that are seeking ever-increasing quality. All STAR programs surpass the minimum licensing requirements that all programs must meet--early care and education programs target quality care that result in positive outcomes for young children. STAR programs are assessed according to staff/child ratios, group size, curriculum, parent involvement, training/education of staff, regulatory compliance, and personnel practices. The 2 STAR designation attained by the ACP program demonstrates the commitment to providing quality care and educational opportunities to the children served. * Staff members are trained and must meet annual competency certification standards. * Children receive personalized attention in an enthusiastic learning environment. * Many staff members are trained as certified Child Development Associates. * Children are provided with age- specific learning environments - an Infant/Toddler Unit, an Early Childhood Unit or a School-Age Child Care program. * Every classroom has appropriate child-size restroom facilities, furniture and indoor and outdoor equipment. * Children enjoy structured activities and free play that encourage imagination, creativity, problem solving and early learning - all designed to foster age-specific development. These standards and protocols exhibit Ephraim McDowell Health's commitment to providing high quality services to the families in our service area. Through the 2 STAR designation, ACP is eligible for technical assistance through the Quality Enhancement Initiative, assistance with staff training and education which is offered through the Early Childhood Development Scholarship Program, and cash STAR Achievement Awards. |
| FORM 990, PART VI, SECTION A, LINE 6 & 7A | MEMBERS OF THE ORGANIZATION --------------------------- EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF JOHN HILL BAILEY CHILDREN'S LEARNING CENTER, INC. EPHRAIM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF JOHN HILL BAILEY CHILDREN'S LEARNING CENTER, INC. ON AN ANNUAL BASIS. |
| FORM 990, PART VII, SECTION A | PART-YEAR OFFICERS ------------------ BILL DEMROW SERVED ON THE BOARD AS VICE CHAIRMAN UNTIL MARCH 2015 WITH ALLEN WHITE REPLACING HIM THROUGH THE REST OF THE YEAR. |
| Software ID: | |
| Software Version: |