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) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
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 |
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| 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 A, line 2 | Richard Bielen serves with Mr. Warren on the Board of Directors of a local insurance company. However, the Hospital has no material transactions with this insurance company. Thomas N. Carruthers, Jr. is counsel in a firm which acts as general counsel for the Hospital as well as counsel to the Obligated Group and Bond counsel. Mitchell Cohen has admitting privileges to the Hospital, is the chairman of the UAB Department of Pediatrics which has an affiliation agreement with the Hospital to provide certain medical services, and is a committee member for the capital campaign for Ronald McDonald House. Derrol Dawkins, M.D. has admitting privileges to the Hospital. William E. Horton is an executive of a bank that is an underwriter and that currently provides the majority of the banking services to the Hospital. Donald M. James is a director of a bank which was an underwriter for the Hospital bonds. Mr. James is also a director for the parent company of an electric utility that provides utility services to the Hospital. In addition, Mr. James is a director for UAB Health System and UAB Health Services Foundation, both of which have an affiliation agreement to provide medical services to the Hospital. He is also an officer of a local construction company of which Mr. Hall & Mr. Styslinger serve on the board. However, the Hospital has no transactions w/ this company. James C. Lee, III is the owner of a company that provides vending services to the Hospital. Charles D. McCrary serves as a Board member for a bank that was an underwriter and that currently provides the majority of the banking services to the Hospital. W. Jerry Oakes, M.D. occupied the Dan Hendley endowed chair, which is funded by the Foundation. Margaret M. Porter is a member of an advisory board for a bank that was an underwriter and that currently provides the majority of the banking services to the Hospital. Stuart A. Royal, M.D. occupied the Harry Burns endowed chair which was funded by The Foundation. Ben Russell is the founder and chairman of the board of a non-profit organization that leases space from the Hospital to provide family service activities to patients and their families. Lee J. Styslinger, III serves as a board member for a bank that is an underwriter and that currently provides the majority of the banking services to the Hospital. The Hospital believes that all business with such firms and businesses is conducted on terms and conditions no less favorable to the Hospital than that with unrelated third parties. |
| Form 990, Part VI, Section B, line 11 | THE COMPLETED FORM 990 IS REVIEWED IN DETAIL BY THE FINANCE AND AUDIT COMMITTEE, AS WELL AS THE BOARD OF TRUSTEES, PRIOR TO FILING THE RETURN. |
| Form 990, Part VI, Section B, line 12c | The Corporate Compliance Officer is responsible for monitoring compliance with the Conflict of Interest Policy. Annual disclosure requests are sent and followed up on to ensure that all are returned. Returned conflict of interest statements are reviewed by the Corporate Compliance Officer and Compliance department staff as well as officers of the organization for accuracy and completeness. Conflict of interest statements are maintained by the compliance department. The compliance officer reports activity related to any potential conflicts of interest, including changes in previously reported conflicts to administration, the Compliance Committee, the Finance & Audit Committee, and the Board of Trustees on a regular basis. |
| Form 990, Part VI, Section B, line 15 | The Hospital maintains oversight concerning all executive compensation action. This process is led by the Hospital Board of Trustees Compensation Committee, which is involved annually, and throughout the year as needed, in providing oversight of all Executive compensation. Total compensation (i.e., base salary, incentive compensation, and executive benefits) of Officers, key employees, and other vice-presidents is approved by the Compensation Committee prior to such compensation being paid. The total compensation that is presented for approval is determined by evaluation of market data comparisons on executive total compensation. This independent, objective market data is provided by the Hospital's independent executive compensation consulting firm, Mercer. All Compensation Committee proceedings, decisions, and actions are documented in Committee minutes that are maintained by the Hospital. |
| Form 990, Part VI, Section C, line 19 | THE CONFLICT OF INTEREST POLICY IS SUMMARIZED IN THE CORPORATE CODE OF CONDUCT WHICH IS AVAILABLE ON THE HOSPITAL'S WEBSITE. THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT GENERALLY AVAILABLE TO THE PUBLIC. |
| Form 990, Part IX, line 11g | Other: Program service expenses 80,413,130. Management and general expenses 8,934,792. Fundraising expenses 0. Total expenses 89,347,922. |
| Form 990, Part IX, line 24e | MANAGEMENT CONTRACTS: Program service expenses 10,718,664. Management and general expenses 1,190,963. Fundraising expenses 0. Total expenses 11,909,627. EQUIPMENT RENTAL AND MAINTENANCE: Program service expenses 10,063,625. Management and general expenses 1,118,181. Fundraising expenses 0. Total expenses 11,181,806. MISCELLANEOUS EXPENSE: Program service expenses 8,019,201. Management and general expenses 891,020. Fundraising expenses 0. Total expenses 8,910,221. MAINTENANCE: Program service expenses 5,882,014. Management and general expenses 653,557. Fundraising expenses 0. Total expenses 6,535,571. BAD DEBT EXPENSE: Program service expenses 5,211,535. Management and general expenses 579,059. Fundraising expenses 0. Total expenses 5,790,594. EQUIPMENT RELATED SUPPLIES: Program service expenses 4,831,782. Management and general expenses 536,865. Fundraising expenses 0. Total expenses 5,368,647. CONTRACT LABOR: Program service expenses 4,387,566. Management and general expenses 487,507. Fundraising expenses 0. Total expenses 4,875,073. CONSULTING FEES: Program service expenses 3,616,605. Management and general expenses 401,845. Fundraising expenses 0. Total expenses 4,018,450. TRANSPORTATION: Program service expenses 3,119,328. Management and general expenses 346,592. Fundraising expenses 0. Total expenses 3,465,920. MINOR MEDICAL EQUIPMENT: Program service expenses 2,912,552. Management and general expenses 323,617. Fundraising expenses 0. Total expenses 3,236,169. SUPPLIES: Program service expenses 1,895,970. Management and general expenses 210,663. Fundraising expenses 0. Total expenses 2,106,633. TELEPHONE: Program service expenses 1,849,168. Management and general expenses 205,463. Fundraising expenses 0. Total expenses 2,054,631. PROFESSIONAL DUES: Program service expenses 1,561,780. Management and general expenses 173,531. Fundraising expenses 0. Total expenses 1,735,311. BILLING EXPENSE: Program service expenses 747,941. Management and general expenses 83,105. Fundraising expenses 0. Total expenses 831,046. BANKING FEES: Program service expenses 623,852. Management and general expenses 69,317. Fundraising expenses 0. Total expenses 693,169. SUBSCRIPTIONS AND PUBLICATIONS: Program service expenses 540,903. Management and general expenses 60,100. Fundraising expenses 0. Total expenses 601,003. REGISTRATION FEES: Program service expenses 517,984. Management and general expenses 57,554. Fundraising expenses 0. Total expenses 575,538. PRINTING AND PUBLICATIONS: Program service expenses 417,099. Management and general expenses 46,344. Fundraising expenses 0. Total expenses 463,443. COLLECTION FEES: Program service expenses 387,902. Management and general expenses 43,100. Fundraising expenses 0. Total expenses 431,002. POSTAGE AND SHIPPING: Program service expenses 310,543. Management and general expenses 34,505. Fundraising expenses 0. Total expenses 345,048. Interpreting and Translation Expense: Program service expenses 281,149. Management and general expenses 31,239. Fundraising expenses 0. Total expenses 312,388. LODGING: Program service expenses 272,934. Management and general expenses 30,326. Fundraising expenses 0. Total expenses 303,260. MEALS: Program service expenses 263,916. Management and general expenses 29,324. Fundraising expenses 0. Total expenses 293,240. NOVELTIES: Program service expenses 203,486. Management and general expenses 22,610. Fundraising expenses 0. Total expenses 226,096. SPECIAL FUNCTIONS: Program service expenses 188,629. Management and general expenses 20,959. Fundraising expenses 0. Total expenses 209,588. Gift shop expenses: Program service expenses 148,548. Management and general expenses 16,505. Fundraising expenses 0. Total expenses 165,053. RECOGNITIONS: Program service expenses 110,542. Management and general expenses 12,282. Fundraising expenses 0. Total expenses 122,824. TELETHON EXPENSE: Program service expenses 703. Management and general expenses 78. Fundraising expenses 0. Total expenses 781. |
| Form 990, Part XI, line 9: | TRANSFER TO ALABAMA CHILDREN'S HOSPITAL FOUNDATION -1,247,294. |
| FORM 990, PART XI, LINE 2C: | THE HOSPITAL MADE NO CHANGES TO ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. |
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| Software Version: |