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. | 0 | |||||
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... | 0 | |||||
| 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.) | 0 | |||||
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 |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 15000272 |
| 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 |
|---|---|
| Pt VI, Line 19 | The Organization provides the 990 to the Finance Committee of the Board of Directors for an independent review. Any questions or concerns are addressed prior to the 990 being filed. Prior to filing, a copy of the completed 990 is provided to the Board of Directors. |
| Pt VI, Line 7a | The Center of Special Care, Inc. is the parent and sole member of the Hospital For Special Care. As such, it approves the appointment of all new members of the Hospital's Board |
| Pt VI, Line 7b | The Center of Special Care, Inc. is the parent and sole member of the Hospital For Special Care. As such, it has final approval over all strategic and Financial Decisions of the made by the Hospitals Board. |
| Pt VI, Line 12c | The Organization requires all officers, directors, managers, and other key employees to complete a conflict of interest statement annually. Every year the statement is presented to those individuals required to complete the form and completion of the form is monitored to ensure compliance. |
| Pt VI, Line 15a | The process for determining the compensation for the organization's CEO, Officers, and key employees is as follows. The organization utilizes a compensation committee consisting entirely of independent members of the Board of Director. Annually, the committee is given recommendations from an independent consultant regarding the compensation of those employees indentified above. The committee has the sole discretion to accept or revise the recommendations of the consultant in setting the compensation of the previously identified employees. |
| Pt VI, Line 19 | The organization makes its financial statements and other operating data available to the general public in its required continuing disclosure on its outstanding municipal debt. These filings have been made to the nationally recognized municpal securities information repositories as mandated by the SEC. All of these filings have been available to the general public for review. In addition, the organization makes its governing documents and conflict of interest policies available to the public upon request. |
| Pt III, Line 2 | In December of 2015 the Hospital opened an eight bed Autism Inpatient unit. The Autism In-patient Unit is established to reduce instances of Emergency Room visits for individuals ages 10 to 21 experiencing the most acute and complex Autism Spectrum Disorder (ASD) and co-occurring psychiatric disorders. |
| Pt VI, Line 15b | The process for determinig the compensation for the organization's CEO, Officers, and key employees is as follows. The organization utilizes a compensation committee consisting entirely of independent members of the Board of Director. Annually, the committee is given recommendations from an idependent consultant regarding the compensation of those employees indentified above. The committee has the sole discretion to accept or revise the recommendations of the consultant in setting the compensation of the previously identified employees. |
| Pt VI, Line 6 | HOSPITAL FOR SPECIAL CARE'S SOLE MEMBER IS THE CENTER OF SPEACIAL CARE, INC. CENTER OF SPECIAL CARE, INC. IS THE PARENT ORGANIZATION OF HOSPITAL FOR HOSPITAL FOR SPECIAL CARE, SPECIAL CARE AND ALL ITS RELATED SUBSIDIARIES. |
| Pt VI, Line 11b | THE ORGANIZATION PROVIDES THE 990 TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR AN INDEPENDENT REVIEW. ANY QUESTIONS OR CONCERNS ARE ADDRESSED PRIOR TO THE 990 BEING FILED. PRIOR TO FILING, A COPY OF THE COMPLETED IS PROVIDED TO THE BOARD OF DIRECTORS. |
| Pt XI | Line 9 change in Equity to affliates |
| Form 990, Part III, Line 4d | OUTPATIENT REHABILITATION SERVICES: INCLUDE MULTIDISCIPLINARY SERVICES TO MEET THE NEEDS 10847502. 0 |
| Form 990, Part III, Line 4d | DESIGNED TO CONSIDER ALL OF THE VARIABLES THAT AFFECT A PATIENT'S ABILITY TO MEET HIS/HER 0. 0. 0. |
| Form 990, Part III, Line 4d | CENTER WITH THE LATEST CARDIOVASCULAR AND STRENGTH TRAINING EQUIPMENT. 0. 0. 0. |
| Form 990, Part III, Line 4d | UCHC0-HSC MUSCLE & NERVE BIOPSY SERVICE, REHABILITATION SERVICES 0. 0. 0. |
| Form 990, Part III, Line 4d | ALSO OFFERS OUTPATIENT PULMONARY REHABILITATION PROGRAM IT HELP PERSONS 0. 0. 0. |
| Form 990, Part III, Line 4d | MODERATE TO VERY SEVERE COPD(CHRONIC OBSTRUCTIVE PULMONARY DISEASE) 0. 0. 0. |
| Form 990, Part III, Line 4d | INVOLVED IN THE LIFE OF THE CHILD. THESE SERVICES MAY BE CONTRACTED 0. 0. 0. |
| Form 990, Part III, Line 4d | THERAPY PROGRAMS FEATURE THE LEE SILVERMAN VOICE TREATMENT 0. 0. 0. |
| Form 990, Part III, Line 4d | PROGRESSIVE RESISTANCE TRAINING TO IMPROVE TONGUE STRENGTH 0. 0. 0. |
| Form 990, Part III, Line 4d | INPATIENT CARE: SATELLITE UNIT/HARTFORD LOCATION IS A 23-BED UNIT 13378999. 0. 16714603. |
| Form 990, Part III, Line 4d | PROCEDURES, BUT WHO CONTINUE TO REQUIRE 24-HR NURSING 0. 0. 0. |
| Form 990, Part III, Line 4d | INPATIENT SERVICES: IN FY 2016 HSC OPENED AN 8 BED INPATIENT 711457. 0. 568259. |
| Software ID: | 15000272 |
| Software Version: |