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.") .... | 132,266 | 338,436 | 360,023 | 301,716 | 377,990 | 1,510,431 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 132,266 | 338,436 | 360,023 | 301,716 | 377,990 | 1,510,431 |
| 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).. | 0 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 1,510,431 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 132,266 | 338,436 | 360,023 | 301,716 | 377,990 | 1,510,431 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 201,734 | 101 | 9,426 | 9,805 | 666 | 221,732 |
| 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.).. | 7,378 | 7,378 | ||||
| 11 | Total support Add lines 7 through 10. | 1,739,541 | |||||
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.") . | 132,266 | 338,436 | 360,023 | 301,716 | 377,990 | 1,510,431 |
| 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...... | 14,911,574 | 14,541,763 | 12,947,802 | 12,020,349 | 13,008,616 | 67,430,104 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 15,043,840 | 14,880,199 | 13,307,825 | 12,322,065 | 13,386,606 | 68,940,535 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support (Subtract line 7c from line 6.) | 68,940,535 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 15,043,840 | 14,880,199 | 13,307,825 | 12,322,065 | 13,386,606 | 68,940,535 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 201,734 | 101 | 9,426 | 9,805 | 666 | 221,732 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 201,734 | 101 | 9,426 | 9,805 | 666 | 221,732 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 7,378 | 7,378 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 15,245,574 | 14,880,300 | 13,317,251 | 12,331,870 | 13,394,650 | 69,169,645 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 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) |
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| 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) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
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 IV 12A | Devereux Cleo Wallace (DCW) is part of the Consolidated Group of the Devereux Foundation (Devereux) and is not audited independently. |
| Form 990 Part VI Section B 11A | Form 990 is provided hard-copy or electronically to all Board of Trustee members, and to the Board of Trustee members of Devereux, DCW's controlling organization, in advance of the filing deadline. Board members are requested to provide comments or questions to the Treasurer. The comments are reviewed by the Treasurer, and where appropriate, changes are made to the Form 990 prior to filing. Additionally, the Treasurer reviews important issues regarding the Form 990 at a designated Board meeting and gives the Board the opportunity to raise any further questions or concerns. The final version of the Form 990 is filed by the May 15 deadline. |
| Form 990 Part VI Section B 12c | DCW has a management contract with Devereux and follows the conflict of interest and governance policies of Devereux. Devereux representatives dealing with clients, parents, guardians, vendors, competitors or anyone who does or seeks to do business with Devereux are to act in Devereux's best interests, excluding any personal preference or advantage. Representatives shall make prompt and full disclosure to his/her manager and to the Internal Audit Department via the Devereux Conflict of Interest form of any prospective or actual situation that involves, may involve, or might appear to involve a conflict of interest. Members of the same family or living within the same domicile may be employed by Devereux in the same center or department unless the center Director or department head finds such employment is not in Devereux's best interest. Relatives of senior management or trustees, as well as those working in Human Resources, Payroll, and Internal Audit shall not be hired by Devereux in any capacity unless approved in advance by the President/CEO. It is the responsibility of each Devereux employee to report any actual or perceived conflicts of interest to management, Human Resources, the Vice President of Audit & Compliance or the Employee Helpline. Annually, a copy of Devereux's business ethics policy is mailed to trustees, officers, directors and key personnel along with the annual Conflict of Interest Disclosure Statement, which must be signed and returned to the Director of Internal Audit within 30 days. The annual disclosure requires an acknowledgement of understanding of Devereux's business ethics policy, as well as disclosure of any conflict, or appearance of a conflict, between personal interests and the interests of Devereux. Failure to comply or falsification of disclosure may result in disciplinary action, including possible dismissal. Newly hired employees in the categories identified above are given this policy on the first day of their employment and are immediately required to complete the annual Conflict of Interest Disclosure Statement. All employees disclosing a conflict or potential conflict must have the Conflict of Interest Disclosure Statement signed by the Executive Director at their location (President/CEO for Corporate staff) prior to sending it to Audit Services. All Annual Conflict of Interest Disclosure Statements identifying a conflict or potential conflict are reviewed by the Vice President of Audit & Compliance and any other officers or senior management determined to be appropriate, and submitted to the Audit & Compliance Committee of the Board of Trustees for review. |
| Form 990 Part VI Section B 15a and b | DCW reviews Executive Directors' salaries against the market on a recurring basis, including a comparison to the Executive Director position at other programs affiliated with Devereux. During this process, the Vice President of Human Resources conducts a review of salaries for benchmark positions for which there is sufficient market survey data. Additionally, Form 990s of other organizations are reviewed. The results of these reviews are compared against all Executive Directors' salaries. The review is intended to make Devereux compensation both reasonable and competitive. The Vice President of Human Resources will make recommendations for adjustments, if necessary. Devereux's market for this salary review is primarily with the health care industry for organizations of our size (budget, number of employees, revenue) and structure (system vs. single entities). However, general industry data as provided by the U.S. Department of Labor or other sources as well as residential and educational surveys that become available or that Devereux may conduct may also be factored into the review. The results of the review conducted are typically validated by an outside compensation consultant at least every 2 years. DCW does not separately compensate its officers. Those officers are all paid by The Devereux Foundation. However, through the Consolidated Organizations' allocation of administrative costs a proportionate amount of those salaries are allocated to DCW. |
| Form 990 Part VI Section C 19 | DCW's Form 990 is available to the public through posting on Guidestar. It is also available upon request. DCW is audited as part of the Consolidated Audit of Devereux. Devereux's Audited Financial Statements are available on its website or upon request. Devereux does not make its conflict of interest policy available to the general public outside of this Form 990. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:650037 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:SUPPLIES TOTAL FEES:489780 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER TOTAL FEES:470472 |
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