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.) .... | 974,885 | 1,113,170 | 1,656,126 | 1,838,598 | 5,121,572 | 10,704,351 |
| 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 | 974,885 | 1,113,170 | 1,656,126 | 1,838,598 | 5,121,572 | 10,704,351 |
| 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).. | 1,048,742 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 9,655,609 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 974,885 | 1,113,170 | 1,656,126 | 1,838,598 | 5,121,572 | 10,704,351 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 11,433 | 6,108 | 4,966 | 3,913 | 6,835 | 33,255 |
| 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.).. | 0 | |||||
| 11 | Total support. Add lines 7 through 10. | 10,737,606 | |||||
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) |
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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) |
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| 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): |
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| 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 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 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) |
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| 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 III, LINE 2 | SEE PART III, LINE 4A. |
| FORM 990, PART VI, LINE 1A | AS A RESULT OF THE MERGER OF THE FOUNDATION WITH THE CHILDREN'S HOSPITAL FOUNDATION AT WMC, INC., THE VOTING BOARD MEMBERS INCREASED FROM SIXTEEN TO TWENTY FIVE MEMBERS WITH FOUR EX-OFFICIO, NON-voting members. |
| FORM 990, PART VI, line 4 | THE BOARD APPrOVED REVISED BYLAWS ATTRIBUTABLE TO THE MERGER OF THE TWO FOUNDATIONS, WMC'S TAKEOVER OF SAINT FRANCIS HOSPITAL AND OTHER NEW PROPOSED CHANGES TO THE BYLAWS. THE SIGNIFICANT CHANGES TO THE FOUNDATION'S BYLAWS ARE AS FOLLOWS: A) INCREASING THE MAXIMUM NUMBER OF VOTING TRUSTEES FROM THIRTY TO FIFTY, B) MAKING LIFE TRUSTEES NON-VOTING, C) ELIMINATING TERMS FOR LIFE TRUSTEES, D) ABILITY TO FORM AD-HOC COMMITTEES, AND E) INCLUSION OF THE MOST RECENT NON-PROFIT LAWS GOVERNING NON-PROFITS. |
| FORM 990, PART vi, line 6 | DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS THE SOLE MEMBER OF THE FOUNDATION IS WESTCHESTER COUNTY HEALTH CARE CORPORATION (WCHCC). |
| FORM 990, PART VI, Line 7A | ELECTION OF THE GOVERNING BODY THE MEMBER (WCHCC) SHALL ELECT THE TRUSTEES FROM AMONG THOSE PERSONS NOMINATED BY THE NONINATING COMMITTEE AND APPROVED BY THE THE BOARD OF TRUSTEES (FROM ARTICLE III SECTION 3.3 OF THE BYLAWS). |
| FORM 990, PART VI, Line 7B | DECISIONS OF THE GOVERNING BOARD THE MEMBER (WCHCC) HAS THE FOLLOWING RESERVED POWERS (SECTION 2.2 OF THE BYLAWS: A) APPROVE POLICIES, B) ELECT AND REMOVE TRUSTEES OF THE FOUNDATION, C) AUTHORIZE AMENDMENTS TO CERTIFICATE OF INCORPORATION AND BYLAWS OF THE FOUNDATION, D) APPROVE AFFILIATION AGREEMENTS, E) APPROVE STRATEGIC AND BUSINESS PLANS, F) APPROVE BUDGETS, G) APPROVE FOUNDATION INVESTMENT POLICIES, H) AUTHORIZE THE FOUNDATION'S PARTICIPATION IN OTHER BUSINESS VENTURES, I) AUTHORIZE THE FOUNDATION'S ORGANIZATION OR FORMATION OF A NEW SUBSIDIARY OR JOINT VENTURE, J) AUTHORIZE THE INCURRENCE OF DEBT, K) APPROVE FOUNDATION'S FRINGE BENEFIT PLANS, L) APPROVE ACCOUNTING POLICIES AND APPOINT OUTSIDE AUDITOR, M) AUTHORIZE ANY VOTE BY THE FOUNDATION IN ITS SUBSIDIARIES OR AFFILIATES, AND N) THE POWER TO APPROVE THE FOUNDATION'S DONOR RECOGNITION LEVELS AND NAMING OF ANY PART OF THE MEMBER'S FACILITIES. FORM 990, PART VI, Lines 8A & 8B GOVERNANCE/NOMINATING COMMITTEE SHALL NOMINATE PERSONS FOR ELECTION AS TRUSTEES OF THE FOUNDATION BY THE MEMBER AND FOR ELECTION OF OFFICERS OF THE FOUNDATION BY THE BOARD OF TRUSTEES. THE COMMITTEE SHALL ALSO PERFORM THE FOLLOWING DUTIES: (ARTICLE IV, SECTION 4.2, PART B OF THE BYLAWS): A) REVIEW, ASSESS AND REPORT TO THE BOARD OF TRUSTEES ON THE GOVERNANCE OF THE FOUNDATION, INCLUDING BUT NOT LIMITED TO, MATTERS RELATED TO THE PERFORMANCE, AND COMPOSITION OF THE BOARD OF TRUSTEES AND ITS STANDING AND SPECIAL COMMITTEES, B) ESTABLISH GOALS AND OBJECTIVES FOR THE BOARD OF TRUSTEES FOR EACH YEAR AND CONDUCT A REVIEW AND ASSESSMENT, C) REVIEW AND REPORT, AT LEAST ANNUALLY, ON THE ACTUAL FUNCTIONING OF THE BOARD OF TRUSTEES, AND D) DEVELOP, IN CONJUNCTION WITH MANAGEMENT, AN ORIENTATION CURRICULUM FOR NEW MEMBERS AND A CONTINUING EDUCATION PROGRAM FOR EXISTING BOARD OF TRUSTEES. THE GOVERNANCE/NOMINATING COMMITTEE SHALL MEET AT LEAST TWICE EACH YEAR AT THE CALL OF THE CHAIR. FINANCE COMMITTEE SHALL REVIEW AND RECOMMEND ANNUAL OPERATING BUDGET TO THE BOARD OF TRUSTEES FOR APPROVAL. THE COMMITTEE CHAIRMAN SHALL REVIEW THE FOUNDATION'S FISCAL STATEMENTS MONTHLY AND REPORT THEM TO THE BOARD. IT SHALL CONSIDER ALL INVESTMENTS AND MATTERS PERTAINING THERETO AND MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES, INCLUDING RECOMMENDATIONS FOR THE ADOPTION AND ANNUAL REVIEW OF AN INVESTMENT POLICY. THE FINANCE COMMITTEE MAY MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES REGARDING DELEGATION OF THE MANAGEMENT OF FOUNDATION ASSETS TO A DISCRETIONARY REGISTERED INVESTMENT ADVISOR(S). THE FINANCE COMMITTEE SHALL REVIEW, AS APPROPRIATE, THE FINANCIAL IMPLICATIONS AND FEASIBILITY OF ANY RECOMMENDATIONS OF THE VARIOUS COMMITTEES OF the BOARD PRIOR TO THEIR PRESENTATION TO THE BOARD. (ARTICLE IV SECTION 4.2 PART C OF THE BYLAWS). THE FINANCE COMMITTEE SHALL MEET AT LEAST QUARTERLY AT THE CALL OF THE CHAIR OF THE COMMITTEE. THE AUDIT COMMITTEE SHALL PERFORM SUCH DUTIES CONSISTENT WITH THE CUSTOMARY AND USUAL ACTIVITIES OF SUCH COMMITTEES IN ENTITIES OF A SIMILAR SIZE AND CHARACTER, INCLUDING, BUT NOT LIMITED TO THE FOLLOWING (ARTICLE IV SECTION 4.2 PART D OF THE BYLAWS): A) INQUIRE INTO THE EXISTENCE AND USE OF INTERNAL POLICIES, PROCEDURES AND CONTROLS WITH RESPECT TO BOTH CASH AND NON-CASH ASSETS OF THE FOUNDATION, B) ASSESS WHETHER SIGNIFICANT RISKS OR EXPOSURES EXIST, WHICH COULD RESULT IN LOSS OR LIABILITY TO THE FOUNDATION, C) REVIEW ANY PUBLIC OFFERING STATEMENT, FINANCIAL STATEMENT, TAX RETURN OR OTHER PUBLISHED REPRESENTATION OR PUBLIC FILING OR REPORT, D) RECOMMEND TO THE BOARD OF TRUSTEES THE SELECTION OF A FIRM TO SERVE AS THE FOUNDATION'S EXTERNAL AUDITORS, E) MEET WITH THE EXTERNAL AUDITORS ENGAGED BY THE BOARD OF TRUSTEES AT THE COMMENCEMENT OF THE ANNUAL AUDIT TO DISCUSS THE SCOPE AND CONDUCT OF SUCH AUDIT AND AGAIN AT THE COMPLETION OF THE ANNUAL AUDIT TO DISCUSS THE FINDINGS, RESULTS AND MANAGEMENT LETTER, AND F) PERFORM SUCH OTHER FUNCTIONS, POWERS AND DUTIES AS MAY, FROM TIME TO TIME, BE REFERRED TO THE AUDIT COMMITTEE BY THE BOARD OF TRUSTEES. THE AUDIT COMMITTEE SHALL MEET AT LEAST QUARTERLY UPON THE CALL OF THE CHAIR. |
| FORM 990, PART VI, Line 11B | DESCRIBE PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW 990 THE 990 IS REVIEWED BY THE FOLLOWING EMPLOYEES OF WCHCC, THE PARENT ENTITY, CONCURRENTLY: THE VP OF FINANCE, THE SVP OF FINANCIAL OPERATIONS, THE CORPORATE COMPLIANCE OFFICER, THE CORPORATION'S INTERNAL GENERAL COUNSEL AND EXECUTIVE VP AND THE OFFICERS WHO SIGN THE FORM 990. |
| FORM 990, PART VI, Line 12C | DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST IN 2008, A CORPORATE-WIDE CONFLICT OF INTEREST POLICY WAS ADOPTED AND INCLUDES ALL RELATED ORGANIZATIONS. THIS POLICY IS MONITORED AND ENFORCED THROUGH REVIEW OF THE DISCLOSURES TO IDENTIFY ANY POTENTIAL OR ACTUAL CONFLICTS. DEPENDING ON THE REVIEW, A COMMITTEE MEETS TO DISCUSS IF THE CONFLICT CAN BE MANAGED OR if THE MEMBERs NEED TO MAKE A CHOICE IN ORDER TO ELIMINATE THE CONFLICT. THE POLICY IS INCLUDED IN OUR ONLINE POLICIES AND PROCEDURES SYSTEM CALLED ELLUCID. |
| FORM 990, PART VI, line 19 | EXPLANATION OF HOW ORGANIZATION MAKES GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENTS AVAILABLE TO THE PUBLIC ORGANIZATION PROVIDES INFORMATION at own website and UPON REQUEST. |
| FORM 990, PART VII, SECTION A | THE FOLLOWING INDIVIDUALs SERVE AS EX-OFFICIO MEMBERs OF THE BOARD OF TRUSTEES. SINCE THE MEMBER SERVES EX-OFFICIO, WITHOUT VOTE, THE MEMBER IS NOT LISTED AS A TRUSTEE IN PART VII: EDWARD LEBOVICS MD, RENEE GARRICK MD, MICHAEL GEWITZ MD AND PAUL HOCHENBERG. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS Net ASSET TRANSFER FROM CHILDREN'S HOSPITAL FOUNDATION - $11,659,010 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING FEES TOTAL FEES:463955 |
| Software ID: | |
| Software Version: |