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 | |||||
| (A)
Adventist Health SystemSunbelt Inc |
591479658 | 3 | Yes | 78,100 | 0 | |
| Total 1 | 78,100 | 0 | ||||
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 | 0 | 0 | ||
| 2 | Recoveries of prior-year distributions | 2 | 0 | 0 | ||
| 3 | Other gross income (see instructions) | 3 | 56,516 | 52,706 | ||
| 4 | Add lines 1 through 3 | 4 | 56,516 | 52,706 | ||
| 5 | Depreciation and depletion | 5 | 0 | 0 | ||
| 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 | 0 | 0 | ||
| 7 | Other expenses (see instructions) | 7 | 109,750 | 113,433 | ||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | -53,234 | -60,727 | ||
| 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 | 2,001,000 | 2,001,000 | ||
| b | Average monthly cash balances | 1b | 263,880 | 209,825 | ||
| c | Fair market value of other non-exempt-use assets | 1c | 0 | 0 | ||
| d | Total (add lines 1a, 1b, and 1c) | 1d | 2,264,880 | 2,210,825 | ||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): 0 |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | 0 | 0 | ||
| 3 | Subtract line 2 from line 1d | 3 | 2,264,880 | 2,210,825 | ||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | 33,973 | 33,162 | ||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | 2,230,907 | 2,177,663 | ||
| 6 | Multiply line 5 by .035 | 6 | 78,082 | 76,218 | ||
| 7 | Recoveries of prior-year distributions | 7 | 0 | 0 | ||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | 78,082 | 76,218 | ||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | -53,234 | |||
| 2 | Enter 85% of line 1 | 2 | -45,249 | |||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | 78,082 | |||
| 4 | Enter greater of line 2 or line 3 | 4 | 78,082 | |||
| 5 | Income tax imposed in prior year | 5 | 0 | |||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | 78,082 | |||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 78,100 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
0 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 0 | |
| 4 Amounts paid to acquire exempt-use assets | 0 | |
| 5 Qualified set-aside amounts (prior IRS approval required) | 0 | |
| 6 Other distributions (describe in Part VI). See instructions | 0 | |
| 7Total annual distributions. Add lines 1 through 6. | 78,100 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
78,100 | |
| 9 Distributable amount for 2015 from Section C, line 6 | 78,082 | |
| 10 Line 8 amount divided by Line 9 amount | 100.0 % | |
| 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 |
78,082 | |||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
0 | |||
| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013.......0 | ||||
| e From 2014.......0 | ||||
| fTotal of lines 3a through e | 0 | |||
| g Applied to underdistributions of prior years | 0 | |||
| h Applied to 2015 distributable amount | 0 | |||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | 0 | |||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ 78,100 | ||||
| a Applied to underdistributions of prior years | 0 | |||
| b Applied to 2015 distributable amount | 78,082 | |||
| c Remainder. Subtract lines 4a and 4b from 4. | 18 | |||
|
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) |
0 | |||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
0 | |||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
18 | |||
| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013.......0 | ||||
| d From 2014.......0 | ||||
| e From 2015.......18 | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part IV, Section D, Line 3: | The Board of South Central, Inc., (the Taxpayer) has establish the investment policy for the company. One member of the Board from the supported organization, Adventist Health System Sunbelt Inc., (AHSSI) is also a member of the Board of the Taxpayer and thus has the opportunity to participate in establishing and reviewing the investment policy. The Taxpayer's investment policy has been discussed with the CFO of AHSSI and he has not suggested any changes. |
| Schedule A, Part V, Section D, Line 8: | Adventist Health System Sunbelt Healthcare Corporation (AHSSHC) is the parent organization of a health system known as Adventist Health System (AHS). AHSSHC is an organization exempt from federal income tax under IRS Section 501(c)(3). AHSSHC and its subsidiary organizations, including Adventist Health System Sunbelt, Inc. (AHSSI), operate 44 hospitals in 10 states throughout the U.S., primarily in the Southeastern portion of the U.S. AHSSHC and its subsidiaries also operate 16 nursing home facilities and other ancillary health care provider facilities, such as ambulatory surgery centers and diagnostic imaging centers. Throughout its existence, South Central Inc. (the Taxpayer), and its subsidiary organizations have held and managed medical office buildings on the campuses of AHSSHC subsidiaries and owned and leased nursing home facilities to nursing home operating subsidiaries of AHSSHC. Additionally, the Taxpayer and its subsidiaries have played a role in other financial transactions within AHS. The Taxpayer and its subsidiary organizations have held tens of millions of dollars of assets used in providing healthcare services in the communities served by AHS. Because of the critical role of the assets provided by the Taxpayer, AHSSI and other operating subsidiaries of AHSSHC have always been aware of and attentive to the operations of the Taxpayer. The assets currently under the management of the Taxpayer are significant enough to AHSSI and its related operating organizations that AHSSI will continue to monitor the management of those assets. The Taxpayer has demonstrated its responsiveness to its supported organizations over its existence through the proper management of the real property that it held through subsidiaries and the conservative investment of excess funds for the purpose of financing the operating activities of AHSSI and its related operating affiliates. |
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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 VI, Section A, line 4 | South Central, Inc., (the Taxpayer) has maintained a close and continuous relationship with Adventist Health System Sunbelt, Inc., (AHSSI) since its inception in 2000. During 2015, the Taxpayer amended its Articles of Incorporation to list Adventist Health System Sunbelt, Inc. as the supported organization. |
| Form 990, Part VI, Section A, line 6 | South Central, Inc. (the filing organization) is a member corporation. The individuals comprising the Board of Directors constitute the membership of the filing organization. |
| Form 990, Part VI, Section A, line 7a | The members of the filing organization have the right to elect, appoint or remove any member of the Board of Directors of the filing organization. |
| Form 990, Part VI, Section A, line 7b | The individuals constituting the Board of Directors of the filing organization are also the members of the filing organization. Accordingly, decisions made by the governing body automatically constitute decisions also made by the membership. |
| Form 990, Part VI, Section B, line 11 | The filing organization's Form 990 was reviewed by the President prior to its filing with the IRS. The review conducted by the President did not include the review of any supporting workpapers that were used in preparation of the Form 990, but did include a review of the entire Form 990 and all supporting schedules. |
| Form 990, Part VI, Section B, line 12c | The Conflict of Interest Policy of the filing organization applies to members of its Board of Directors and its principal officers (to be known as Interested Persons). In connection with any actual or possible conflict of interests, any member of the Board of Directors of the filing organization or any principal officer of the filing organization (i.e. Interested Persons) must disclose the existence of any financial interest with the filing organization and must be given the opportunity to disclose all material facts concerning the financial interest/arrangement to the Board of Directors of the filing organization or to any members of a committee with board delegated powers that is considering the proposed transaction or arrangement. Subsequent to any disclosure of any financial interest/arrangement and all material facts, and after any discussion with the relevant Board member or principal officer, the remaining members of the Board of Directors or committee with board delegated powers shall discuss, analyze, and vote upon the potential financial interest/arrangement to determine if a conflict of interest exists. According to the filing organization's Conflict of Interest Policy, an Interested Person may make a presentation to the Board of Directors (or committee with board delegated powers), but after such presentation, shall leave the meeting during the discussion of, and the vote on, the transaction or arrangement that results in a conflict of interest. Each Interested Person, as defined under the filing organization's Conflict of Interest Policy, shall annually sign a statement which affirms that such person has received a copy of the Conflict of Interests policy, has read and understands the policy, has agreed to comply with the policy, and understands that the filing organization is a charitable organization that must primarily engage in activities which accomplish one or more of its exempt purposes. The filing organization's Conflict of Interest Policy also requires that periodic reviews shall be conducted to ensure that the filing organization operates in a manner consistent with its charitable purposes. |
| Form 990, Part VI, Section C, line 19 | The financial statements, governing documents and conflict of interest policy of the filing organization are not generally made available to the public. |
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