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.) .... | 4,873,601 | 7,151,105 | 5,124,332 | 42,208,674 | 5,045,401 | 64,403,113 |
| 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 | 4,873,601 | 7,151,105 | 5,124,332 | 42,208,674 | 5,045,401 | 64,403,113 |
| 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. | 64,403,113 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 4,873,601 | 7,151,105 | 5,124,332 | 42,208,674 | 5,045,401 | 64,403,113 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 833,894 | 2,955,245 | 1,529,676 | 1,851,982 | 930,416 | 8,101,213 |
| 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.).. | 342,667 | 449,194 | 456,849 | 660,642 | 695,414 | 2,604,766 |
| 11 | Total support. Add lines 7 through 10. | 75,109,092 | |||||
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) |
||||
| 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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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1 AND PART III, LINE 1 TO SOLICIT, MAINTAIN & ENHANCE THE VALUE OF PUBLIC CONTRIBUTIONS TO PROVIDE FINANCIAL SUPPORT TO WOMEN & CHILDREN'S HOSPITAL OF BUFFALO IN THEIR MISSION TO DELIVER UNPARALLELED PEDIATRIC AND WOMEN'S HEALTHCARE SERVICES. WITH SUPPORT FROM ITS BOARD OF DIRECTORS AND MANY OTHER VOLUNTEERS, THE ORGANIZATION RAISES GIFTS IN THE FORM OF CASH, STOCKS, ESTATE GIFTS, CORPORATE GIFTS, AND GRANTS FROM PRIVATE FOUNDATIONS. |
| ORGANIZATION'S MOST SIGNIFICANT ACTIVITIES | FORM 990, PART III, LINE 4A HEALTH SERVICES AND SPECIALIZED PEDIATRIC HOSPITAL SITE THAT IS A DIVISION OF KALEIDA HEALTH BY PROVIDING FUNDING FOR PATIENT CARE, EDUCATION AND RESEARCH. THE PRIMARY PROGRAMS AND ACTIVITIES OF THE ORGANIZATION INCLUDE: 1. FESTIVAL OF TREES - THE 68TH ANNUAL BLACK-TIE AND THE MAIN EVENT IN SUPPORT OF WOMEN & CHILDREN'S HOSPITAL OF BUFFALO, SYMBOLIZES THE BOND BETWEEN THE HOSPITAL AND THE COMMUNITY THAT IT SERVES. THE TOTALLY VOLUNTEER DRIVEN EVENT HAS RAISED OVER $7 MILLION WITH THE 2015 YEAR'S PROCEEDS BEING UTILIZED TO BENEFIT THE JOHN R. OISHEI CHILDREN'S HOSPITAL. OVER 750 GUESTS ATTENDED THE FESTIVAL GALA. NO CHILD IS EVER TURNED AWAY FROM WOMEN & CHILDREN'S HOSPITAL, WHERE EVERY FAMILY IS ENTITLED TO THE VERY BEST CARE NO MATTER THEIR ABILITY TO PAY. 2. KISS CARE FOR KIDS RADIOTHON AIRS ANNUALLY IN MAY ON WKSE-FM RADIO AND KISS 98.5 TO BENEFIT WOMEN & CHILDREN'S HOSPITAL. BROADCASTING LIVE FROM THE WOMEN & CHILDREN'S HOSPITAL, KISS 98.5 MORNING SHOW HOSTS INVITE LISTENERS TO PLEDGE DONATIONS BY CALLING PHONE LINES STAFFED BY VOLUNTEERS FROM A VARIETY OF PROMINENT WNY BUSINESSES. THE KISS CARE FOR KIDS RADIOTHON IS COORDINATED WITH THE CHILDREN'S MIRACLE NETWORK, A NON-PROFIT ORGANIZATION DEDICATED TO HELPING KIDS BY RAISING FUNDS FOR LOCAL CHILDREN'S HOSPITALS ACROSS NORTH AMERICA. ONE HUNDRED PERCENT OF THE PROCEEDS GENERATED DURING THE RADIOTHON BENEFIT WOMEN & CHILDREN'S HOSPITAL OF BUFFALO. DURING ITS 15 YEAR HISTORY THE RADIOTHON HAS RAISED OVER $3.4 MILLION IN PLEDGES. 3. KICKING FOR MIRACLES - AN EVENT HELD IN SEPTEMBER EACH YEAR SPONSORED BY MASTER CHONG'S TAE KWON DO SCHOOLS WITH HOURS OF EXCITING DEMONSTRATIONS AND BOARD BREAKING EXCITEMENT. THIS CREATIVE AND FUN FILLED ENTERTAINMENT, THE NATION'S LARGEST TYPE OF SUCH AN EVENT IN THE NATION, INSTILLS THE IMPORTANCE OF COMMUNITY INTO THE YOUNG STUDENTS OF MASTER CHONG'S TAE KWON DO SCHOOLS. IN THE PAST 21 YEARS, MASTER CHONG AND HIS GROUP HAVE RAISED OVER $1,000,000 TO BENEFIT THE SICK AND INJURED CHILDREN OF WESTERN NEW YORK. IT IS ONE OF THE UNIQUE FUNDRAISERS IN ITS' BASIC CONCEPT OF KIDS RAISING MONEY FOR KIDS. 4. PRO-AM GOLF TOURNAMENT - A GOLF TOURNAMENT HELD ANNUALLY IN JUNE TO RAISE FUNDS TO SUPPORT THE MISSION OF WOMEN AND CHILDREN'S HOSPITAL OF BUFFALO. IN 2015 PROCEEDS WERE DIRECTED TO HELP COMPLETE THE BUILDING OF THE JOHN R. OISHEI CHILDREN'S HOSPITAL. TOURNAMENT SPONSORS RECEIVE GOLF, MEALS AND GOLF-RELATED PRIZES IN EXCHANGE FOR THEIR CONTRIBUTION. DURING THE EVENT, TICKETS ARE ALSO SOLD ALLOWING ATTENDEES A CHANCE TO WIN VARIOUS DONATED ITEMS, INCREASING THE PROCEEDS OF THE EVENT. 116 GOLFERS PARTICIPATED IN THE 2015 EVENT. THE EVENT KICKS OFF WITH A PRE-EVENT AUCTION AT A LOCAL RESTAURANT WHICH FEATURES A TICKET AUCTION AND LIVE AUCTION FOR GUESTS. A PAID TICKET IS REQUIRED FOR ADMISSION. 5. THE BARBIE EVENT - IS HOSTED BY TWIG, A VOLUNTEER ORGANIZATION OF WOMEN AND CHILDREN'S HOSPITAL. THE 2015 THEME WAS "GET YOUR SPARKLE ON." THE EVENT IS UNDERWRITTEN BY MATTEL / FISHER PRICE AND TICKETS ARE SOLD FOR THE EVENT. NEARLY 100 SCHOOL AGE GIRLS PARTICIPATED IN INTERACTIVE ACTIVITIES WITH "BARBIE" INCLUDING A NAIL SALON, DRAWING STATION, LEARN TO DANCE AND A SHOPPING BOUTIQUE JUST FOR GIRLS. EACH CHILD HAS HER PICTURE TAKEN WITH BARBIE DURING LUNCH AND PARTICIPATES IN A TICKET AUCTION OF "EVERYTHING BARBIE." 100 ADULTS WERE ALSO IN ATTENDANCE. 6. CELEBRATION BY THE SHORE - IS AN EVENT HELD IN JULY AT A PRIVATE RESIDENCE WHICH FEATURES WINE TASTINGS AND EXCEPTIONAL FOOD DISPLAYS. THE EVENT IS HELD OUTDOORS AND INCLUDES A NATIONAL DANCE BAND. A LIVE AUCTION IS HELD TO MAXIMIZE THE DONATION IN SUPPORT OF THE CAMPAIGN TO COMPLETE THE JOHN R. OISHEI CHILDREN'S HOSPITAL. THIS IS A TICKETED EVENT. |
| ORGANIZATION'S MEMBER & MEMBER RIGHTS | FORM 990, PART VI, SECTION A, QUESTION 6, 7A, & 7B PART VI, SECTION A, QUESTION 6 - THE ORGANIZATION IS A MEMBER (NOT A STOCK) CORPORATION UNDER THE NEW YORK STATE LAW, THE ORGANIZATION'S SOLE CORPORATION MEMBER IS KALEIDA HEALTH, A RELATED NOT-FOR-PROFIT CORPORATION. PART VI, SECTION A, QUESTION 7A - IN ACCORDANCE WITH THE TERMS AND REQUIREMENTS OF ITS GOVERNING DOCUMENTS (I.E. BYLAWS), ON AN ANNUAL BASIS THE ORGANIZATION'S CURRENT BOARD MEMBERS RECOMMEND THE LIST OF CANDIDATES FOR MEMBERSHIP TO THE GOVERNING BODY FOR THE SUBSEQUENT TERM TO THE KALEIDA BOARD OF DIRECTORS. THE KALEIDA BOARD OF DIRECTORS APPROVE AND ELECT THESE CANDIDATES TO SERVE AS THE ORGANIZATIONS BOARD OF DIRECTORS. PART VI, SECTION A, QUESTION 7B - KALEIDA HEALTH, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY INCLUDING THE AMENDMENT OF BYLAWS AND CHARTERS, REMOVAL OF MEMBERS OF THE GOVERNING BODY AND THE DECISION TO DISSOLVE THE ORGANIZATION. |
| REVIEW PROCESS FOR FORM 990 | FORM 990, PART VI, SECTION B, QUESTION 11B ORGANIZATION'S MANAGEMENT, IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, KPMG LLP, REVIEW THE FORM 990. THE FINANCIAL REVIEW IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOR THE RELEVANT TIME PERIOD. BEFORE THE 990 IS FILED WITH THE IRS THE EXECUTIVE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE FORM 990 AND PROVIDES A COPY OF THE SAME TO THE ORGANIZATION'S FULL BOARD OF DIRECTORS. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C UPON EMPLOYMENT AND ANNUALLY THEREAFTER EACH KEY EMPLOYEE AND BOARD MEMBER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, PROVIDING SUFFICENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THE ORGANIZATION CAN (1) DETERMINE WHETHER ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST MAY EXIST, AND (2) MONITOR WORK OR SERVICE ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE, OFFICER OR DIRECTOR IN A POSITION WHERE THERE MAY BE AN APPEARANCE, POTENTIAL OR ACTUAL, OF A CONFLICT OF INTEREST OR A QUESTION OF OBJECTIVITY. THE COMPLETED CONFLICT OF INTEREST FORMS AND DISCLOSURE FORMS ARE RETURNED TO THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, QUESTIONS 15A & 15B | ON A REGULAR BASIS, THE ORGANIZATION PROVIDES DOCUMENTATION TO THE COMPENSATION COMMITTEE OF THE BOARD OF KALEIDA HEALTH (THE FILING ORGANIZATION'S SOLE CORPORATE MEMBER) WITH RESPECT TO THE COMPENSATION OF THE ORGANIZATION'S KEY EMPLOYEE FOR REVIEW AND APPROVAL. SUCH INFORMATION INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX EXEMPT ORGANIZATIONS IN THE WESTERN NEW YORK COMMUNITY AS WELL AS COMPENSATION FOR THIS POSITION WITH OTHER FOUNDATIONS THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. |
| ACCESS TO ORGANIZATIONAL DOCUMENTS | FORM 990, PART VI, SECTION C, QUESTION 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE OFFICES OF KALEIDA HEALTH (THE FILING ORGANIZATION'S SOLE CORPORATE MEMBER) AT 726 EXCHANGE STREET, SUITE 200, BUFFALO, NY 14120. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. |
| UNRELATED BUSINESS INCOME | KALEIDA HEALTH, THE ENTITY'S PARENT, MAINTAINS A MASTER INVESTMENT ACCOUNT THAT HOLDS ALL OF ITS SEPERATE SUBSIDIARY INVESTMENTS. KALEIDA HEALTH REPORTS ANY UNRELATED BUSINESS INCOME RESULTING FROM INVESTMENTS IN LIMITED PARTNERSHIPS HELD FOR THE BENEFIT OF THE WOMEN & CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION ON ITS 990-T. |
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