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.") .... | ||||||
| 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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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) 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.") . | 1,741,363 | 1,944,599 | 1,804,347 | 1,973,596 | 1,800,360 | 9,264,265 |
| 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...... | 25,454,054 | 26,940,547 | 24,274,049 | 19,611,446 | 17,588,906 | 113,869,002 |
| 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. | 27,195,417 | 28,885,146 | 26,078,396 | 21,585,042 | 19,389,266 | 123,133,267 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 1,375,507 | 1,491,780 | 1,105,282 | 1,243,881 | 1,272,000 | 6,488,450 |
| 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.. | 1,375,507 | 1,491,780 | 1,105,282 | 1,243,881 | 1,272,000 | 6,488,450 |
| 8 | Public support (Subtract line 7c from line 6.) | 116,644,817 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 27,195,417 | 28,885,146 | 26,078,396 | 21,585,042 | 19,389,266 | 123,133,267 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 120,807 | 36,604 | 52,141 | 70,542 | 153,364 | 433,458 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 120,807 | 36,604 | 52,141 | 70,542 | 153,364 | 433,458 |
| 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.) .. | 2,028 | 39,799 | 834 | 3,940,924 | 13,222 | 3,996,807 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 27,318,252 | 28,961,549 | 26,131,371 | 25,596,508 | 19,555,852 | 127,563,532 |
| 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 | ||||
| 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) |
||||
| 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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| 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 I, LINE 1 AND PART III, LINE 1 | ST. FRANCIS COMMUNITY HEALTH SERVICES (SFCHS), A SUBSIDIARY OF ST. FRANCIS HEALTHCARE SYSTEM OF HAWAII, PROVIDES COMMUNITY-BASED CARE TO MEET THE PHYSICAL, SPIRITUAL, AND PSYCHOSOCIAL NEEDS OF CLIENTS AND PATIENTS STATEWIDE. THE SISTERS OF ST. FRANCIS INTRODUCED MANY OF THESE FIRST-TO-MARKET HEALTHCARE PROGRAMS IN THE STATE OF HAWAII. AS PART OF ST. FRANCIS HEALTHCARE SYSTEM OF HAWAII, ST. FRANCIS COMMUNITY HEALTH SERVICES CARRIES ON THE LEGACY OF ST. MARIANNE COPE AND THE SISTERS OF ST. FRANCIS, WHO CAME TO THE ISLANDS IN 1883 TO CARE FOR THOSE AFFLICTED WITH HANSEN'S DISEASE. ST. FRANCIS COMMUNITY HEALTH SERVICES SERVES ALL THOSE IN NEED, INCLUDING THE MOST VULNERABLE, AND OFFERS CHARITY CARE FOR THOSE IN NEED OF FINANCIAL ASSISTANCE TO CARRY ON THE HEALTHCARE SYSTEM'S MISSION OF CREATING HEALTHY COMMUNITIES IN THE SPIRIT OF CHRIST'S HEALING MINISTRY. |
| FORM 990, PART III, LINE 3 | EFFECTIVE SEPTEMBER 30, 2014 AND JUNE 30, 2014, ST. FRANCIS COMMUNITY HEALTH SERVICES TERMINATED ITS HOSPICE - WEST AND HOME CARE SERVICES, RESPECTIVELY, PROGRAMS AS PART OF ITS FUTURE PLAN TO FOCUS ON ITS EXISTING PROGRAMS AND TO THE DEVELOPMENT OF ADDITIONAL PROGRAMS IN PROVIDING SPECIALIZED NURSING CARE. OPERATING RESULTS FOR THE HOME CARE SERVICES PROGRAM ARE CLASSIFIED AS DISCONTINUED OPERATIONS IN PART VIII AND PART IX. |
| FORM 990, PART VI, SECTION A, LINE 1 | PURSUANT TO THE BYLAWS, THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL HAVE THE AUTHORITY TO BIND ST. FRANCIS COMMUNITY HEALTH SERVICES (CHS) IN ALL MATTERS RELATING TO THE REGULAR BUSINESS OF CHS DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY LIMITATIONS IMPOSED BY THE BOARD OF DIRECTORS, AND WITH UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE WILL BE REFERRED TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE CORPORATE MEMBER OF ST. FRANCIS COMMUNITY HEALTH SERVICES IS ST. FRANCIS HEALTHCARE SYSTEM OF HAWAII. |
| FORM 990, PART VI, SECTION A, LINE 7A | ST. FRANCIS HEALTHCARE SYSTEM OF HAWAII, AS THE SOLE CORPORATE MEMBER, APPROVES THE APPOINTMENT OF THE DIRECTORS OF ST. FRANCIS COMMUNITY HEALTH SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 7B | ST. FRANCIS HEALTHCARE SYSTEM OF HAWAII, AS THE SOLE CORPORATE MEMBER, HAS THE FOLLOWING POWERS RESERVED TO APPROVE THE FOLLOWING: A) ANY CHANGE IN THE PHILOSOPHY, MISSION, AND/OR PURPOSE OF THE CORPORATION; B) THE ADOPTION AND/OR AMENDMENT OF THE ARTICLES OF INCORPORATION; C) THE ADOPTION AND/OR AMENDMENT OF THE BYLAWS; D) THE APPOINTMENT OF DIRECTORS OF THE BOARD, AND REMOVAL OF DIRECTORS WITH OR WITHOUT CAUSE; E) APPOINT THE PRESIDENT OF THE CORPORATION; F) APPOINT THE CHIEF EXECUTIVE; G) APPROVE OR DISAPPROVE ANY SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS AND/OR SERVICES, OR ANY MERGER, CONSOLIDATION, REORGANIZATION, DIVESTING TRANSACTION OR ANY SIMILAR TRANSACTION REGARDING THE SAME, PLUS ALL OTHER ANCILLARY TRANSACTIONS NECESSARY OR APPROPRIATE TO CONSUMMATE THE SAME; H) THE DISSOLUTION OF THE CORPORATION AND DISPOSITION OF ASSETS; I) THE PURCHASE, SALE, LEASE OR MORTGAGE OF REAL PROPERTY; TO APPROVE THE PURCHASE, SALE, OR GIFT OF CAPITAL ASSETS; J) THE CORPORATION'S ANNUAL BUDGET, INCLUDING BUDGETS FOR OPERATIONS, CAPITAL EXPENDITURES, AND CASH FLOW. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 AND SUPPORTING WORKPAPERS WERE REVIEWED BY THE CHIEF FINANCIAL OFFICER OF ST. FRANCIS HEALTHCARE SYSTEM OF HAWAII AND THE COMPANY'S TAX ADVISORS, KMH LLP. A COPY OF THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | A CONFLICT OF INTEREST QUESTIONNAIRE IS COMPLETED PRIOR TO EMPLOYMENT FOR ALL EMPLOYEES AND DIRECTORS. CONFLICT OF INTEREST QUESTIONNAIRES ARE REVIEWED BY HR PERSONNEL AND UPDATED ON AN ANNUAL BASIS. AFTER REVIEW BY HR PERSONNEL, POTENTIAL CONCERNS ARE REFERRED TO MANAGEMENT PERSONNEL AND RECOMMENDATIONS FOR RESOLUTIONS OF CONFLICTS ARE REFERRED TO THE CORPORATE COMPLIANCE STEERING COMMITTEE. IF A POTENTIAL OR IDENTIFIED CONFLICT OF INTEREST CANNOT BE RESOLVED BY THE AFOREMENTIONED COMMITTEE, THE MATTER WILL BE REFERRED TO THE ORGANIZATIONAL ETHICS COMMITTEE FOR ADVICE AND RECOMMENDATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNMENT DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE GENERAL PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 4,333,376. MANAGEMENT AND GENERAL EXPENSES 590,915. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,924,291. |
| FORM 990, PART XI, LINE 9: | ROUNDING -5. ALLOCATION OF INVESTMENT INCOME FROM ST. FRANCIS MEDICAL CENTER - WEST -54,282. |
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