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.") .... | 26,154,853 | 21,586,182 | 22,018,755 | 24,547,652 | 23,995,368 | 118,302,810 |
| 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 | 26,154,853 | 21,586,182 | 22,018,755 | 24,547,652 | 23,995,368 | 118,302,810 |
| 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).. | 2,044,380 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 116,258,430 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 26,154,853 | 21,586,182 | 22,018,755 | 24,547,652 | 23,995,368 | 118,302,810 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 5,182,994 | 5,175,906 | 6,315,861 | 6,178,920 | 7,061,324 | 29,915,005 |
| 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. | 148,217,815 | |||||
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 | 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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 | ||||
| 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 VI, SECTION A, LINE 1 | DURING THE INTERVALS BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, THE EXECUTIVE COMMITTEE POSSESSES AND MAY EXERCISE ALL POWERS AND FUNCTIONS OF THE BOARD OF DIRECTORS IN THE DIRECTION OF THE AFFAIRS OF THE CORPORATION IN ALL CASES WHERE SPECIFIC DIRECTIONS HAVE NOT HAVE BEEN GIVEN BY THE BOARD OF DIRECTORS. IN ADDITION TO EXERCISING THE FOREGOING INTERIM POWERS, THE EXECUTIVE COMMITTEE EXCLUSIVELY EXERCISES THE BOARD'S AUTHORITY, PURSUANT TO A.C.A. SECTION 4-33-825(D), WITH RESPECT TO THE FOLLOWING: (A) TO MANAGE, INVEST, AND REINVEST THE FUNDS AND PROPERTY OF THE CORPORATION, TO SELECT AND EMPLOY BROKERS, INVESTMENT ADVISORS AND FUND MANAGERS, AND TO SUPERVISE THE PERFORMANCE THEREOF, AND GENERALLY TO EXERCISE THE INVESTMENT FUNCTION AND POWERS OF THE BOARD; (B) TO ESTABLISH THE CORPORATION'S ANNUAL BUDGETS, TO MONITOR INCOME AND EXPENSES IN COMPARISON TO BUDGET, TO BORROW FUNDS FOR PURPOSES THAT SEEM IN THE BEST INTEREST OF THE CORPORATION, AND GENERALLY TO EXERCISE THE FINANCE FUNCTION AND POWERS OF THE BOARD; (C) TO PURCHASE REAL OR PERSONAL PROPERTY ON THE CREDIT OF THE CORPORATION, AND IN CONNECTION WITH SUCH PURCHASE, OR IN CONNECTION WITH OTHER BORROWINGS OF THE CORPORATION, TO AUTHORIZE THE CORPORATION'S OFFICERS TO EXECUTE AND DELIVER PROMISSORY NOTES OR OTHER EVIDENCES OF INDEBTEDNESS OF THE CORPORATION, AND TO MORTGAGE OR PLEDGE CORPORATE PROPERTY TO SECURE PAYMENT OF SUCH INDEBTEDNESS, AND TO REPAY SUCH INDEBTEDNESS; AND, (D) TO APPLY THE UNRESTRICTED FUNDS OF THE CORPORATION TO OR FOR THE BENEFIT OF ARKANSAS CHILDREN'S HOSPITAL AND ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE, INC., AND TO MAKE ALL RELATED DETERMINATIONS SUBJECT TO THE APPROVAL OF THE ACH BOARD. THE EXECUTIVE COMMITTEE IS COMPRISED OF THE FOLLOWING: THE CHIEF EXECUTIVE OFFICER OF ACH, WHO IS ALSO THE CHAIRMAN OF THE FOUNDATION BOARD OF DIRECTORS; SIX (6) MEMBERS OF THE ACH BOARD; ONE (1) MEMBER OF THE ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE BOARD; AND THREE AT LARGE DIRECTORS WHO ARE NOMINATED BY THE EXECUTIVE COMMITTEE OF THE FOUNDATION AND WHO ARE ELECTED TO THE EXECUTIVE COMMITTEE BY THE ACH BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE FOUNDATION'S SOLE MEMBER IS ARKANSAS CHILDREN'S HOSPITAL (ACH). |
| FORM 990, PART VI, SECTION A, LINE 7A | ARKANSAS CHILDREN'S HOSPITAL (THE MEMBER) HAS THE RIGHT TO ELECT ALL DIRECTORS OF THE FOUNDATION AND HAS THE RIGHT TO REMOVE AND REPLACE ANY AND ALL DIRECTORS OF THE FOUNDATION WITH OR WITHOUT CAUSE WHENEVER, IN ITS BEST JUDGMENT, THE BEST INTERESTS OF THE CORPORATION WILL BE SERVED. |
| FORM 990, PART VI, SECTION A, LINE 7B | ARKANSAS CHILDREN'S HOSPITAL (ACH) MUST APPROVE ANY AMENDMENTS TO THE FOUNDATION'S ARTICLES OF INCORPORATION AND BYLAWS. ALL RIGHTS OF THE MEMBER WITH RESPECT TO THE FOUNDATION ARE EXERCISED THROUGH THE BOARD OF DIRECTORS OF ACH. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE DRAFT FORM 990, WHICH IS RECONCILED TO THE FOUNDATION'S INTERNAL FINANCIAL STATEMENTS AND THE ARKANSAS CHILDREN'S HOSPITAL CONSOLIDATED AUDIT REPORT, IS INITIALLY REVIEWED IN DETAIL WITH THE FOUNDATION'S PRESIDENT AND VICE PRESIDENT. THE DRAFT IS ALSO REVIEWED IN DETAIL WITH BOTH THE SVP/CFO AND VP OF FINANCIAL OPERATIONS OF ARKANSAS CHILDREN'S HOSPITAL. IF THE REVIEW BY THE FOUNDATION'S MANAGEMENT RESULTS IN REVISIONS TO THE DRAFT FORM 990, THOSE REVISIONS ARE MADE, AND THE FORM 990 TO BE FILED, LESS DONORS' NAMES AND ADDRESSES ON SCHEDULE B, IS PROVIDED TO THE FOUNDATION BOARD'S EXECUTIVE COMMITTEE PRIOR TO THE RETURN BEING FILED. IN ADDITION, THE FORM 990, LESS DONORS' NAMES AND ADDRESSES ON SCHEDULE B, IS PROVIDED TO BOTH THE CHAIRMAN OF THE BOARD AND THE TREASURER OF ARKANSAS CHILDREN'S HOSPITAL AND IS MADE AVAILABLE TO THE FULL FOUNDATION BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE FOUNDATION BOARD IS GOVERNED BY THE ARKANSAS CHILDREN'S HOSPITAL'S BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY. ANNUAL DISCLOSURE OF CONFLICTS IS REQUIRED OF ALL BOARD MEMBERS. THE ANNUAL DISCLOSURES ARE REVIEWED BY THE FOUNDATION'S PRESIDENT AND BY THE FOUNDATION BOARD'S CHAIRMAN. DISCLOSURES ARE ALSO RECEIVED BY BOTH THE SVP/CFO AND VP OF FINANCIAL OPERATIONS OF ARKANSAS CHILDREN'S HOSPITAL FOR REPORTING PURPOSES. DURING THE YEAR, WHILE BOARD MEMBERS MAY PARTICIPATE IN INITIAL DISCUSSION, BOARD MEMBERS WHO HAVE A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISIONS IN THE RELATED TRANSACTION AND ABSTAIN FROM VOTING, WHICH IS NOTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR THE FOUNDATION'S PRESIDENT AND SENIOR VICE PRESIDENT IS REVIEWED BY THE ARKANSAS CHILDREN'S HOSPITAL BOARD COMPENSATION COMMITTEE WHICH IS ESTABLISHED THROUGH THE BYLAWS OF ARKANSAS CHILDREN'S HOSPITAL TO DISCHARGE THE DUTY OF THE BOARD IN FULFILLING ITS OVERSIGHT RESPONSIBILITIES FOR DETERMINING THE ADEQUACY AND REASONABLENESS OF THE COMPENSATION PAID THE CEO AND OTHER EMPLOYEES THAT THE COMMITTEE BELIEVES ARE IN A POSITION TO EXERCISE A SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE HOSPITAL AND ITS RELATED ORGANIZATIONS. THE COMMITTEE IS COMPOSED OF MEMBERS WHO PERSONALLY RECEIVE NO COMPENSATION, FEES, OR OTHER BENEFITS FROM THE HOSPITAL OR RELATED ORGANIZATIONS. THE COMMITTEE MAY RELY UPON REASONED WRITTEN OPINIONS OF QUALIFIED LEGAL, ACCOUNTING, VALUATION AND EXECUTIVE COMPENSATION EXPERTS. THE COMMITTEE HAS THE SOLE AUTHORITY TO RETAIN AND TERMINATE ANY SPECIAL ADVISORS USED TO ASSIST IN THE EVALUATION OF COMPENSATION. THE COMMITTEE CONTEMPORANEOUSLY, WITH MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION OF DISQUALIFIED PERSONS, DOCUMENTS IN A WRITTEN REPORT TO THE EXECUTIVE COMMITTEE AND THE BOARD, THE BASIS FOR ITS DECISIONS. SALARY RANGES FOR THE NOTED POSITIONS WERE REVIEWED IN DETAIL WITH EXTERNAL COMPENSATION CONSULTANTS IN A PRIOR YEAR. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE FOUNDATION'S 990 AND 990-T ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AS REQUIRED. |
| FORM 990, PART XI, LINE 9: | TRANSFER OF NET ASSETS TO ANNUITY RESERVE -3,976. |
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| Software Version: |