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.) .... | ||||||
| 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.") . | 0 | |||||
| 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...... | 32,275,966 | 35,449,414 | 36,672,996 | 37,913,362 | 40,084,758 | 182,396,496 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 32,275,966 | 35,449,414 | 36,672,996 | 37,913,362 | 40,084,758 | 182,396,496 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 0 | 0 | 0 | 0 | 0 |
| 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 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public support. (Subtract line 7c from line 6.) | 182,396,496 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 32,275,966 | 35,449,414 | 36,672,996 | 37,913,362 | 40,084,758 | 182,396,496 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2,460 | 3,038 | 4,537 | 2,254 | 6,392 | 18,681 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 2,460 | 3,038 | 4,537 | 2,254 | 6,392 | 18,681 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 77 | 137 | 0 | 0 | 0 | 214 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 32,278,503 | 35,452,589 | 36,677,533 | 37,915,616 | 40,091,150 | 182,415,391 |
| 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): |
|||||
| 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 |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part III, Line 12 Other Income | DESCRIPTION - MISCELLANEOUS, COLUMN A - 77.0, COLUMN B - 137.0, COLUMN C - , COLUMN D - , COLUMN E - , COLUMN F - 214.0; |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |
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, Line 15b COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES | IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS, PERFORMED BY ST. AGNES HEALTHCARE, A RELATED ORGANIZATION OF SETON MEDICAL GROUP, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE PRECEDING PARAGRAPH HOLDS TRUE FOR OFFICERS OR KEY EMPLOYEES WITH THE EXCEPTION OF THE CHIEF OPERATING OFFICER ( BEAU HIGGINBOTHAM) POSITION. THE COMPENSATION FOR THIS POSITION WAS DETERMINED BY THE ST. AGNES HEALTHCARE HUMAN RESOURCES DIRECTOR OF COMPENSATION WHO PERIODICALLY REVIEWS COMPARABILITY DATA OF INDIVIDUALS AT OTHER ORGANIZATIONS THAT HOLD THE SAME TITLE. THIS POSITION ALSO IS ELIGIBLE FOR MERIT INCREASES WHICH ARE PART OF THE ORGANIZATION WIDE COMPENSATION STRATEGY. THE ST. AGNES HEALTHCARE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION FOR MEMBERS OF THE ST. AGNES HEALTHCARE EXECUTIVE MANAGEMENT GROUP, KEY PHYSICIANS, AND THE OVERALL ORGANIZATION WIDE MERIT INCREASE. SINCE THE CHIEF OPERATING OFFICER POSITION IS NOT PART OF THE ST. AGNES HEALTHCARE EXECUTIVE MANAGEMENT GROUP, THE COMPENSATION FOR THIS POSITION IS NOT INDIVIDUALLY REVIEWED AND APPROVED BY THE ST. AGNES HEALTHCARE COMPENSATION COMMITTEE. |
| Form 990, Part VI, Line 1b ADDITIONAL INFORMATION | THERE ARE NO INDEPENDENT BOARD MEMBERS BECAUSE ALL BOARD MEMBERS RECEIVE REASONABLE COMPENSATION FOR SERVICES PROVIDED TO SETON MEDICAL GROUP OR ARE COMPENSATED BY A RELATED ORGANIZATION FOR SERVICES PROVIDED TO THE RELATED ORGANIZATION. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Seton Medical Group has a sole corporate member, St. Agnes Healthcare, Inc. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Seton Medical Group has a sole corporate member St. Agnes Healthcare, Inc., who has the ability to elect members to the governing body of Seton Medical Group. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The following powers and responsibilities shall be expressly reserved to the sole member of the corporation who shall retain and exercise such powers in addition to any additional powers and responsibilities as shall be conferred by the laws of the state of Maryland, the corporation's articles of incorporation or the bylaws: approve, interpret, and change any statement of mission, philosophy, ethical and religious directive, role and purpose of the corporation or any other local organization; approve the bylaws of the corporation or any other local organization; appoint 4 directors to the board of directors of the corporation and remove, with or without cause, any directors of the corporation whether or not appointed by the sole member; approve the merger, dissolution, consolidation or reorganization of the corporation or any other local organization; approve the formation of other local organizations or entities by the corporation; approve the acquisition, sale, lease, transfer or other alienation of property of the corporation or any other local organization; approve capital or operating budgets of the corporation; approve debt incurred by the corporation; approve the disposition of the assets of the corporation or any other local organization, at the time of its dissolution; establish policy concerning charity care, quality of care and services of the corporation; establish policy and procedures concerning finance and resources of the corporation, including but not limited to compensation and benefit plans or policies for physicians employees of or under contract with the corporation; approve an internal auditing and compliance program for the corporation; approve the appointment of the President of the corporation and the Vice-President/Chief Operating Officer of the corporation and remove, with or without cause the President of the corporation or the Vice President/Chief Operating Officer of the corporation; provided, however, that the sole member of the corporation shall confer with the board of directors of the corporation concerning the appointment or removal of the president of the corporation or the vice president/chief operating officer of the corporation; approve the criteria and the process for the evaluation of the president of the corporation; approve all third party payer agreements or managed care contracts entered into by the corporation regardless of whether the agreement is with a governmental or private entity; take any action to correct any action taken by the corporation or any local organization when the action taken by the corporation or local organization is inconsistent with the governing documents or policies of St. Agnes Healthcare, Inc., Ascension Health or the ethical or religious directives for catholic health facilities. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Management, including certain officers, works diligently to complete the form 990 and attached schedules in a thorough manner. Prior to filing the return, all board members are provided the form 990 and management team members are available to answer any board members' questions. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Annually, St. Agnes healthcare distributes a conflicts of interest disclosure form that is completed by board members, the executive team, board committees, purchasing agents, legal counsel, medical leadership, certain members of management, and those responsible for management and governance of Seton medical group. Any conflicts, or potential conflicts that are identified are examined by the St. Agnes healthcare corporate responsibility officer and appropriate measures are taken. |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization will provide any documents open to public inspection upon written request. |
| Form 990, Part VII, Section A BOARD DIRECTORS COMPENSATION AND HOURS WORKED | Joseph W Cook, Victor B Madrid, Kenneth H Williams, Erica J Leventhal and Debra Goldman Curtis are employed physicians working for Seton Medical Group. They also serve as board officers and directors. The compensation reported for them in part VII is attributable to compensation earned in their capacity as a physician. Various board of director members work at the related organization, St. Agnes healthcare. Adrian Long, Nancy Hammond, Patrick Mutch, William Higginbotham and Scott Furniss work an additional 48.6 hours at St. Agnes Healthcare. All persons listed as working 50 hours are full-time employees of the organization. The use of 50 hours on this return is only intended to denote that these persons are full-time employees even though such persons may work significantly more hours during the week on average. |
| Form 990, Part VIII, Line 2f Other Program Service Revenue | - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | Medical Records - Total Revenue: 1245, Related or Exempt Function Revenue: 1245, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Umbilical Cord Sampling - Total Revenue: 200, Related or Exempt Function Revenue: 200, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Interest from Payors - Total Revenue: 2170, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 2170; All Other Revenue - Total Revenue: -15, Related or Exempt Function Revenue: -15, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | OTHER CHANGES IN NET ASSETS OR FUND BALANCES - 2454937; ROUNDING - -1; |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |