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.") . | ||||||
| 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 | ||||
| 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 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 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) |
||||
| 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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| 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 6 | PALMETTO HEALTH IS THE SOLE MEMBER. |
| Form 990, Part VI, Section A, line 7a | THE SOLE MEMBER, PALMETTO HEALTH, HAS THE AUTHORITY AND PRIVILEGE TO APPROVE OR REMOVE DIRECTORS ON THE BOARD. |
| Form 990, Part VI, Section A, line 7b | THE SOLE MEMBER, PALMETTO HEALTH, IS GRANTED THE AUTHORITY AND PRIVILEGE TO: 1. APPROVE THE ADDITION OR ADMISSION OF ANY NEW MEMBERS OF THE CORPORATION AND THE DETERMINATION OF ANY CONSIDERATION OR TERMS FOR SUCH MEMBERSHIP. 2. APPROVE THE MERGER, CONSOLIDATION, SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS ON THE CORPORATION. 3. APPROVE THE DISSOLUTION OF THE CORPORATION. 4. APPROVE THE BORROWING OF MONEY BY THE CORPORATION IN EXCESS OF $500,000 FROM ANY PERSON OR ENTITY OTHER THAN THE MEMBER OR THE INCURRING OF ANY OTHER DEBT ON BEHALF OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF THE CORPORATION'S BUSINESS. 5. APPROVE ANY LIEN, PLEDGE, SECURITY INTEREST OR OTHER ENCUMBERANCE EXCEPT FOR THOSE SECURING DEBT ISSUED BY THE MEMBER, MECHANIC'S LIENS FOR ACCOUNTS NOT PAST DUE, AND TAX LIENTS NOT YET DUE AND PAYABLE. 6. APPROVE THE INDEMNIFICATION OF ANY OFFICER, DIRECTOR, EMPLOYEE, OR AGENT OF THE CORPORATION AS MAY BE PERMITTED PURSANT TO SECTIONS 33-31-850 THROUGH 33-31-858 OF THE ACT. 7. APPROVE OF ANY DISTRIBUTION OF ASSETS UPON LIQUIDATION OF THE CORPORATION. 8. APPROVE ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OF THE CORPORATION 9. APPROVE THE AMENDMENT OR REPEAL OF THE BYLAWS. |
| Form 990, Part VI, Section B, line 11 | PALMETTO HEALTH TUOMEY'S FORM 990 WAS REVIEWED IN DETAIL BY THE DIRECTOR OF ACCOUNTING AND SYSTEM VICE PRESIDENT OF FINANCE. THE FORM WAS DISCUSSED AND REVIEWED IN DETAIL BY OUTSIDE TAX ADVISORS. THE 990 WAS PROVIDED TO PALMETTO HEALTH TUOMEY'S BOARD OF DIRECTORS AND EACH MEMBER WAS ALLOWED AMPLE TIME FOR REVIEW AND TO MAKE INQUIRIES BEFORE FILING WITH THE IRS. |
| Form 990, Part VI, Section B, line 12c | EACH MEMBER OF THE BOARD OF DIRECTORS SHALL COMPLETE AN ANNUAL ACKNOWLEDGEMENT STATEMENT THAT EACH OF THEM (A) HAS RECEIVED A COPY OF THE RULES OF CONDUCTED (CONFLICTS OF INTEREST POLICY), (B) HAS READ AND UNDERSTANDS THE POLICY, (C) AGREES TO COMPLY WITH THE POLICY, (D) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES, AND (E) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THESE ACKNOWLEDGEMENT STATEMENTS ARE RETURED TO THE AUDIT, COMPLIANCE, AND FINANCE COMMITTEE FOR REVIEW AND FOLLOW-UP AS APPROPRIATE. THE CHAIR OF THE AUDIT COMPLIANCE AND FINANCE COMMITTEE REPORTS TO THE FULL BOARD THAT THE ABOVE-REFERENCED PROCESS HAS BEEN COMPLETED. UPON HIRE, EACH EMPLOYEE IS EDUCATED ON PALMETTO HEALTH TUOMEY'S POTENTIAL CONFLICTS OF INTEREST POLICY AND IS ASKED TO DOCUMENT ANY RELATIONSHIPS THAT MAY CREATE A POTENTIAL CONFLICT OF INTEREST ON A FORM THAT IS REVIEWED BY CORPORATE COMPLIANCE AND RETAINED IN THE EMPLOYEE'S HUMAN RESOURCES FILE. ANNUALLY, THE POLICY IS REVIEWED VIA COMPUTER-BASED TRAINING THAT IS MANDATORY FOR ALL EMPLOYEES. SITUATIONS THAT ARE BELIEVED TO BE ACTUAL CONFLICTS ARE ADDRESSED BY CORPORATE COMPLIANCE, DEPARTMENT MANAGEMENT AND SENIOR LEADERSHIP AS NECESSARY. |
| Form 990, Part VI, Section B, line 15 | EACH MEMBER OF THE BOARD OF DIRECTORS SHALL COMPLETE AN ANNUAL ACKNOWLEDGEMENT STATEMENT THAT EACH OF THEM (A) HAS RECEIVED A COPY OF THE RULES OF CONDUCTED (CONFLICTS OF INTEREST POLICY), (B) HAS READ AND UNDERSTANDS THE POLICY, (C) AGREES TO COMPLY WITH THE POLICY, (D) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES, AND (E) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THESE ACKNOWLEDGEMENT STATEMENTS ARE RETURED TO THE AUDIT, COMPLIANCE, AND FINANCE COMMITTEE FOR REVIEW AND FOLLOW-UP AS APPROPRIATE. THE CHAIR OF THE AUDIT COMPLIANCE AND FINANCE COMMITTEE REPORTS TO THE FULL BOARD THAT THE ABOVE-REFERENCED PROCESS HAS BEEN COMPLETED. UPON HIRE, EACH EMPLOYEE IS EDUCATED ON PALMETTO HEALTH'S POTENTIAL CONFLICTS OF INTEREST POLICY AND IS ASKED TO DOCUMENT ANY RELATIONSHIPS THAT MAY CREATE A POTENTIAL CONFLICT OF INTEREST ON A FORM THAT IS REVIEWED BY CORPORATE COMPLIANCE AND RETAINED IN THE EMPLOYEE'S HUMAN RESOURCES FILE. ANNUALLY, THE POLICY IS REVIEWED VIA COMPUTER-BASED TRAINING THAT IS MANDATORY FOR ALL EMPLOYEES. SITUATIONS THAT ARE BELIEVED TO BE ACTUAL CONFLICTS ARE ADDRESSED BY CORPORATE COMPLIANCE, DEPARTMENT MANAGEMENT AND SENIOR LEADERSHIP AS NECESSARY. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE PUBLISHED ANNUALLY AND QUARTERLY FINANCIAL INFORMATION INFORMATION IS AVAILABLE TO THE PUBLIC AT WWW.DACBOND.COM |
| FORM 990, PART VI, LINE 1B | PALMETTO HEALTH TUOMEY'S BOARD OF DIRECTORS DOES NOT POSSESS A MAJORITY OF INDEPENDENT DIRECTORS. PALMETTO HEALTH TUOMEY'S SOLE MEMBER IS PALMETTO HEALTH. PALMETTO HEALTH'S BOARD OF DIRECTORS MAINTAINS A MAJORITY INDEPENDENCE. 17 OUT OF 19 DIRECTORS ARE INDEPENDENT. |
| Form 990, Part IX, line 11g | Outside Contract Services: Program service expenses 6,285,074. Management and general expenses 5,446,328. Fundraising expenses 0. Total expenses 11,731,402. Professional Fees: Program service expenses 103,878. Management and general expenses 6,751,243. Fundraising expenses 0. Total expenses 6,855,121. Consulting: Program service expenses 0. Management and general expenses 385,641. Fundraising expenses 0. Total expenses 385,641. |
| Form 990, Part XI, line 9: | CHANGE IN MEMBERSHIP INTEREST FOUNDATION 4,761,012. EQUITY TRANSFER FROM PALMETTO HEALTH 165,344,727. GRANT EXPENSE 2,988,183. |
| PART XII, LINE 2C | THE ORGANIZATION HAS NOT CHANGED ITS PROCESS. |
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