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) |
||||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
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 I, LINE 1 | EISENHOWER MEDICAL CENTER, A NOT-FOR-PROFIT ORGANIZATION, EXISTS TO SERVE THE CHANGING HEALTHCARE NEEDS OF OUR REGION BY PROVIDING EXCELLENCE IN PATIENT CARE WITH SUPPORTIVE EDUCATION AND RESEARCH. |
| FORM 990, PART III, LINES 4A & 4B | KEY ACHIEVEMENTS (FISCAL YEAR 2016) IN JULY 2015, EISENHOWER MEDICAL CENTER IS NAMED FOR THE FOURTH CONSECUTIVE YEAR AS ONE OF THE NATIONS MOST WIRED HOSPITALS IN THE 2015 MOST WIRED SURVEY BENCHMARKING STUDY RELEASED IN THE JULY ISSUE OF 'HOSPITALS & HEALTH NETWORKS', THE JOURNAL OF THE AMERICAN HOSPITAL ASSOCIATION. IN SEPTEMBER 2015, EISENHOWER LUCY CURCI CANCER CENTER HOSTS THE SEVENTH ANNUAL ARNOLD PALMER PROSTATE CENTER SYMPOSIUM, A SERIES OF WEEKLY LECTURES REGARDING THE PREVENTION, DIAGNOSIS AND TREATMENT OF PROSTATE CANCER IN RECOGNITION OF NATIONAL PROSTATE CANCER AWARENESS MONTH. IN SEPTEMBER 2015, EISENHOWER MEDICAL CENTER ACHIEVES EXEMPLAR STATUS FOR ITS NURSING IMPROVING CARE FOR HEALTHSYSTEM ELDERS (NICHE) PROGRAM, MAKING IT THE FIRST AND ONLY PROGRAM IN THE COACHELLA VALLEY TO RECEIVE THE NICHE DESIGNATION. THE DESIGNATION HIGHLIGHTS EISENHOWERS COMMITMENT TO EXCELLENCE IN THE CARE OF PATIENTS 65 AND OLDER. IN OCTOBER 2015, EISENHOWER IS RECOGNIZED AS A LEADER IN LGBT HEALTHCARE EQUALITY IN THE HEALTHCARE EQUALITY INDEX 2015, AN ANNUAL SURVEY CONDUCTED BY THE HUMAN RIGHTS CAMPAIGN (HRC) FOUNDATION. EISENHOWER EARNS TOP MARKS FOR ITS COMMITMENT TO EQUITABLE, INCLUSIVE CARE FOR LGBT PATIENTS AND THEIR FAMILIES FOR THE THIRD CONSECUTIVE YEAR. IN OCTOBER 2015, EISENHOWER SCHNITZER/NOVACK BREAST CENTER HOSTS A SERIES OF LECTURES TO EDUCATE THE COMMUNITY ABOUT BREAST CANCER PREVENTION, SCREENING, DIAGNOSIS AND TREATMENT IN RECOGNITION OF NATIONAL BREAST CANCER AWARENESS MONTH. IN OCTOBER 2015, EISENHOWER RECEIVES A THREE-YEAR RE-ACCREDITATION OF THE TAMKIN CARDIOVASCULAR AND PULMONARY REHABILITATION PROGRAM FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. IN NOVEMBER 2015, EISENHOWER IS HONORED WITH AN "A" RATING THE TOP GRADE IN PATIENT SAFETY IN THE HOSPITAL SAFETY SCORE ADMINISTERED BY THE LEAPFROG GROUP. THE FIRST AND ONLY HOSPITAL SAFETY RATING TO BE PEER-REVIEWED IN 'THE JOURNAL OF PATIENT SAFETY', THE SCORE IS FREE TO THE PUBLIC AND DESIGNED TO GIVE CONSUMERS INFORMATION THEY CAN USE TO PROTECT THEMSELVES AND THEIR FAMILIES WHEN FACING A HOSPITAL STAY. IN NOVEMBER 2015, EISENHOWER MEDICAL CENTER IS NAMED ONE OF THE NATIONS 50 TOP CARDIOVASCULAR HOSPITALS BY TRUVEN HEALTH ANALYTICS FOR ITS SUPERIOR CLINICAL OUTCOMES. EISENHOWER IS THE ONLY HOSPITAL IN RIVERSIDE AND SAN BERNARDINO COUNTIES TO EARN THIS PRESTIGIOUS RECOGNITION FOR 2016. IN NOVEMBER 2015, BNP PARIBAS OPEN EXECUTIVES PRESENT EISENHOWER SCHNITZER/NOVACK BREAST CENTER WITH A DONATION IN HONOR BREAST CANCER AWARENESS MONTH. FOR EACH TICKET SOLD IN THE MONTH OF OCTOBER TO THE TENNIS EVENT, $1 WAS DONATED TO EISENHOWERS BREAST CENTER. ON NOVEMBER 16, 2015, THE DENNIS AND PHYLLIS WASHINGTON NAME IS UNVEILED ON THE ORIGINAL EISENHOWER HOSPITAL BUILDING. THROUGH A GENEROUS DONATION BY THE WASHINGTONS, MATCHED BY NUMEROUS OTHER DONORS, EISENHOWER IS ABLE TO PROCEED WITH THE SEISMIC RETROFIT OF THE ORIGINAL HOSPITAL BUILDING AS REQUIRED BY SENATE BILL 1953. ON DECEMBER 12, 2015, EISENHOWER MEDICAL CENTER HOLDS ITS INAUGURAL EISENHOWER REINDEER RUN A 5K RUN/WALK TO CELEBRATE ITS 45TH ANNIVERSARY ON ITS MAIN CAMPUS IN RANCHO MIRAGE. IN JANUARY 2016, EISENHOWER LUCY CURCI CANCER CENTER IS GRANTED A THREE-YEAR ACCREDITATION FROM THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS. ON JANUARY 30, EISENHOWER MEDICAL CENTER HOSTS THE COMMUNITY HEART CONFERENCE AT THE ANNENBERG CENTER FOR HEALTH SCIENCES. ON FEBRUARY 23, EISENHOWER HOSTS THE 21ST ANNUAL JIM COOK DAY OF HOPE FOR DIABETES, FEATURING NATALIE STRAND, MD, AT THE ANNENBERG CENTER FOR HEALTH SCIENCES AT EISENHOWER. IN MARCH 2016, EISENHOWER MEDICAL CENTER IS AWARD THE ADVISORY BOARD COMPANYS 2016 WORKPLACE OF THE YEAR AWARD, WHICH RECOGNIZES HOSPITALS AND HEALTH SYSTEMS NATIONWIDE THAT HAVE OUTSTANDING LEVELS OF EMPLOYEE ENGAGEMENT. EISENHOWER IS ONE OF ONLY 20 ORGANIZATIONS NATIONWIDE TO RECEIVE THE AWARD. IN MARCH 2016, EISENHOWER MEDICAL CENTER IS RECOGNIZED FOR THE FOURTH CONSECUTIVE YEAR AS A LEADER IN LGBT HEALTHCARE EQUALITY IN THE HEALTHCARE EQUALITY INDEX 2016, AN ANNUAL SURVEY CONDUCTED BY THE HUMAN RIGHTS CAMPAIGN FOUNDATION, THE EDUCATIONAL ARM OF THE COUNTRYS LARGEST LESBIAN, GAY, BISEXUAL AND TRANSGENDER ORGANIZATION. ON MARCH 19, 2016, EISENHOWER LUCY CURCI CANCER CENTER HOSTS THE 13TH ANNUAL COMMUNITY CANCER AWARENESS DAY WITH A FOCUS ON COLORECTAL CANCER PREVENTION, DETECTION AND TREATMENT. IN APRIL 2016, EISENHOWER MEDICAL CENTER RECEIVES CHEST PAIN CENTER WITH PRIMARY PCI WITH RESUSCITATION ACCREDITATION FROM THE SOCIETY OF CARDIOVASCULAR PATIENT CARE. EISENHOWER RECEIVED ITS FIRST ACCREDITATION AS A CHEST PAIN CENTER IN 2006. THIS IS THE FIFTH CONTINUOUS ACCREDITATION CYCLE IN WHICH EISENHOWER HAS PARTICIPATED. IN APRIL 2016, EMPLOYEE LYNNE MALESTIC, RN, IS CHOSEN AS THE 2016 CURE EXTRAORDINARY HEALER FOR ONCOLOGY NURSING, A NATIONAL RECOGNITION FOR NURSES WHO HAVE DEDICATED THEIR CAREERS TO HELPING PATIENTS WITH CANCER, THEIR FAMILIES AND CO-WORKERS IN THE FIELD OF CANCER. IN APRIL 2016, EISENHOWER MEDICAL CENTER RECEIVES THE GOLD AWARD FROM THE HEALTHCARE PUBLIC RELATIONS AND MARKETING ASSOCIATION FOR EISENHOWERS PRINT PUBLICATION, 'HEALTHY LIVING' MAGAZINE. IN JUNE 2016, EISENHOWER RECEIVES RE-CERTIFICATION AS A PRIMARY STROKE CENTER FROM THE JOINT COMMISSION. |
| FORM 990, PART VI, LINE 2 | Description of relationships Kathryn B. Sample and Steven B. Sample have a family relationship. FORM 990, PART VI, LINE 6 THE BOARD OF TRUSTEES ARE MEMBERS OF EISENHOWER MEDICAL CENTER. |
| FORM 990, PART VI, LINE 7A | POWER TO ELECT OR APPOINT MEMBERS TRUSTEES HAVE THE RIGHT TO ELECT THE GOVERNING BOARD MEMBERS OF THE EISENHOWER MEDICAL CENTER BOARD OF DIRECTORS. |
| FORM 990, PART VI, LINE 7B | DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS MEMBERS HAVE THE RIGHT TO VOTE ON THE FOLLOWING MAJOR DECISIONS: ANY MATERIAL CHANGE IN THE MISSION OF EMC; THE MERGER OF EMC WITH ANY OTHER BUSINESS ENTITY; THE DISSOLUTION OF EMC; THE SALE OF ALL OR SUBSTANTIALLY ALL OF EMC'S ASSETS; AND ANY MATTER ON WHICH A MEMBER OF CALIFORNIA NON-PROFIT CORPORATION IS REQUIRED TO BE PERMITTED TO VOTE ON UNDER APPLICABLE LAW. |
| FORM 990, PART VI, LINE 11B | PROCESS USED TO REVIEW THE FORM 990 THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND SUBSEQUENTLY REVIEWED BY MANAGEMENT. AFTER MANAGEMENT'S REVIEW, THE FORM 990 IS PRESENTED TO THE BOARD AFTER FILING. |
| FORM 990, PART VI, LINE 12C | MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST ANNUALLY, RELATED PARTIES INCLUDING OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE SURVEYED FOR TRANSACTIONS THAT COULD GIVE RISE TO CONFLICTS. WRITTEN QUESTIONNAIRES ARE REVIEWED BY LEGAL AND FINANCE TO DETERMINE IF ADDITIONAL QUESTIONS OR INFORMATION SHOULD BE DOCUMENTED REGARDING SPECIFIC TRANSACTIONS. ALL NEW CONTRACTS ARE REVIEWED BY EXECUTIVE MANAGEMENT FOR CONFLICT CONSIDERATIONS. GENERAL COUNSEL REVIEWS ALL STATEMENTS SUBMITTED BY BOARD MEMBERS WHO INDICATE A POTENTIAL CONFLICT. GENERAL COUNSEL ADVISES THE CEO AND CHAIRMAN OF THE BOARD OF ANY MATERIAL CONFLICTS SO THAT THE INDIVIDUAL CAN BE REACHED FROM ANY DISCUSSION OR DELIBERATION PERTAINING TO THE CONFLICT. |
| FORM 990, PART VI, LINES 15A & 15B | PROCESS FOR DETERMINING COMPENSATION EISENHOWER MEDICAL CENTER ENGAGES AN INDEPENDENT CONSULTING FIRM TO PROVIDE THE BOARD'S COMPENSATION COMMITTEE BENCHMARKED SURVEY DATA FOR THE EXECUTIVE LEADERSHIP TEAM IN THE ORGANIZATION. THE CONSULTANT PROVIDES ANALYSIS OF SALARIES (ON AN ANNUAL BASIS), INCENTIVE PLANS AND BENEFITS (ON A BIANNUAL BASIS) AS COMPARED TO PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS. THIS REVIEW WAS COMPLETED AND PRESENTED TO THE COMPENSATION COMMITTEE IN FEBRUARY 2016. THIS PROCESS WAS CONTEMPORANEOUSLY SUBSTANTIATED IN THE MEETING MINUTES OF THE COMPENSATION COMMITTEE. |
| FORM 990, PART VI, LINE 19 | PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC EISENHOWER MEDICAL CENTER RELEASES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC UPON REQUEST. THAT REQUEST MAY BE EITHER VERBAL OR WRITTEN. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICES (NON-EMPLOYEES): PHYSICIAN SERVICES $53,426,474 PURCHASED SERVICES-OTHER $19,739,039 COLLECTION SERVICES $3,712,831 PROFESSIONAL FEES $28,801,024 OTHER MEDICAL SERVICES $5,483,328 ----------- TOTAL $111,162,696 |
| FORM 990, PART XI, LINE 9 | PENSION RELATED CHANGES - (19,430,380) CHANGE IN NPV OF PLEDGES AND DOUBTFUL ALLOWANCES - (3,448,622) CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS - 500,000 --------------- TOTAL (22,379,002) |
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