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 |
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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) |
||||
| 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 4 | The organization changed language in their by-laws to reference "Campus President" rather than "Chief Executive Officer". Starting in Oct 2016, Campus president for BEH will be an employee of Greenville Health System. BEH also changed the Mission/Vision in FY2016. |
| Form 990, Part VI, Section A, line 6 | THE ORGANIZATION CONSISTS OF ONE CLASS OF MEMBERSHIP CONSISTING OF TWO MEMBERS: PALMETTO HEALTH, A SOUTH CAROLINA NONPROFIT CORPORATION, AND GREENVILLE HEALTH CORPORATION, A SOUTH CAROLINA NONPROFIT CORPORATION. |
| Form 990, Part VI, Section A, line 7a | THE ORGANIZATION'S BOARD OF DIRECTORS SHALL CONSIST OF FOUR INDIVIDUALS APPOINTED AS DIRECTORS BY PALMETTO HEALTH AND FOUR INDIVIDUALS APPOINTED AS DIRECTORS BY GREENVILLE HEALTH CORPORATION. |
| Form 990, Part VI, Section A, line 7b | RESERVED POWERS OF THE MEMBERS. THE FOLLOWING ACTIONS SHALL REQUIRE THE APPROVAL OF BOTH OF THE MEMBERS: (A) CHANGES OR AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS THAT WOULD AFFECT ANY AUTHORITY OR PRIVILEGE OF A MEMBER (AS PROVIDED IN ARTICLE XII, SECTION 2); (B) THE ADMISSION OF A NEW MEMBER OF CORPORATION; (C) THE SALE, LEASE, EXCHANGE, TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CORPORATION; (D) APPROVAL OF ANY CHANGE IN THE NAME OF CORPORATION; (E) THE MERGER, CONSOLIDATION, DIVISION, DISSOLUTION, OR LIQUIDATION OF CORPORATION; AND (F) THE ISSUANCE OF DEBT OR CREATION OF, OR ENTRY INTO ANY AGREEMENT THAT CREATES, AN OBLIGATION IN AN AMOUNT GREATER THAN $5,000,000. INDIVIDUAL MEMBER RESERVED POWERS. THE FOLLOWING POWERS SHALL BE RESERVED TO EACH OF THE MEMBERS INDIVIDUALLY: (A) ELECTION OF A MEMBER'S DIRECTORS PURSUANT TO ARTICLE IV, SECTION 2(A); (B) APPOINTMENT OF A DIRECTOR TO FILL A VACANCY IN A MEMBER'S DIRECTORS PURSUANT TO ARTICLE IV, SECTION 2(D); AND (C) REMOVAL OF A MEMBER'S DIRECTORS PURSUANT TO ARTICLE IV, SECTION 5(B). |
| Form 990, Part VI, Section B, line 11 | THE ORGANIZATION'S FORM 990 WAS INITIALLY REVIEWED BY THE FINANCE COMMITTEE APPOINTED BY THE BOARD ALONG WITH THE ORGANIZATION'S TAX PREPARERS WHO WERE AVAILABLE TO ANSWER QUESTIONS AND PROVIDE ADDITIONAL INFORMATION. AFTER THE FINANCE COMMITTEE'S APPROVAL, THE 990 WAS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW AND APPROVAL WITH THE OPPORTUNITY FOR COMMENTS AND CHANGES BEFORE FILING WITH THE IRS. |
| Form 990, Part VI, Section B, line 12c | BOARD MEMBERS ARE REQUIRED TO COMPLETE CONFLICT OF INTEREST DISCLOSURES ANNUALLY. IN ADDITION, BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE PERTAINING SPECIFICALLY TO CONFLICTS OF INTEREST REQUIRED TO BE DISCLOSED ON THE ORGANIZATION'S 990. WHENEVER A POTENTIAL CONFLICT EXISTS, BOARD MEMBERS AND OFFICERS RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON THE TRANSACTION WITH THE POTENTIAL CONFLICT. |
| Form 990, Part VI, Section B, line 15 | THE BOARD WORKS WITH THE DIRECTOR OF HUMAN RESOURCES AT PALMETTO HEALTH, A PARTNER IN THE JOINT VENTURE. THE DIRECTOR OF HUMAN RESOURCES UTILIZES AN INDEPENDENT CONSULTANT TO ANALYZE THE EXECUTIVE COMPENSATION PROGRAM. THE INDEPENDENT CONSULTANT GENERATES AN ANALYTICAL REPORT CALLED THE "COMPENSATION REVIEW". THE COMPENSATION REVIEW INCLUDES MARKET ANALYSES FOR BASE SALARIES, TOTAL CASH COMPENSATION, BENEFITS AND PREQUISITES AND AGGREGATE TOTAL COMPENSATION VALUES FOR POSITIONS. THE BOARD REVIEWS THE INFORMATION IN THE COMPENSATION REVIEW RELATING TO AGGREGATE TOTAL COMPENSATION PAID TO POSITIONS THAT ARE FUNCTIONALLY SIMILAR AT SIMILARLY-SITUATED ORGANIZATIONS. THE BOARD APPROVES THE COMPENSATION LEVELS PAYABLE THE CEO, CFO, AND KEY EMPLOYEES UTILIZING THE INFORMATION CONTAINED IN THE COMPENSATION REVIEW. |
| Form 990, Part VI, Section C, line 18 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST AND ON WWW.GUIDESTAR.ORG. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC IN THE ADMINISTRATION OFFICE. |
| Form 990, Part IX, line 11g | Consultants: Program service expenses 364,168. Management and general expenses 0. Fundraising expenses 0. Total expenses 364,168. Purchased Services: Program service expenses 13,593,014. Management and general expenses 15,039. Fundraising expenses 0. Total expenses 13,608,053. Medical Services: Program service expenses 15,402,104. Management and general expenses 0. Fundraising expenses 0. Total expenses 15,402,104. |
| Form 990, Part XI, line 9: | MEMBERSHIP INTEREST IN FOUNDATION 51,558. TEMPORARY NET ASSETS RELEASED FROM RESTRICTIONS |
| FORM 990, PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
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