Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) |
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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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| 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.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | ON JANUARY 22, 2019, ADVOCATE AURORA HEALTH, INC. ("AURORA"), AURORA MEDICAL GROUP, INC., M&M HEALTH CARE, INC., AND BAMC (COLLECTIVELY THE "PARTIES") ENTERED INTO A MEMBERSHIP AGREEMENT (THE "MEMBERSHIP AGREEMENT"). UNDER THE TERMS OF THE MEMBERSHIP AGREEMENT, THE PARTIES AGREED TO RESTATE THE ARTICLES OF INCORPORATION AND BYLAWS OF BAMC TO REMOVE M&M HEALTH CARE AS A MEMBER OF BAMC AND TO MAKE AURORA THE SOLE MEMBER OF BAMC. THIS CHANGE WAS EFFECTIVE ON APRIL 1, 2019. |
| FORM 990, PART VI, SECTION A, LINE 6 | IN 2014, BAMC AND AURORA HEALTH CARE NORTH, INC. NEGOTIATED AN ARRANGEMENT UNDER WHICH M&M AND AURORA BECAME THE SOLE MEMBERS OF BAMC. M&M HOLDS 51% OF THE VOTING INTERESTS IN BAMC AND AURORA HOLDS 49% OF THE VOTING INTERESTS. |
| FORM 990, PART VI, SECTION A, LINE 7A | BAY AREA MEDICAL CENTER'S BY-LAWS INDICATE THAT THE BOARD OF DIRECTORS OF THE CORPORATION SHALL BE NINE (9), FIVE OF WHOM SHALL BE APPOINTED BY M&M HEALTH CARE, INC. AND FOUR OF WHOM SHALL BY APPOINTED BY AURORA HEALTH CARE NORTH, INC. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CORPORATE MEMBERS HAVE RETAINED THE FOLLOWING RESERVED POWERS OVER THE CORPORATION SUCH THAT NONE OF SUCH ACTIONS MAY BE TAKEN BY THE CORPORATION WITHOUT THE UNANIMOUS APPROVAL OF ALL CORPORATE MEMBERS, AND THE CORPORATE MEMBERS, ACTING UNANIMOUSLY, MAY INITIATE AND TAKE SUCH ACTIONS: - TO CHANGE THE CORPORATION'S MISSION OR PURPOSE; - TO APPROVE ANY AMENDMENT TO THE ARTICLES OF INCORPORATION, BYLAWS OR OTHER GOVERNING DOCUMENTS OF THE CORPORATION, INCLUDING THE CONFLICT OF INTEREST, INSIDER TRANSACTION, AND CONFIDENTIALITY POLICY ADOPTED BY THE BOARD OF DIRECTORS FROM TIME TO TIME; - TO APPROVE ALL MATTERS RELATING TO THE MEMBERSHIP OF THE CORPORATION OR ANY RIGHTS ARISING FROM SUCH MEMBERSHIP, INCLUDING THE ISSUING OF ADDITIONAL MEMBERSHIPS IN THE CORPORATION, RECLASSIFYING MEMBERSHIPS IN THE CORPORATION, CREATING A NEW CLASS OF MEMBERSHIP IN THE CORPORATION, BRINGING ON A NEW MEMBER OF THE CORPORATION, TRANSFERRING MEMBERSHIPS IN THE CORPORATION OR ANY RIGHTS ARISING THEREFROM OR REDEEMING MEMBERSHIPS IN THE CORPORATION OR ANY RIGHTS ARISING FROM THEREFROM; - TO APPROVE ANY INDEBTEDNESS FOR BORROWED MONEY TO BE INCURRED OR GUARANTEED ON BEHALF OF THE CORPORATION, EXCEPT THAT FINANCING FOR A FACILITY PLAN DEVELOPED IN 2014 OR 2015 AND APPROVED BY SUPER-MAJORITY BOARD APPROVAL DOES NOT REQUIRE THE UNANIMOUS APPROVAL OF ALL CORPORATE MEMBERS; - TO APPROVE CAPITAL LEASES IN EXCESS OF $3,000,000 IN THE AGGREGATE (AS DETERMINED BY TOTAL LEASE AND OTHER PAYMENTS); |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DIRECTOR OF FINANCE HAS FORM 990 AVAILABLE ON SITE FOR BOARD MEMBERS TO REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD OF DIRECTORS - PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS OF INTEREST SHALL FILE FORMAL STATEMENTS DISCLOSING ACTUAL OR POTENTIAL CONFLICTS WHENEVER AN ACTUAL OR POTENTIAL CONFLICT ARISES; BEFORE ANY TRANSACTIONS CONSTITUTING A CONFLICT OR POTENTIAL CONFLICT IS CONSUMMATED; AND ONCE EACH CALENDAR YEAR SO LONG AS THE CONFLICT OR POTENTIAL CONFLICT CONTINUES TO EXIST. THE DISCLOSURE STATEMENT SHALL INCLUDE A DESCRIPTION OF THE RELATIONSHIP OR INTEREST CAUSING THE CONFLICT OR POTENTIAL CONFLICT, THE ROLE IN THE RELATIONSHIP OR TRANSACTION PLAYED BY THE PERSON HAVING THE CONFLICT, AND THE BENEFITS AND DETRIMENTS ACCRUING TO THE HOSPITAL AND TO THE PERSON HAVING THE CONFLICT AS A RESULT OF THE CONTRACT, TRANSACTION, OR RELATIONSHIP. ANY MEMBER OF THE BOARD OF DIRECTORS HAVING AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER CONSTITUTING A CONFLICT. THE INTERESTED DIRECTOR MAY, HOWEVER, BE COUNTED FOR THE PURPOSE OF DETERMINING WHETHER A QUORUM OF THE BOARD, OR OF A COMMITTEE OF THE BOARD, EXISTS. THE MATTER CONSTITUTING THE CONFLICT SHALL BE APPROVED IF IT IS APPROVED BY A MAJORITY OF DISINTERESTED DIRECTORS VOTING ON THE MATTER. THE CONFLICT OF INTEREST POLICY SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF THE BOARD OF DIRECTORS AND THAT ANY NEW MEMBERS OF THE SAID BOARD OF DIRECTORS BE ADVISED OF THE POLICY UPON ENTERING ON THE DUTIES OF HIS/HER OFFICE. IN ADDITION TO THE BOARD OF DIRECTORS BEING HELD TO THE CONFLICT OF INTEREST POLICY, COPIES OF THE POLICY ARE PROVIDED TO ALL MANAGEMENT EMPLOYEES. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED ANNUALLY BY ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES. THE COMPLETED FORMS ARE KEPT ON FILE BY ADMINISTRATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTOR'S COMPENSATION COMMITTEE REVIEWS COMPARABLE COMPENSATION INFORMATION ON OTHER HOSPITALS AND ESTABLISHES BAMC'S EXECUTIVE COMPENSATION LEVELS. MEMBERS OF THE COMPENSATION COMMITTEE DO NOT HAVE A CONFLICT OF INTEREST AND THE CONCLUSIONS ARE SUBSTANTIATED. THE REVIEW PROCESS TAKES PLACE AT LEAST ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DEEMS THESE DOCUMENTS PROPRIETARY SO THEY ARE NOT MADE AVAILABLE TO THE PUBLIC, EXCEPT THAT THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990. |
| FORM 990, PART VII, SECTION A, ROGER SNEATH | THE ORGANIZATION REPORTED THE AMOUNT PAID TO R SNEATH ASSOCIATES, LLC ON THE LISTING OF OFFICERS AND DIRECTORS OF $362,123 THIS AMOUNT IS FOR MANAGEMENT SERVICES ROGER SNEATH PROVIDED TO THE ORGANIZATION AND $7,800 FOR RENTS PAID. |
| FORM 990, PART IX, LINE 11G | EMERGENCY ROOM SERVICES: PROGRAM SERVICE EXPENSES 2,225,571. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,225,571. ACL TESTING: PROGRAM SERVICE EXPENSES 4,418,789. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,418,789. ENVIRONMENT / WASTE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,712,798. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,712,798. PATIENT FINANCE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 814,461. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 814,461. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,848,395. MANAGEMENT AND GENERAL EXPENSES 1,737,155. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,585,550. |
| FORM 990, PART XI, LINE 9: | INCREASE IN BENEFICIAL INTEREST IN BAMC FOUNDATION, INC. 375,251. CHANGE IN POSTRETIREMENT BENEFIT OBLIGATION OTHER THAN EXPENSE 193,413. RECLASSIFICATION OF ACCUMULATED LOSS ON DESIGNATED CASHFLOW HEDGE 38,645. MEMBER EQUITY CONTRIBUTION 532,292. EQUITY TRANSFER FROM ABAMG -15,719,910. GRANTS FOR PP&E 200,000. |
| FORM 990, PART IV, LINE 12 | BAY AREA MEDICAL CENTER WAS AUDITED AS PART OF A CONSOLIDATED AUDIT. BAMC ASSETS MADE UP 99% OF TOTAL ASSETS IN THE CONSOLIDATED AUDIT. |
| FORM 990, PART XI, LINE 2B AND 2C | BAY AREA MEDICAL CENTER WAS AUDITED AS PART OF A CONSOLIDATED AUDIT. SEE EXPLANATION TO PART IV, LINE 12. |
| Software ID: | |
| Software Version: |