SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
KERSHAWHEALTH
 
Employer identification number

57-6005963
Return Reference Explanation
FORM 990 PART IV LN 20B THE ORGANIZATION WILL BE RECEIVING AUDITED FINANCIAL STATEMENTS FOR THE 09/30/2015 PERIOD. THE FINANCIAL STATEMENTS WERE NOT ISSUED PRIOR TO THE FILING OF THE FORM 990 AND THEREFORE ARE NOT ATTACHED.
FORM 990, PART VI, SECTION A, LINE 1 AN EXECUTIVE COMMITTEE IS COMPOSED OF THE CHAIRMAN OF THE BOARD, THE VICE CHAIRMAN, THE CHAIR OF THE FINANCE COMMITTEE, THE CHAIR OF THE STRATEGIC PLANNING COMMITTEE AND ANY OTHER BOARD MEMBERS APPOINTED BY THE CHAIRMAN, NOT EXCEEDING A TOTAL OF FOUR BOARD MEMBERS. THE CHAIRMAN OF THE BOARD CHAIRS THE MEETINGS OF THE COMMITTEE. WHEN THE FULL BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE HAS THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE ORGANIZATION, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OR BY STATUTE. IF NECESSARY, THE BOARD ENUMERATES AND DELINEATES THE DUTIES AND POWERS OF THE EXECUTIVE COMMITTEE BY RESOLUTION.
FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE BOARD ARE APPOINTED BY THE KERSHAW COUNTY COUNCIL FOR TERMS OF SIX YEARS AND UNTIL THEIR SUCCESSORS ARE APPOINTED AND QUALIFIED. ALL APPOINTEES TO THE BOARD ARE TO BE RESIDENTS OF KERSHAW COUNTY, SOUTH CAROLINA WITH AT LEAST ONE MEMBER FROM EACH OF THE FOUR TOWNSHIPS.
FORM 990, PART VI, SECTION B, LINE 11 THE RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT WITH ASSISTANCE AND OVERSIGHT BY MANAGEMENT. A DIGITAL COPY OF THE COMPLETED FORM 990 WAS PROVIDED TO EACH VOTING BOARD MEMBER PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS COVERED IN THE CODE OF CONDUCT AND ANNUAL COMPLIANCE EDUCATION. IT IS ALSO MADE AVAILABLE ON THE ORGANIZATION'S INTRANET WHICH CAN BE ACCESSED BY ALL EMPLOYEES. POTENTIAL CONFLICT DISCLOSURES ARE PRESENTED TO THE BOARD COMPLIANCE COMMITTEE AND THE COMMITTEE DETERMINES WHETHER OR NOT A CONFLICT EXISTS.
FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF TRUSTEES FROM TIME TO TIME ENGAGES AN INDEPENDENT CONSULTANT TO PROVIDE COMPARISON ANALYSIS FOR COMPENSATION LEVELS FOR THE CEO. THE EXECUTIVE COMMITTEE OF THE BOARD DETERMINES AND APPROVES THE COMPENSATION FOR THE CEO OF THE ORGANIZATION. A MARKET ANALYSIS IS CONDUCTED BY HUMAN RESOURCES FOR ALL OTHER LEADERSHIP EMPLOYEES AND COMPENSATION LEVELS ARE APPROVED BY THE CEO.
FORM 990, PART VI, SECTION C, LINE 18 PHOTOCOPIES OF THE FORM 990 ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. PLEASE SEE PART VI, LINE 20.
FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,617,278. MANAGEMENT AND GENERAL EXPENSES 1,070,038. FUNDRAISING EXPENSES 9,244. TOTAL EXPENSES 7,696,560. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,528,645. MANAGEMENT AND GENERAL EXPENSES 2,889,473. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,418,118. CONSULTANTS: PROGRAM SERVICE EXPENSES 79,380. MANAGEMENT AND GENERAL EXPENSES 21,757. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 101,137. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 3,397,450. MANAGEMENT AND GENERAL EXPENSES 218,056. FUNDRAISING EXPENSES 169. TOTAL EXPENSES 3,615,675. OUTSIDE FEES: PROGRAM SERVICE EXPENSES 20,387. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,387. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 78,970. MANAGEMENT AND GENERAL EXPENSES 383,565. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 462,535.
FORM 990, PART XI, LINE 9: ADJUSTMENT FOR GASB 68 - PENSION LIABILITY -1,407,693.
FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version: