TY 2014 Form 990 Schedule O

efile Public Visual Render ObjectId: 201641339349300939 - Submission: 2016-05-12 TIN: 41-1813221

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.
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Attach to Form 990 or 990-EZ.
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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

CENTRACARE HEALTH SYSTEM

Employer identification number

41-1813221

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11	ANNUALLY AT THE BOARD'S APRIL MEETING, PRIOR TO FILING WITH THE IRS, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW THE IRS FORM 990 WITH THE STAFF, TO ASK QUESTIONS AND SEEK CLARIFICATIONS, AND TO APPROVE THE FINAL DOCUMENT.
FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE.
FORM 990, PART VI, SECTION B, LINE 15	THE COMPENSATION AND BENEFITS OF THE PRESIDENT AND THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT REQUIRED BY LAW TO BE MADE AVAILABLE TO THE PUBLIC AND CENTRACARE HEALTH SYSTEM DOES NOT MAKE THEM AVAILABLE.
FORM 990, PART IX, LINE 11G	MISCELLANEOUS: PROGRAM SERVICE EXPENSES 12,917,128. MANAGEMENT AND GENERAL EXPENSES 1,244,174. FUNDRAISING EXPENSES 62,932. TOTAL EXPENSES 14,224,234. CONTRACTED SERVICES/PURCH SVCS: PROGRAM SERVICE EXPENSES 7,007,722. MANAGEMENT AND GENERAL EXPENSES 689,377. FUNDRAISING EXPENSES 272,206. TOTAL EXPENSES 7,969,305.
FORM 990, PART XI, LINE 9:	PENSION PLAN ADJUSTMENT -9,444. NET EQUITY TRANSFERS BTWN RELATED ORGS 20,289,294. CAPITAL CONTRIBUTION 43,939. NON-CONTROLLING INTEREST DISTRIBUTION -800,000. NON-CONTROLLING INTEREST NET INCOME 1,079,114.

Return Reference

Explanation

FORM 990, PART VI, SECTION B, LINE 11

ANNUALLY AT THE BOARD'S APRIL MEETING, PRIOR TO FILING WITH THE IRS, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW THE IRS FORM 990 WITH THE STAFF, TO ASK QUESTIONS AND SEEK CLARIFICATIONS, AND TO APPROVE THE FINAL DOCUMENT.

FORM 990, PART VI, SECTION B, LINE 12C

THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE.

FORM 990, PART VI, SECTION B, LINE 15

THE COMPENSATION AND BENEFITS OF THE PRESIDENT AND THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL.

FORM 990, PART VI, SECTION C, LINE 19

GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT REQUIRED BY LAW TO BE MADE AVAILABLE TO THE PUBLIC AND CENTRACARE HEALTH SYSTEM DOES NOT MAKE THEM AVAILABLE.

FORM 990, PART IX, LINE 11G

MISCELLANEOUS: PROGRAM SERVICE EXPENSES 12,917,128. MANAGEMENT AND GENERAL EXPENSES 1,244,174. FUNDRAISING EXPENSES 62,932. TOTAL EXPENSES 14,224,234. CONTRACTED SERVICES/PURCH SVCS: PROGRAM SERVICE EXPENSES 7,007,722. MANAGEMENT AND GENERAL EXPENSES 689,377. FUNDRAISING EXPENSES 272,206. TOTAL EXPENSES 7,969,305.

FORM 990, PART XI, LINE 9:

PENSION PLAN ADJUSTMENT -9,444. NET EQUITY TRANSFERS BTWN RELATED ORGS 20,289,294. CAPITAL CONTRIBUTION 43,939. NON-CONTROLLING INTEREST DISTRIBUTION -800,000. NON-CONTROLLING INTEREST NET INCOME 1,079,114.

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

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