Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST PATRICK'S HOME FOR THE AGED AND INFIRM
Employer identification number
13-1740033
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
370,430
115,718
223,936
146,253
137,234
993,571
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......
28,173,344
28,373,040
27,419,050
28,064,266
26,705,725
138,735,425
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.
28,543,774
28,488,758
27,642,986
28,210,519
26,842,959
139,728,996
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
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.
0
c
Add lines 7a and 7b..
0
8
Public Support (Subtract line 7c from line 6.)
139,728,996
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
28,543,774
28,488,758
27,642,986
28,210,519
26,842,959
139,728,996
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
602,239
774,666
507,619
453,543
154,764
2,492,831
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
602,239
774,666
507,619
453,543
154,764
2,492,831
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 IV.)
259,908
438,990
285,510
489,629
239,160
1,713,197
13
Total support (Add lines 9, 10c, 11 and 12.).
29,405,921
29,702,414
28,436,115
29,153,691
27,236,883
143,935,024
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
97.080 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
96.680 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
1.730 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
1.890 %
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS CAFETERIA INCOME COMMISSIONS & DISCOUNTS INCOME FROM GIFT SHOPS CARMELITE SISTERS REMIBURSEMENT
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
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 to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST PATRICK'S HOME FOR THE AGED AND INFIRM
Employer identification number
13-1740033
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
THERE ARE FIVE MEMBERS OF THE CORPORATION THAT INCLUDE THE OFFICES OF THE SUPERIOR GENERAL AND FOUR MEMBERS OF THE GENERAL COUNCIL OF THE CARMELITE SISTERS FOR THE AGED INFIRM.
FORM 990, PART VI, SECTION A, LINE 7A
THE BOARD OF DIRECTORS OF ST. PATRICK'S HOME FOR THE AGED AND INFIRM SHALL BE ELECTED BY THE MEMBERS AT EACH ANNUAL MEETING OF THE MEMBERS CORPORATION BY MAJORITY VOTE. MEMBERS CAN ALSO SERVE ON THE BOARD OF DIRECTORS AS MEMBER-DIRECTORS. ALL STANDARDS APPLICABLE TO DIRECTORS IN THE BY-LAWS SHALL ALSO APPLY TO MEMBER-DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B
THE CORPORATE MEMBERS RETAIN THE RIGHT TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11
THE FACILITY HAS ITS FORM 990 REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. UPON COMPLETION OF THE FORM, IT IS SUBMITTED TO THE FINANCE COMMITTEE FOR REVIEW AND APPROVAL. THEREAFTER, THE FINANCE COMMITTEE WILL REPORT TO THE BOARD OF DIRECTORS AT THE NEXT SCHEDULED QUARTERLY MEETING, AT WHICH TIME EACH BOARD MEMBER WILL RECEIVE A COPY OF THE FORM 990. ALL NECESSARY COMMENTS AND CHANGES WILL BE RECORDED TO ENSURE A COMPLETE AND ACCURATE FORM 990 IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C
ST. PATRICK'S HOME FOR THE AGED AND INFIRM, INC. IS STRONGLY COMMITTED TO A POLICY OF COMPLIANCE WITH ALL CONFLICT OF INTEREST PROVISIONS UNDER LAW. SUCH COMPLIANCE IS OF CRITICAL IMPORTANCE TO THE NON-PROFIT, CHARITABLE MISSION AND ACTIVITIES OF ST. PATRICK'S HOME. BY FOLLOWING THIS POLICY, ALL BOARD MEMBERS WILL ASSURE THAT THE REPUTATION, GOOD WILL AND MISSION OF ST. PATRICK'S HOME ARE PRESERVED AND MAINTAINED IN GOOD STANDING. REMUNERATION: NO MEMBER OF THE BOARD OF DIRECTORS SHALL RECEIVE REMUNERATION FOR SERVICES RENDERED IN CONNECTION WITH SUCH MEMBER'S RESPONSIBILITIES AS A DIRECTOR OF THIS CORPORATION. EXPENSES INCIDENTAL TO ATTENDANCE AT THE MEETING OF THE BOARD OF DIRECTORS MAY BE PAID TO THE MEMBERS OF THE BOARD WITH BOARD APPROVAL. ANNUAL DISCLOSURE: IN ORDER TO PROPERLY IMPLEMENT THIS POLICY, EACH BOARD MEMBER SHALL SIGN AN ANNUAL DISCLOSURE, SETTING FORTH ALL POTENTIAL AND ACTUAL CONFLICTS OF INTEREST OR INDICATING THAT NO SUCH CONFLICTS EXIST. THIS DISCLOSURE SHALL BE IN THE FORM OF A LETTER DIRECTED TO THE MEMBERS OF THE CORPORATION. ACKNOWLEDGEMENT: BY SIGNING THIS POLICY STATEMENT, THE BOARD MEMBER ACKNOWLEDGES THAT HE OR SHE HAS READ THE STATEMENT, UNDERSTANDS WHAT HIS OR HER RESPONSIBILITIES ARE AS A BOARD MEMBER AND WILL FULLY COMPLY WITH THE REQUIREMENTS SET FORTH ABOVE. FORM 990, PART VI, SECTION B, LINE 13: WHISTLEBLOWER POLICY THE HOME HAS A WRITTEN WHISTLEBLOWER POLICY AND PROCEDURE. THE POLICY IS INCORPORATED IN THE HOME'S CORPORATE COMPLIANCE PROGRAM. THE POLICY ALLOWS FOR EMPLOYEES AND OTHER INDIVIDUALS TO REPORT INCIDENTS AND OR ABUSES ANONYMOUSLY TO THE CORPORATE COMPLIANCE OFFICER VIA THE CORPORATE COMPLIANCE HOTLINE OR CORPORATE COMPLIANCE BOXES LOCATED THROUGHOUT THE PREMISES.
FORM 990, PART VI, SECTION B, LINE 15
A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION FOR COVERED INDIVIDUALS BASED ON RELEVANT DATA INCLUDING COMPARABILITY COMPENSATION FOR SIMILARLY SITUATED ENTITIES AND INDEPENDENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS AS DEEMED NECESSARY. COMPENSATION PAID TO THE ADMINISTRATOR AND ASSISTANT ADMINISTRATOR: PLEASE NOTE THAT BOTH THE ADMINISTRATOR AND ASSISTANT ADMINISTRATOR AS WOMAN RELIGIOUS MEMBERS OF THE CARMELITE SISTERS FOR THE AGED AND INFIRM, INC. HAVE TAKEN A VOW OF POVERTY AND ARE PROVIDED WITH ZERO (0) COMPENSATION FROM THE FACILITY. ALL COMPENSATION THAT WOULD HAVE BEEN PAID TO THE ADMINISTRATOR AND ASSISTANT ADMINISTRATOR ON BEHALF OF SERVICES PROVIDED TO THE FACILITY IS INSTEAD PAID TO THE CARMELITE SISTERS OF THE AGED AND INFIRM, INC. RATHER THAN THE INDIVIDUALS. FOR 2010, THE HOME PAID THE ORDER AN AMOUNT OF $278,029 FOR SERVICES THE ADMINISTRATOR AND ASSISTANT ADMINISTRATOR PROVIDED TO THE FACILITY.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS; CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND TAX FILINGS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION ALSO FILES REPORTS WITH VARIOUS GOVERNMENTAL AGENCIES AS A REQUIREMENT FOR PARTICIPATION IN GOVERNMENT PROGRAMS, WHICH THE AGENCIES MAY MAKE AVAILABLE TO THE PUBLIC. THE ORGANIZATIONS FORM 990 IS AVAILABLE TO THE PUBLIC ON GUIDESTAR'S WEBSITE.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
PENSION LIABILITY ADJUSTMENT 305,461. TOTAL TO FORM 990, PART XI, LINE 5: 305,461.
PART XI, LINE 2C
THE BOARD OF DIRECTORS HAS DESIGNATED A COMMITTEE TO MANAGE THE PROCESSES OF SELECTION AND OVERSIGHT OF THE AUDIT AND INDEPENDENT ACCOUNTANT. THE COMMITTEE MEETS WITH MANAGEMENT AND THE INDEPENDENT AUDITORS TO REVIEW THE ENGAGEMENT PROPOSAL; RESULTS OF THE AUDIT; DRAFT AUDIT REPORT; MANAGEMENT LETTER. THE COMMITTEE MAY MEET WITH THE INDEPENDENT AUDITORS IN EXECUTIVE SESSION BEFORE CONCLUDING ITS REVIEW AND ACCEPTANCE OF THE ANNUAL AUDIT REPORT. THE COMMITTEE REPORTS ITS FINDINGS AND MAKES ITS RECOMMENDATION TO THE BOARD OF DIRECTORS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.