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
ALVERNA APARTMENTS
Employer identification number
41-1351177
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.") .
1,044
313
678
520
0
2,555
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......
552,059
562,780
555,540
466,054
508,961
2,645,394
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
0
0
51,166
50,815
101,981
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
6
Total. Add lines 1 through 5.
553,103
563,093
556,218
517,740
559,776
2,749,930
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.
132,418
140,015
141,757
163,106
163,986
741,282
c
Add lines 7a and 7b..
132,418
140,015
141,757
163,106
163,986
741,282
8
Public Support (Subtract line 7c from line 6.)
2,008,648
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...
553,103
563,093
556,218
517,740
559,776
2,749,930
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
22,364
21,978
16,781
10,251
8,373
79,747
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
22,364
21,978
16,781
10,251
8,373
79,747
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
0
13
Total support (Add lines 9, 10c, 11 and 12.).
575,467
585,071
572,999
527,991
568,149
2,829,677
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
70.990 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
76.110 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
2.820 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
3.110 %
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 (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000128
Software Version:
v2010.1.0
-
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
ALVERNA APARTMENTS
Employer identification number
41-1351177
Identifier
Return Reference
Explanation
PROGRAM SERVICE ACCOMPLISHMENTS
FORM 990, PART III, LINE 4A
INTRODUCTION: MISSION, VISION AND TAX-EXEMPT PURPOSES THE MISSION OF ALVERNA APARTMENTS IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH BY BRINGING IT NEW LIFE, ENERGY AND VITALITY IN THE 21ST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS WE MOVE TOWARD THE CREATION OF HEALTHIER COMMUNITIES. THE VISION FOR ALVERNA APARTMENTS IS TO CREATE THE BEST POSSIBLE RESIDENTIAL EXPERIENCE BY IGNITING THE SPIRIT FOR SUPERIOR CARE AND SERVICE. THE PURPOSES OF ALVERNA APARTMENTS ARE EXCLUSIVELY CHARITABLE WITHIN INTERNAL REVENUE SERVICE CODES AND REGULATIONS AS WELL AS RELATED PROVISION OF MINNESOTA STATE LAW. SPECIFICALLY, IT IS A 501(C)(3), NOT-FOR-PROFIT CORPORATION FORMED TO CONSTRUCT AND MAINTAIN HOUSING FACILITIES FOR THE ELDERLY AND HANDICAPPED, AND HAS BEEN SPECIALLY DESIGNED TO MEET THEIR PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS AND TO PROMOTE THEIR HEALTH, SECURITY AND HAPPINESS WHERE NO ADEQUATE HOUSING FACILITIES EXIST FOR SUCH PURPOSES. IN ADDITION, IT WAS FORMED TO ASSIST IN CARRYING OUT THE HEALING MINISTRY OF ITS FOUNDERS-THE FRANCISCAN SISTERS OF LITTLE FALLS AND ITS CURRENT SPONSOR CATHOLIC HEALTH INITIATIVES. ALVERNA APARTMENTS IS A 60-UNIT, SENIOR HOUSING COMPLEX SUBSIDIZED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD). IT OFFERS A SECURE LIVING ENVIRONMENT IN WHICH TENANTS CAN PURSUE OPTIMAL INDEPENDENCE AND FOSTER CONNECTIONS TO THE COMMUNITY. ALVERNA APARTMENTS PARTICIPATES IN THE HUD PROGRAM AND IS RATED ACCORDING TO VARIOUS QUALITY INDICATORS. FINALLY, ALVERNA APARTMENTS ENGAGES IN COMMUNITY OUTREACH ACTIVITIES SUCH AS SCHEDULING ASSISTANCE WITH TAX PREPARATION FOR SENIORS, CONDUCTING HEALTH SCREENINGS AND PARTICIPATING IN COMMUNITY HEALTH FAIRS. BOARD OF DIRECTORS THE BOARD OF DIRECTORS FOR ALVERNA APARTMENTS IS AN 11-MEMBER GOVERNING BOARD, THE MAJORITY OF WHICH ARE INDEPENDENT INDIVIDUALS WHO SERVE AS REPRESENTATIVES OF THE COMMUNITY. THE BOARD OVERSEES THE OPERATIONS OF ALVERNA APARTMENTS. QUALITATIVE DESCRIPTION OF COMMUNITY BENEFIT: ALL APPLICANTS MUST BE AGE 62 OR OLDER. ONLY ONE PERSON NEEDS TO BE QUALIFIED FOR A COUPLE TO BE ELIGIBLE. ALVERNA APARTMENTS SERVES ALL PERSONS IN THE COMMUNITY ON A NON-DISCRIMINATORY BASIS AND DOES NOT DISCRIMINATE ON THE BASIS OF RACE, SEX, NATIONAL ORIGIN, CREED, DISABILITY OR SEXUAL PREFERENCE. FOR THE COMFORT OF PEOPLE WITH DISABILITIES, SIX APARTMENTS HAVE BEEN SPECIALLY DESIGNED FOR EASY ACCESSIBILITY. APPLICANTS WITH EXTREMELY LOW INCOME ARE GIVEN PRIORITY CONSIDERATION FOR OCCUPANCY. RENT RANGES FROM $729 TO $918 MONTHLY. DURING THE FISCAL YEAR ENDING JUNE 30, 2011, ALVERNA APARTMENTS HOUSED 67 DIFFERENT TENANTS FOR A TOTAL OF 21,003 APARTMENT DAYS. AS PREVIOUSLY STATED, RENTAL ASSISTANCE APPLICANTS WITH EXTREMELY LOW INCOME ARE GIVEN PRIORITY CONSIDERATION FOR OCCUPANCY. FINANCIAL ASSISTANCE IS AVAILABLE THROUGH HUD. AS A HUD-SUBSIDIZED, SECTION 8/202 (ELDERLY PROPERTY) FACILITY, THE AMOUNT OF RENT THAT A TENANT IS REQUIRED TO PAY IS DETERMINED BY USING A FORMULA, WHICH INCLUDES AN INDIVIDUAL'S GROSS INCOME (INCLUDING INCOME FROM ASSETS), AND OUT-OF-POCKET MEDICAL EXPENSES FOR ALL PERSONS IN THE HOUSEHOLD. THE OUT-OF-POCKET MEDICAL EXPENSES ARE DEDUCTED FROM GROSS INCOME (MINUS 3% OF THE GROSS INCOME), WHICH LEAVES AN AMOUNT OF ADJUSTED INCOME. TENANT RENT IS BASED ON 30% OF THE CALCULATED ADJUSTED INCOME. ALL SUBSIDIZED TENANTS ARE REQUIRED BY HUD TO BE RECERTIFIED ANNUALLY IN ORDER TO VERIFY INCOME AND MEDICAL EXPENSES. ON THE AVERAGE, OVER 90% OF THE OCCUPANTS/UNITS RECEIVE RENTAL ASSISTANCE. CURRENTLY, 94% OF OCCUPANTS ARE RECEIVING RENTAL ASSISTANCE. TENANTS HAVE CONVENIENT ACCESS TO HOME CARE AND OTHER HEALTH CARE SERVICES AS WELL AS THE AVAILABILITY OF REASONABLY PRICED TRANSPORTATION THROUGH THE MORRISON COUNTY PUBLIC TRANSIT SYSTEM (MORRTRANS). THE LARGE COMMUNITY DINING AND ACTIVITY AREA HOSTS MANY GROUP ACTIVITIES THAT TENANTS CAN PARTICIPATE IN, SUCH AS BINGO SPONSORED BY THE TENANT COUNCIL; HEALTH-RELATED PRESENTATIONS BY THE CENTRAL MINNESOTA COUNCIL ON AGING, PUBLIC HEALTH AND THE MORRISON COUNTY EXTENSION OFFICE, AND OTHERS; EXERCISE CLASSES; MOVIES, A SOCIAL HOUR; CARD PLAYING; PRAYER MEETINGS; ETC., WHICH PROVIDE CONTINUITY AND CONNECTION TO THE COMMUNITY FOR THE TENANTS AS WELL AS ENHANCE THEIR QUALITY OF LIFE. FAMILIES OF TENANTS ROUTINELY ARE GIVEN ACCESS TO THE AREA, FREE OF CHARGE, FOR SUCH FUNCTIONS AS BIRTHDAY PARTIES, ANNIVERSARIES, HOLIDAYS, ETC. IN PARTICULAR, THE DINING AREA IS DONATED TO A NUMBER OF COMMUNITY GROUPS FOR USE AS THEIR MEETING AREA. SUCH GROUPS INCLUDE, BUT ARE NOT LIMITED TO: TAKE OFF POUNDS SENSIBLY (TOPS), THE SECULAR FRANCISCANS, AND A COMMUNITY GARDEN CLUB THAT MEET ON A MONTHLY BASIS. A TOTAL OF 36 ALVERNA APARTMENTS TENANTS VOLUNTEERED FOR OVER 1,217 HOURS LAST YEAR TO VARIOUS COMMUNITY PROGRAMS. THE PROGRAMS AND SERVICES DESCRIBED THROUGHOUT THIS REPORT NOT ONLY SERVE ALL PERSONS IN THE COMMUNITY, BUT ALSO HELP TO REDUCE THE BURDENS ON LOCAL GOVERNMENT. ALVERNA APARTMENTS' APPROACH TO COMMUNITY BENEFIT REVOLVES AROUND SERVING THE NEEDS OF ALL PEOPLE THROUGHOUT THE SERVICE AREA. ALVERNA APARTMENTS IS LOCATED IN LITTLE FALLS, MINNESOTA, AND SERVES PEOPLE THROUGHOUT MORRISON COUNTY AND THE SURROUNDING AREA OF CENTRAL MINNESOTA. MORRISON COUNTY HAS A POPULATION OF APPROXIMATELY 32,000. ACCORDING TO 2010 U.S. CENSUS BUREAU DATA, THE COUNTY IS THE ELEVENTH POOREST COUNTY IN MINNESOTA BASED ON PER CAPITA INCOME, WITH A PER CAPITA INCOME OF $22,934 COMPARED TO $29,582 STATEWIDE. THE AVERAGE ANNUAL INCOME FOR ALVERNA APARTMENTS TENANTS IS NEARLY $14,892. MORRISON COUNTY ALSO HAS A HIGHER RATE OF SENIORS, WITH 16.1% OF THE POPULATION AGE 65 OR OLDER IN COMPARISON TO 12.7% STATEWIDE. THE AVERAGE AGE FOR AN ALVERNA APARTMENTS TENANT IS 85.2 YEARS. OF THE AREAS SERVED BY ALVERNA APARTMENTS, TWO SMALL PORTIONS OF MORRISON COUNTY, A SMALL AREA IN THE NORTHEASTERN SECTION OF THE COUNTY NEAR HILLMAN, AND A SECOND AREA IN AND AROUND THE RANDALL LAKES AREA ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS BASED ON INCOME.
Classes of members or stockholders
Form 990, Part VI, Section A, Line 6
THE ORGANIZATION'S SOLE CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES, A COLORADO NONPROFIT CORPORATION.
Members or stockholders electing members of governing body
Form 990, Part VI, Section A, Line 7a
THE ORGANIZATION'S SOLE CORPORATE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS.
Decisions requiring approval by members or stockholders
Form 990, Part VI, Section A, Line 7b
THE ORGANIZATION'S CORPORATE MEMBER IS CATHOLIC HEALTH INITIATIVES ("CHI"). PURSUANT TO ARTICLE V, SECTION 5.4 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: - SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF ALVERNA APARTMENTS - AMENDMENT OF THE CORPORATE DOCUMENTS OF ALVERNA APARTMENTS - APPROVE MEMBERS OF ALVERNA APARTMENTS BOARD - REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ALVERNA APARTMENTS - APPROVAL OF ISSUANCE OF DEBT BY ALVERNA APARTMENTS - APPROVAL OF PARTICIPATION OF ALVERNA APARTMENTS IN A JOINT VENTURE - APPROVAL OF FORMATION OF A NEW CORPORATION BY ALVERNA APARTMENTS - APPROVAL OF A MERGER INVOLVING ALVERNA APARTMENTS - APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF ALVERNA APARTMENTS - TO REQUIRE THE TRANSFER OF ASSETS BY ALVERNA APARTMENTS TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS - ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR ALVERNA APARTMENTS PURSUANT TO ARTICLE V, SECTION 5.5 OF THE ORGANIZATION'S BYLAWS, CHI MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Review of form 990 by governing body
Form 990, Part VI, Section B, Line 11a
AFTER THE FORM 990 IS PREPARED BY CHI TAX DEPARTMENT, THE UNITY FAMILY HEALTHCARE CFO/VP OF FINANCE REVIEWS A COPY OF THE RETURN AND PROVIDES COPIES TO THE BOARD MEMBERS AT THE NEXT FINANCE, AUDIT AND COMPLIANCE COMMITTEE MEETING. COPIES ARE AVAILABLE FOR ALL REMAINING BOARD MEMBERS' REVIEW FROM ADMINISTRATION. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Conflict of interest policy
Form 990, Part VI, Section B, Line 12c
THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL DIRECTORS AND OFFICERS WHO ARE MEMBERS OF THE BOARD OF DIRECTORS OR MEMBERS OF ANY BOARD COMMITTEE. EACH DIRECTOR MUST PROMPTLY AND FULLY REPORT TO THE BOARD CHAIR SITUATIONS THAT MAY CREATE A CONFLICT OF INTEREST WHEN HE OR SHE BECOMES AWARE OF SUCH SITUATIONS. IN THE CASE OF AN OFFICER, DISCLOSURE MUST BE MADE TO THE ORGANIZATION'S PRESIDENT AND CHIEF EXECUTIVE OFFICER, WHO WILL REPORT SUCH DISCLOSURE TO THE BOARD CHAIR. IN ANY SITUATION WHERE A DIRECTOR OF OFFICER IS IN DOUBT, FULL DISCLOSURE SHOULD BE MADE SO AS TO PERMIT AN IMPARTIAL AND OBJECTIVE DETERMINATION. A WRITTEN RECORD OF THE DISCLOSURE WILL BE MADE. IN ADDITION TO THE ONGOING DISCLOSURE OBLIGATION, THE ORGANIZATION'S PRESIDENT AND CHIEF EXECUTIVE OFFICER ANNUALLY SENDS ALL DIRECTORS AND OFFICERS A COPY OF THE CONFLICT OF INTEREST POLICY AND DISCLOSURE STATEMENT. THE DIRECTORS AND OFFICERS MUST PROMPTLY COMPLETE, SIGN, AND RETURN THE STATEMENT TO THE ORGANIZATION'S PRESIDENT AND CHIEF EXECUTIVE OFFICER. THE COMPLETED STATEMENTS ARE REVIEWED BY THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND THE BOARD CHAIR. THE BOARD CHAIR MAKES FURTHER INVESTIGATION OF CONFLICT OF INTEREST DISCLOSURES AS HE/SHE DEEMS APPROPRIATE.
Process used to establish compensation of top management official
Form 990, Part VI, Section B, Line 15a
THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION IS PAID BY CHI. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHI'S COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER, 2011. IN ADDITION, IN DECEMBER 2009, HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS.
Public Disclosure
Form 990, Part VI, Section C, Line 19
THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.ORG. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT PUBLICLY AVAILABLE.
PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES
FORM 990, PART VI, SECTION B, LINE 15B
DURING THE TAX YEAR ENDED 6/30/11, NO OTHER OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THIS QUESTION IS MORE APPROPRIATELY ANSWERED AS "N/A" BUT HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS.
FORM 990, PART VI, SECTION A, LINE 1A
COMMITTEE COMPOSITION AND AUTHORITY
THE BOARD OF DIRECTORS MAY, BY RESOLUTION ADOPTED BY A MAJORITY OF THE DIRECTORS THEN IN OFFICE, ESTABLISH ONE OR MORE COMMITTEES, AS NEEDED OR REQUIRED TO CONDUCT AND TRANSACT THE BUSINESS OF THE CORPORATION. EXCEPT AS OTHERWISE PROVIDED IN THE ORGANIZATION'S BYLAWS, THE BOARD OF DIRECTORS MAY SET THE QUALIFICATIONS FOR MEMBERSHIP ON ANY COMMITTEE IT MAY ESTABLISH, PROVIDED THAT EACH COMMITTEE SHALL CONSIST OF AT LEAST TWO DIRECTORS OF THE CORPORATION. COMMITTEES MAY INCLUDE PERSONS OTHER THAN DIRECTORS, EXCEPT THAT A COMMITTEE THAT HAS AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MUST INCLUDE ONLY DIRECTORS OF THE CORPORATION. MINUTES OF ALL COMMITTEE MEETINGS SHALL BE RECORDED AND COPIES OF SUCH MINUTES SHALL BE PROVIDED TO THE BOARD OF DIRECTORS. ACTIONS OF COMMITTEES SHALL BE REPORTED TO THE FULL BOARD OF DIRECTORS, BUT ACTIONS OF COMMITTEES WHICH INCLUDE PERSONS OTHER THAN DIRECTORS SHALL BE SUBJECT TO RATIFICATION BY THE FULL BOARD OF DIRECTORS.
ESTIMATE OF HOURS DEVOTED TO RELATED ORGANIZATIONS
FORM 990, PART VII, SECTION A, LINE 1A
THE INDIVIDUALS LISTED IN PART VII THAT REPORT COMPENSATION PAID BY A RELATED ORGANIZATION DEVOTE APPROXIMATELY 60 HOURS PER WEEK TO THE RELATED ORGANIZATIONS AND RECEIVE COMPENSATION IN EXCHANGE FOR THEIR SERVICES PROVIDED.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.