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
2012
Open to Public Inspection
Name of the organization
SUNSHINE TERRACE FOUNDATION INC
Employer identification number
87-0208619
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 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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
221,042
686,638
325,298
194,239
340,366
1,767,583
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3
221,042
686,638
325,298
194,239
340,366
1,767,583
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)..
816,693
6
Public support. Subtract line 5 from line 4.
950,890
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
7
Amounts from line 4..
221,042
686,638
325,298
194,239
340,366
1,767,583
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
37,067
7,592
3,892
2,172
1,813
52,536
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
0
11
Total support (Add lines 7 through 10).
1,820,119
12
Gross receipts from related activities, etc. (see instructions)
..................
12
59,476,228
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
52.240 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
48.290 %
16a
33 1/3% support test—2012.
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—2011.
If the organization did not check a 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—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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 IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
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 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012
Additional Data
Software ID:
12000229
Software Version:
2012v2.0
-
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
2012
Open to Public Inspection
Name of the organization
SUNSHINE TERRACE FOUNDATION INC
Employer identification number
87-0208619
Identifier
Return Reference
Explanation
STATISTICS OF INTEREST FROM 2012:
1. WE ARE IN OUR 65TH YEAR OF SERVICE TO OUR COMMUNITY AS A 501(C)(3) CHARITABLE NONPROFIT HEALTH CARE PROVIDER.2. WE SERVE APPROXIMATELY 250 PEOPLE PER DAY, AND AVERAGE AROUND 345 EMPLOYEES (FULL AND PART TIME).3. WE PROVIDE SUB-ACUTE, SHORT-TERM REHABILITATIVE, SKILLED, EXTENDED, RESPITE, AND SPECIALIZED DEMENTIA CARE SERVICES IN OUR REHABILITATION CENTER; IN-HOME PERSONAL SERVICES, SKILLED & NON-SKILLED HOME HEALTH CARE, PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES, AS WELL AS FITNESS TRAINING AT OUR OUTPATIENT CLINIC; FITNESS TRAINING AT OUR WELLNESS CENTER, AND LEVEL TWO ASSISTED LIVING SERVICES INCLUDING OVERNIGHT RESPITE STAYS IN OUR TERRACE GROVE ASSISTED LIVING CENTER.4. WE ARE CERTIFIED TO PROVIDE BOTH MEDICAID SERVICES, CONTRACTED WITH THE VETERANS ADMINISTRATION AND MANAGED CARE ORGANIZATIONS, AND PROVIDE UNCOMPENSATED CARE TO INDIVIDUALS WHO HAVE NO SOURCE OF REIMBURSEMENT. WE ARE FULLY LICENSED BY THE UTAH DEPARTMENT OF HEALTH FOR OUR REHABILITATION CENTER, IN-HOME PERSONAL CARE, HOME HEALTH AND ASSISTED LIVING SERVICES. WE ARE PROUD OF OUR REGULATORY COMPLIANCE HISTORY.5. WE ARE ACTIVE MEMBERS OF THE UTAH HEALTH CARE (STATE AFFILIATE OF THE AMERICAN HEALTH CARE ASSOCIATION), THE AMERICAN HEALTH CARE ASSOCIATION, AND THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE. OUR CEO AND NURSING HOME ADMINISTRATORS ARE ACTIVE MEMBERS OF THE AMERICAN COLLEGE OF HEALTH CARE ADMINISTRATORS.6. OUR ADMINISTRATIVE COSTS IN 2012 WERE 15%; FUND RAISING COSTS WERE LESS THAN 1%. OUR DONORS GAVE $531,109 IN 2012. TOTAL VOLUNTEER HOURS IN 2012 WERE 56,5637. IN 2012, WE PROVIDED $1,644,433 IN STATE DEFINED UNCOMPENSATED CARE. WE ARE VERY GRATEFUL FOR OUR PROPERTY TAX EXEMPTION GRANTED BY CACHE COUNTY, UTAH, AND FOR OUR FEDERAL TAX EXEMPT STATUS AS WELL.8. OUR BOARD MEMBERS ARE VOLUNTEERS FROM OUR COMMUNITY.9. IT IS OUR PLEASURE TO PROVIDE MEETING ROOMS FOR COMMUNITY ORGANIZATIONS FREE OF CHARGE. FOR EXAMPLE, THE ALZHEIMER'S SUPPORT GROUP MEETS FOR A FREE MEAL AND THEIR EDUCATION SESSION EACH MONTH AT OUR ASSISTED LIVING CENTER.10. WE ARE ACTIVE IN SERVICE CLUBS AND VOLUNTEER COMMUNITY ORGANIZATIONS.11. IT IS OUR PRIVILEGE TO PROVIDE A PRACTICUM SETTING FOR STUDENTS OF HEALTH CARE RELATED PROFESSIONS, AND MENTOR ADMINISTRATORS' IN TRAINING.THE SUNSHINE TERRACE FOUNDATION HAS A SIXTY-FIVE YEAR HISTORY OF ACHIEVING ITS MISSION STATEMENT OF "WELLNESS, INDEPENDENCE, DIGNITY, AND QUALITY OF LIFE FOR THOSE WE SERVE." THROUGH THE COLLABORATING EFFORTS OF A VERY SUPPORTIVE COMMUNITY NETWORK OUR CAMPUS OF CONTINUING CARE HAS REACHED LITERALLY THOUSANDS OF INDIVIDUALS BOTH INSIDE AND OUTSIDE OF OUR STATE, WHO HAVE NEEDED HEALTH CARE ASSISTANCE.WE PRIDE OURSELVES IN BEING COMMUNITY RUN, BUT MORE IMPORTANTLY A COMMUNITY FOCUSED ORGANIZATION, THIS YEAR WE HAVE RECORDED 731,497 COMMUNITY VOLUNTEER HOURS SINCE 2003. IN 2012 WE HAD 56,563 VOLUNTEER HOURS. IN THE PAST 30 YEARS THE SUNSHINE TERRACE FOUNDATION HAS BEEN A 13-TIME RECIPIENT OF THE GOVENOR'S PRESTIGIOUS VOLUNTEER AWARD, "THE SILVER BOWL." WE HAVE ALSO HAD 9 WINNERS OF THE UTAH HEALTH CARE ASSOCIATION "VOLUNTEER OF THE YEAR" AWARD. WE ARE HONORED TO HAVE A VOLUNTEER BOARD OF DIRECTORS WITH SOME OF THE MOST PRESTIGIOUS INDIVIDUALS IN THE STATE, RANGING FROM ATTORNEYS, ACCOUNTANTS, PROFESSORS, BUSINESS PEOPLE AND DOCTORS.
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
AVAILABLE UPON REQUEST AND LOCATED ON COMPANY WEBSITE. ORGANIZATIONAL DOCUMENTS ARE ALSO SUPPLIED AT THE ANNUAL MEETING.
Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
HEALTH BENEFITS ARE RENEWED YEARLY. EMPLOYEES MUST BE EMPLOYED 3 MONTHS AT A MINIMUM AVERAGE OF 30 HOURS PER WEEK TO QUALIFY. COMPENSATION IS DETERMINED BY STATE WAGE RATES FOR ALL JOB DESCRIPTIONS. THE CEO IS EVALUATED ON A YEARLY BASIS AND A ONE-YEAR EXTENSION OF EMPLOYEMENT IS OFFERED UPON A POSITIVE EVALUATION AND CONSENSUS BY THE BOARD OF DIRECTORS.
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
THE MEMBERS OF THE BOARD ARE CONSCIENTIOUS OF CONFLICT OF INTEREST ACTIVITIES AND VOLUNTARILY BRING UP THEIR OWN ACTIVITIES FOR DISCUSSION IF THEY FEEL IT MIGHT VIOLATE, OR GIVE THE PERCEPTION OF VIOLATING, THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. THE EXECUTIVE COMMITTEE MONITORS AND ADDRESSES ISSUES THAT MIGHT BE POTENTIAL CONFLICTS OF INTEREST. THE MANAGEMENT AND COMMITTEE STRUCTURE OF SUNSHINE TERRACE FOUNDATION ALSO PROMOTES THE ONGOING MONITORING OF CONFLICT OF INTEREST ACTIVITIES. THE MEMBERS OF THE BOARD ARE ALL KNOWN TO EACH OTHER, AS THEY ARE ALL PART OF THE SAME COMMUNITY. THIS MAKES IT EASIER TO IDENTIFY SITUATIONS WHERE A CONFLICT OF INTEREST MAY EXIST.
Form 990, Part VI, Line 11b
Form 990, Part VI, Line 11b: Form 990 Review Process
THE FINANCE COMMITTEE DOES AN IN-DEPTH REVIEW OF THE 990, BRINGS QUESTIONS AND CONCERNS TO THE ATTENTION OF MANAGEMENT FOR RESOLUTION AND MAKES SUGGESTIONS ON THE COMMENTARY PORTION OF THE FORM. AFTER RECOMMENDED CHANGES FROM THE FINANCE COMMITTEE ARE MADE, THE FORM 990 GOES TO EACH MEMBER OF THE BOARD OF DIRECTORS WHERE QUESTIONS AND CONCERNS ARE ADDRESSED. COMMENTARY CHANGES ARE MADE. THE FINANCE COMMITTEE AGAIN REVIEWS THE FORM 990 AND MAKES A RECOMENDATION FOR APPROVAL TO THE BOARD OF DIRECTORS. THE FULL BOARD OF DIRECTORS APPROVES THE FORM 990 PRIOR TO THE FILING OF THE RETURN.
Form 990, Part VI, Line 6
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder
A PERSON IS CONSIDERED A MEMBER OF SUNSHINE TERRACE FOUNDATION, INC. WHEN THEY HAVE PAID THEIR YEARLY DUES OF $10
Form 990, Part III, Line 4d
Form 990, Part III, Line 4d: Other Program Services Description
OTHER PROGRAM SERVICES 4: SUNSHINE HOME HEALTH CARE AND SUNSHINE HOSPICE- A LICENSED FULL SERVICE HOME HEALTH & HOSPICE AGENCY OFFERING BOTH SKILLED NURSING ALONG WITH SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY. SUNSHINE HOME HEALTH IS LICENSED AS A PERSONAL CARE AGENCY OFFERING NON-SKILLED AND RESPITE SERVICES. OUR HOME HEALTH AND HOSPICE ARE BOTH CHAP CERTIFIED. WE BELONG TO THE UTAH ASSOCIATION OF HOME CARE, UTAH HOSPICE AND PALLIATIVE CARE ORGANIZATION AND THE NATIONAL ASSOCIATION OF HOME CARE & HOSPICE. IN 2012, WE HAD A 65% INCREASE IN HOME HEALTH & HOSPICE CLIENTS FROM 2011. SUNSHINE HOME HEALTH & SUNSHINE HOSPICE PROVIDES EDUCATION ON HEALTH, MEDICATIONS AND PERSONAL CARE TO CLIENTS AND LOVED ONES IN THE HOME. NURSES DELIVER IV INFUSIONS, WOUND CARE, AND DIABETIC CARE AND ACUTE AND POST-SURGICAL CARE. THERAPY IS ALSO PROVIDED TO INCREASE HEALTH, SAFETY AND INDEPENDENCE IN THE HOME AND COMMUNITY. WE ALSO SERVICE CLIENTS WITH NON-SKILLED NEEDS SUCH AS PERSONAL CARE, BATHING & GROOMING, SHOPPING AND ERRANDS, HOMEMAKING AND RESPITE CARE.
Form 990, Part III, Line 2
Form 990, Part III, Line 2: New Services
DURING 2012, WE BEGAN OFFERING ACCREDITED HOSPICE SERVICES AS PART OF OUR HOME HEALTH CARE PROGRAM.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.