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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CATHOLIC SOCIAL SERVICES INC
Employer identification number
31-4379437
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
3,310,371
3,443,576
4,193,242
3,772,894
3,139,204
17,859,287
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
3,310,371
3,443,576
4,193,242
3,772,894
3,139,204
17,859,287
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.
17,859,287
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
3,310,371
3,443,576
4,193,242
3,772,894
3,139,204
17,859,287
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
63,110
46,315
32,534
50,180
59,723
251,862
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
546
4,250
4,796
11
Total support (Add lines 7 through 10).
18,115,945
12
Gross receipts from related activities, etc. (see instructions)
..................
12
991,738
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
98.580 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
98.540 %
16a
33 1/3% support test—2013.
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—2012.
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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
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) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CATHOLIC SOCIAL SERVICES INC
Employer identification number
31-4379437
Return Reference
Explanation
FORM 990, PART III, LINE 2
CSS LAUNCHED THE FRIENDLY VISITING PROGRAM IN JUNE 2013. THE FRIENDLY VISITING PROGRAM IS A COMMUNITY-BASED PROGRAM THAT UTILIZES VOLUNTEERS TO PROVIDE SUPPORT AND ONE-ON-ONE ASSISTANCE TO ISOLATED SENIORS IN FRANKLIN COUNTY. FRIENDLY VISITING VOLUNTEERS ARE MATCHED WITH A LOCAL, ISOLATED, AND LONELY INDIVIDUALS IN AN EFFORT TO HELP SENIORS LIVING ALONE, TO REMAIN INDEPENDENT IN THEIR OWN HOME.
FORM 990, PART III, LINE 3
IN 2013, CATHOLIC SOCIAL SERVICES CONTINUED TO BE THE SPONSOR FOR THE LONG TERM CARE OMBUDSMAN PROGRAM (LTCOP) UNTIL MAY AT WHICH TIME IT TRANSITIONED TO A NEW SPONSORING AGENCY. THIS PROGRAM SERVED EIGHT CENTRAL OHIO COUNTIES (OH REGION 6 INCLUDES FRANKLIN, DELAWARE, UNION, MADISON, LICKING, FAIRFIELD, PICKAWAY AND FAYETTE COUNTIES) AND IS ONE OF 12 DESIGNATED PROGRAMS IN OHIO. THE LTCOP PERFORMS THE DUTIES OF ADVOCACY, COMPLAINT RESOLUTION, AND GENERAL INFORMATION PROVISION FOR ACTUAL AND POTENTIAL RECIPIENTS OF LONG-TERM CARE SERVICES IN NURSING HOMES, RESIDENTIAL CARE/ASSISTED LIVING FACILITIES, ADULT CARE FACILITIES, AS WELL AS HOME AND COMMUNITY BASED SERVICES.
FORM 990, PART VI, SECTION A, LINE 6
CATHOLIC SOCIAL SERVICES, INC IS INCORPORATED IN THE STATE OF OHIO AS A SOLE MEMBER NON-PROFIT 501(C)(3) CORPORATION. THE SOLE MEMBER OF CATHOLIC SOCIAL SERVICES, INC. IS THE DIOCESAN CHARITIES MEMBERSHIP CORPORATION, ALSO INCORPORATED AS A NON-PROFIT 501(C)(3) CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A
THE DIOCESAN CHARITIES MEMBERSHIP CORPORATION, AS THE SOLE MEMBER OF CATHOLIC SOCIAL SERVICES, INC. HAS APPROVAL AUTHORITY OVER MEMBERSHIP OF THE BOARD OF DIRECTORS OF CATHOLIC SOCIAL SERVICES, INC.
FORM 990, PART VI, SECTION A, LINE 7B
BESIDES APPROVAL OF MEMBERSHIP TO THE CATHOLIC SOCIAL SERVICES INC'S BOARD OF DIRECTORS, THE DIOCESAN CHARITIES MEMBERSHIP CORPORATION HAS RESERVED POWERS OVER ANY SIGNIFICANT DECISIONS REGARDING ORGANIZATIONAL CHANGES SUCH AS THE AGENCY MISSION OR ACQUISITION OF DEBT.
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 WAS PREPARED BY SCHNEIDER DOWNS & CO., INC. BASED ON INPUT FROM THE AUDITED FINANCIAL STATEMENTS, VARIOUS INTERNAL DOCUMENTS AND CSS MANAGEMENT. THE COMPLETED FORM 990 WAS REVIEWED BY THE PRESIDENT AND TREASURER, THE FINANCE COMMITTEE AND THEN THE FULL CSS BOARD. INPUT AS TO THE COMPLETENESS AND ACCURACY WAS SOLICITED FROM ALL AND INCORPORATED INTO THE FINAL DOCUMENT THAT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12C
ANNUALLY, IN ACCORDANCE WITH THE AGENCY'S CONFLICT OF INTEREST POLICY, BOARD MEMBERS ARE REQUIRED TO REVIEW THE POLICY AND SIGN A FORM INDICATING EITHER 'NO CONFLICT' OR IDENTIFYING AND EXPLAINING A CONFLICT IF ONE EXISTS. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, POTENTIAL REMEDIES ARE REVIEWED BY THE CEO AND BOARD CHAIR. ALL REMEDIES ARE DOCUMENTED AND SIGNED BY THE CEO, BOARD CHAIR AND IDENTIFIED BOARD MEMBER. SHOULD A MATTER COME BEFORE THE BOARD WHERE A CONFLICT EXISTS FOR ONE OR MORE BOARD MEMBERS, THE CONFLICT IS IDENTIFIED AND THOSE MEMBERS DO NOT PARTICIPATE IN THE DISCUSSION OR VOTE.
FORM 990, PART VI, SECTION B, LINE 15
ALL CSS STAFF, INCLUDING THE CEO AND DIRECT REPORTS, ARE EVALUATED BI-ANNUALLY USING COMPARATIVE DATA FROM A SALARY SURVEY CONDUCTED EVERY TWO YEARS BY THE OHIO ASSOCIATION OF NON-PROFIT ORGANIZATIONS, THAT INCLUDES INFORMATION SPECIFIC TO OHIO. IN ADDITION, THE HR COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE 990 FILINGS OF SEVERAL LOCAL NON-PROFIT ORGANIZATIONS AND LEARNED THAT AGENCY SALARY RANGES WERE COMPETITIVE FOR THE CEO. IN ESTABLISHING THE SALARY LEVEL FOR THE CEO, SPECIFIC OBJECTIVES ARE SET AT THE BEGINNING OF EACH YEAR WITH THE BOARD OF DIRECTORS. EACH YEAR, THE CEO SUBMITS A WRITTEN EVALUATION OF HIS/HER PERFORMANCE VERSUS THOSE OBJECTIVES. THE BOARD CHAIR SOLICITS INPUT FROM CSS' EXECUTIVE COMMITTEE AFTER WHICH THE CHAIR FINALIZES THE CEO'S EVALUATION. AN ANNUAL MERIT INCREASE IS THEN CONSIDERED BASED ON THE CEO'S PERFORMANCE AGAINST THE OBJECTIVES. THE FINAL SALARY IS RECOMMENDED BY THE BOARD CHAIR AND HR CHAIR AND REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19
GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, THE ANNUAL (AUDITED) FINANCIAL STATEMENTS AND THE FORM 990 ARE AVAILABLE UPON REQUEST AT NO CHARGE.
FORM 990, PART XI, LINE 9:
ADJUSTMENT TO FAIR VALUE OF FUNDS HELD IN TRUST BY OTHERS 296,586.
FORM 990, PART XII, LINE 2C:
THE FINANCE COMMITTEE OVERSEES THE ANNUAL AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS. THE INDEPENDENT AUDITORS HAVE BEEN SELECTED THROUGH A PROPOSAL PROCESS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.