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
THE EVERGREENS
Employer identification number
21-0634485
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.") ....
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
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.") .
649,596
695,433
293,340
249,801
331,960
2,220,130
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......
19,109,654
20,443,654
21,269,975
20,282,473
21,238,727
102,344,483
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.
19,759,250
21,139,087
21,563,315
20,532,274
21,570,687
104,564,613
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
12,699
20,470
22,476
13,681
24,087
93,413
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..
12,699
20,470
22,476
13,681
24,087
93,413
8
Public support (Subtract line 7c from line 6.)
104,471,200
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...
19,759,250
21,139,087
21,563,315
20,532,274
21,570,687
104,564,613
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
1,659,459
1,266,762
1,292,803
1,069,982
936,099
6,225,105
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
1,659,459
1,266,762
1,292,803
1,069,982
936,099
6,225,105
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.)..
21,418,709
22,405,849
22,856,118
21,602,256
22,506,786
110,789,718
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
94.300 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
93.710 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
5.620 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
6.220 %
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
THE EVERGREENS
Employer identification number
21-0634485
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 7A
ARTICLE 3.02 OF THE BYLAWS PROVIDE THAT THREE TRUSTEES MAY BE APPOINTED BY THE BISHOP OF THE DIOCESE OF NEW JERSEY.
FORM 990, PART VI, SECTION B, LINE 11
THE ORGANIZATION ENGAGED A PROFESSIONAL CPA FIRM WITH EXPERIENCE IN NOT-FOR-PROFIT TAX RETURN PREPARATION. THE FIRM WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE FIRM PREPARED A DRAFT FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL FOR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL REVIEWED THE DRAFT FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. CHANGES WERE MADE TO THE DRAFT FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL FOR FINAL REVIEW AND APPROVAL. THE PRESIDENT/CEO OF THE ORGANIZATION REVIEWS THE FINAL DRAFT BEFORE PRESENTING THE FORM 990 TO THE AUDIT COMMITTEE. THE BOARD OF TRUSTEES HAS DELEGATED THE AUDIT COMMITTEE TO OVERSEE, REVIEW AND APPROVE THE FORM 990 PROCESS. ONCE THE AUDIT COMMITTEE REVIEWED AND APPROVED THE DOCUMENT, A COPY WAS SENT TO EACH MEMBER OF THE BOARD OF TRUSTEES EITHER ELECTRONICALLY OR BY COURIER PRIOR TO FILING THE DOCUMENT.
FORM 990, PART VI, SECTION B, LINE 12C
THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS, SENIOR MANAGEMENT, AND OTHER KEY PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. IT IS A BOARD MEMBER'S RESPONSIBILITY TO NOTIFY THE PRESIDENT/CEO OF ANY CHANGES THAT WOULD CREATE A CONFLICT DURING THE YEAR. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION'S PRESIDENT/CEO FOR REVIEW ANNUALLY. IF A CONFLICT OF INTEREST EXISTS, IT IS ADDRESSED WITH THE BOARD CHAIR AND INDIVIDUAL WITH THE CONFLICT. AN INDIVIDUAL WITH A CONFLICT MAY BE ASKED TO LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE CONFLICT IS DISCUSSED AND VOTED UPON.
FORM 990, PART VI, SECTION B, LINE 15
CEO/PRESIDENT COMPENSATION - BOARD EXECUTIVE COMPENSATION COMMITTEE OF FOUR BOARD MEMBERS IS CHAIRED BY THE BOARD CHAIR. THE COMMITTEE REVIEWS THE ANNUAL COMPARISON STUDY CONTRACTED THROUGH HUMAN RESOURCES AND PREPARED BY AN OUTSIDE FIRM. THE COMMITTEE'S ANNUAL RECOMMENDATION FOR THE CEO/PRESIDENT COMPENSATION IS PRESENTED TO THE ENTIRE BOARD FOR REVIEW AND APPROVAL IN EXECUTIVE SESSION AT A REGULARLY SCHEDULED BOARD MEETING. THE CHAIR OF THE EXECUTIVE COMPENSATION COMMITTEE DOCUMENTS THE REVIEW PROCESS IN THE COMMITTEE MEETING MINUTES. SENIOR STAFF - THE CEO USES THE SAME COMPARISON STUDY REFERRED TO ABOVE AND CONSULTS WITH THE BOARD CHAIR IN ANNUALLY SETTING THE COMPENSATION OF THE COO (WHEN FILLED), VP OF FINANCE & CFO, DIRECTOR OF DEVELOPMENT (WHEN FILLED), AND VP OF HEALTH SERVICES. THE MEDICAL DIRECTOR IS CONTRACTED THROUGH COOPER HEALTH SYSTEM. ACCORDINGLY, THE ORGANIZATION HAS NO INPUT RELATIVE TO HER COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY SECRETARY OF STATE. THE ORGANIZATION ALSO MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:
VALUATION GAIN, BENEFICIAL INTEREST IN PERPETUAL TRUSTS 66,243.
FORM 990, PART VII AND SCHEDULE J, PART II
PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OF THIS ORGANIZATION'S BOARD OF TRUSTEES.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.