Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 10,000 | 8,575 | 13,390 | 31,965 |
| 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...... | 873,845 | 7,742,891 | 9,037,098 | 10,740,240 | 28,394,074 | |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | |||||
| 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. | 0 | 873,845 | 7,752,891 | 9,045,673 | 10,753,630 | 28,426,039 |
| 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.) | 28,426,039 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 0 | 873,845 | 7,752,891 | 9,045,673 | 10,753,630 | 28,426,039 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 188 | 1,258 | 1,673 | 1,693 | 4,812 | |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 188 | 1,258 | 1,673 | 1,693 | 4,812 | |
| 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 VI.) .. | 1,600 | 1,600 | 0 | 3,200 | ||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 0 | 874,033 | 7,755,749 | 9,048,946 | 10,755,323 | 28,434,051 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| PART VI, SECTION A, LINES 2, 6, 7A & 7B | THE ORGANIZATION IS A NEW JERSEY NONPROFIT CORPORATION FORMED BY ITS TWO (2) MEMBERS, VISITING NURSE ASSOCIATION HEALTH GROUP, INC. AND ENGLEWOOD HOSPITAL AND MEDICAL CENTER. THE ORGANIZATION IS GOVERNED AND CONTROLLED BY A BOARD OF TRUSTEES GENERALLY CONSISTING OF INDIVIDUALS EQUALLY APPOINTED BY ITS TWO (2) MEMBERS. THE TRUSTEES OF THE ORGANIZATION ARE ALSO OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES OF THE MEMBER ORGANIZATIONS. THE MEMBERS ALSO MAINTAIN CERTAIN RIGHTS AND POWERS OVER SELECTED DECISIONS MADE BY THE BOARD OF TRUSTEES. SUCH DECISIONS WHICH ARE SUBJECT TO APPROVAL BY THE MEMBERS INCLUDE CHANGES TO THE GOVERNING DOCUMENTS, DISSOLUTION OF THE ORGANIZATION, MERGER OR ASSET ACQUISITION AND/OR DISPOSAL PLANS, BUDGET APPROVALS, DEBT ACQUISITION AND APPOINTMENT OR TERMINATION OF THE CHIEF EXECUTIVE OF THE ORGANIZATION. |
| PART VI, SECTION B, LINE 11B | THE BOARD OF TRUSTEES OF THE ORGANIZATION HAS DELEGATED RESPONSIBILITY FOR REVIEWING THE FORM 990 TO CERTAIN OFFICERS AND MANAGEMENT OFFICIALS OF THE ORGANIZATION. A COPY OF THE COMPLETED FORM 990 WAS REVIEWED BY THE SELECTED OFFICERS AND MANAGEMENT OFFICIALS OF THE ORGANIZaTION AND PROVIDED TO THE BOARD OF TRUSTEES PRIOR TO SUBMISSION. |
| PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE CHIEF EXECUTIVE AND OTHER KEY EMPLOYEES OF THE ORGANIZATION IS REVIEWED AND APPROVED BY SELECTED MEMBERS OF THE BOARD OF TRUSTEES AFTER CONSIDERATION OF COMPENSATION ARRANGEMENTS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR SIMILAR SERVICES, COMPENSATION SURVEYS AND OTHER MATTERS TO DETERMINE THAT NO MORE THAN REASONABLE COMPENSATION IS PAID. |
| PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY IN PLACE TO ADDRESS ANY AND ALL CONFLICTS THAT ARISE, ARE REPORTED OR ARE OTHERWISE DISCOVERED. ON AN ANNUAL BASIS, ALL MEMBERS OF THE BOARD OF TRUSTEES ALONG WITH ALL MEMBERS OF THE MANAGEMENT TEAM AND CERTAIN OTHER EMPLOYEES ARE PROVIDED A CURRENT COPY OF THE POLICY AND ARE ALSO REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. THESE QUESTIONNAIRES ARE REVIEWED AND RESOLVED, AS NECESSARY, BY THE BOARD OF TRUSTEES. |
| PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST, ON A DISCRETIONARY BASIS. |
| PART VI, SECTION A, LINE 3 | THE ORGANIZATION HAS ENTERED INTO A MANAGEMENT SERVICES AGREEMENT WITH VISITING NURSE ASSOCIATION HEALTH GROUP, INC. TO PERFORM CERTAIN MANAGEMENT DUTIES. SUCH SERVICES INCLUDE, AMONG OTHER ITEMS, THE PREPARATION OF ANNUAL BUDGETS; THE EXECUTION AND IMPLEMENTATION OF ALL POLICIES AND DIRECTIVES OF THE BOARD OF TRUSTEES; THE ESTABLISHMENT OF RATES AND CHARGES FOR SERVICES RENDERED; THE MAINTENANCE OF ALL PROPER AND APPROPRIATE BOOKS AND RECORDS REGARDING THE BUSINESS AND OPERATIONS; THE PAYMENT OF ALL BILLS FOR SERVICES RENDERED TO THE ORGANIZATION; THE ISSUANCE OF ALL BILLS FOR SERVICES RENDERED; THE PROVISION OF ALL GENERAL ADMINISTRATIVE SERVICES; THE PROPER MAINTENANCE AND IMPLEMENTATION OF ALL NECESSARY AND APPROPRIATE PAYROLL AND HUMAN RESOURCE RECORDS; THE PROVISION OF FINANCIAL AND OTHER REPORTS WITH RESPECT TO THE OPERATIONS OF THE ORGANIZATION; AND THE TIMELY PREPARATION AND SUBMISSION OF COST REPORTS, TAX RETURNS AND OTHER SUCH FILINGS AND SUBMISSIONS AS MAY BE REQUIRED UNDER APPLICABLE LAW. |
| PART IV, LINE 28 | BASED ON THE INSTRUCTIONS TO FORM 990, THE ORGANIZATION BELIEVES THAT PART IV, QUESTION 28 CAN BE ANSWERED NO, AND THAT THE ORGANIZATION DOES NOT NEED TO COMPLETE SCHEDULE L, PART IV. IN THE INTEREST OF COMPLETE DISCLOSURE, HOWEVER, THE FOLLOWING INFORMATION IS PROVIDED: PETER GAYLORD, SHERL BRAND AND JOHN HARZ ARE EMPLOYEES AND OFFICERS OF VISITING NURSE ASSOCIATION HEALTH GROUP, INC. (GROUP). THE GROUP IS AN AFFILIATED NONPROFIT ORGANIZATION THAT IS A FIFTY (50%) PERCENT MEMBER OF THE ORGANIZATION AND PROVIDED MANAGEMENT SERVICES TO THE ORGANIZATION IN THE AMOUNT OF $758,333 IN 2014. THE GROUP IS THE SOLE CORPORATE MEMBER OF VISITING NURSE ASSOCIATION OF CENTRAL JERSEY, INC. (VNACJ) AND VISITING NURSE ASSOCIATION OF CENTRAL JERSEY PERSONAL CARE, INC. (PC). VNACJ AND PC PROVIDED SKILLED AND OTHER NURSING AND HOME HEALTH AIDES SERVICES TO THE ORGANIZATION IN THE AMOUNT OF $50,502 IN 2014. |
| PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS DISTRIBUTIONS TO MEMBERS $2,100,000 |
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