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.") . | 267,088 | 91,405 | 72,500 | 333,335 | 120,151 | 884,479 |
| 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...... | 7,866,984 | 8,305,115 | 8,176,533 | 7,882,451 | 7,712,155 | 39,943,238 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 1,892 | 2,021 | 2,570 | 2,470 | 8,953 | |
| 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. | 8,134,072 | 8,398,412 | 8,251,054 | 8,218,356 | 7,834,776 | 40,836,670 |
| 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.) | 40,836,670 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 8,134,072 | 8,398,412 | 8,251,054 | 8,218,356 | 7,834,776 | 40,836,670 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 10,827 | 12,785 | 17,475 | 34,006 | 34,360 | 109,453 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 10,827 | 12,785 | 17,475 | 34,006 | 34,360 | 109,453 |
| 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 VI.) .. | 52,360 | 46,409 | 79,614 | 111,115 | 114,812 | 404,310 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 8,197,259 | 8,457,606 | 8,348,143 | 8,363,477 | 7,983,948 | 41,350,433 |
| 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) |
||||
|
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 |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS INCOME - 2010 AMOUNT: $ 2,390. 2011 AMOUNT: $ 10,100. 2012 AMOUNT: $ 14,175. 2014 AMOUNT: $ 80,590. BEAUTY AND BARBER SHOP - 2010 AMOUNT: $ 34,324. 2011 AMOUNT: $ 31,313. 2013 AMOUNT: $ 25,888. 2014 AMOUNT: $ 7,194. VENDING MACHINES - 2010 AMOUNT: $ 706. 2011 AMOUNT: $ 966. 2012 AMOUNT: $ 955. 2013 AMOUNT: $ 1,134. 2014 AMOUNT: $ 1,338. MEDICAL RECORDS FEE - 2010 AMOUNT: $ 91. CASH DISCOUNTS ON PURCHASES - 2010 AMOUNT: $ 1,457. 2011 AMOUNT: $ 4,030. 2012 AMOUNT: $ 4,032. 2013 AMOUNT: $ 2,772. 2014 AMOUNT: $ 2,122. CAFETERIA INCOME - 2010 AMOUNT: $ 13,392. REIMBURSEMENT-CARMELITE SISTERS - 2012 AMOUNT: $ 34,565. 2013 AMOUNT: $ 5,696. BAD DEBT - 2012 AMOUNT: $ 8,000. INSURANCE PROCEEDS - 2012 AMOUNT: $ 17,887. 2013 AMOUNT: $ 48,755. 2014 AMOUNT: $ 23,568. REIMBURSEMENT - 2013 AMOUNT: $ 26,870. |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THERE SHALL BE FIVE MEMBERS OF THE CORPORATION. THE MEMBERS OF THIS CORPORATION SHALL BE THE SUPERIOR GENERAL AND THE VICAR GENERAL OF THE CARMELITE ORDER FOR THE AGED AND INFIRM, AND THREE MEMBERS TO BE APPOINTED BY THE EXISTING MEMBERSHIP. |
| FORM 990, PART VI, SECTION A, LINE 7A | DIRECTORS ARE ELECTED BY THE MAJORITY VOTE OF THE MEMBERS OF THE CORPORATION AT THEIR ANNUAL MEETING. THE TERM OF OFFICE OF THE DIRECTOR SHALL BE FOR ONE YEAR OR UNTIL THEIR SUCCESSOR ARE DULY ELECTED AND QUALIFIED. ELECTED DIRECTORS SHALL BE SUBJECT TO REMOVAL WITHOUT ANY CAUSE AT ANY TIME BY THE AFFIRMATIVE VOTE OF THE MAJORITY OF THE MEMBERS OF THE CORPORATION. THE CORPORATE MEMBERS RETAIN THE RIGHT TO APPOINT OR REMOVE MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBERS OF THE CORPORATION: - TO FORMULATE AND CHANGE FROM TIME TO TIME, THE PHILOSOPHY, OBJECTIVES, AND PURPOSES OF THE CORPORATION FOR WHICH IT WAS AND IS FORMED AND EXISTS. - TO ELECT THE MEMBERS AND DIRECTORS, AND TO REMOVE THE SAME WITH OR WITHOUT CAUSE. - TO APPOINT AND REMOVE THE ADMINISTRATOR OF ANY FACILITY OWNED OR OPERATED BY THE CORPORATION. - TO AMEND, REVISE, ALTER, REPEAL OR OTHERWISE MODIFY THE CERTIFICATE OF INCORPORATION OR THE BY-LAWS OF THIS CORPORATION. - TO APPROVE ANY BORROWING OF FUNDS IN EXCESS OF THE BORROWING AUTHORITY TO BE GRANTED FROM TIME TO TIME BY THE MEMBERS TO THE BOARD OF DIRECTORS. - TO ACQUIRE, PURCHASE, SELL, LEASE, MORTGAGE, TRANSFER, OR ENCUMBER REAL ESTATE AND TO CONSTRUCT OR UNDERTAKE THE DESTRUCTION OF BUILDINGS OWNED BY THE CORPORATION. - TO MERGE, CONSOLIDATE, OR AFFILIATE THIS CORPORATION WITH ANOTHER CORPORATION, ORGANIZATION OR PROGRAM. - TO REQUIRE A CERTIFIED AUDIT OF CORPORATE FUNDS AT ANY TIME AND TO NAME THE CERTIFIED PUBLIC ACCOUNTANT WHO IS TO PERFORM THE AUDIT. - TO LIQUIDATE, DISSOLVE OR TERMINATE THE EXISTENCE OF THIS CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON SUCH TERMINATION OR DISSOLUTION IN CONFORMITY WITH SECTION 501(C)3 OF THE INTERNAL REVENUE CODE OF 1986 AS AMENDED. - TO MAKE GIFTS AND DONATIONS OR LOANS TO OTHER CHARITIES INCLUDING BUT NOT LIMITED TO OTHER CORPORATIONS RELATED TO THE CARMELITE SISTERS FOR THE AGED AND INFIRM, PROVIDED SUCH GIFTS, DONATIONS OR LOANS ARE NOT CONTRARY TO THE GOVERNING STATE LAW OR DO NOT MATERIALLY ADVERSELY AFFECT ANY REIMBURSEMENT TO THE CORPORATION FOR THE PROVISION OF CARE. - TO MAKE AND PROMULGATE WRITTEN OR OTHER STATEMENTS OF POLICY AS MAY BE REQUIRED BY ANY GOVERNMENTAL REGULATORY AGENCY. |
| FORM 990, PART VI, SECTION B, LINE 11 | ST. JOSEPH NURSING HOME COMPANY OF UTICA HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW. THE FINANCE COMMITTEE REPORTS TO THE BOARD OF DIRECTORS REGARDING THE REVIEW, AND A ELECTRONIC COPY OF FORM 990 IS PROVIDED TO THE BOARD. ANY COMMENTS AND RECOMMENDATIONS BY THE BOARD ARE INCLUDED IN THE FINAL COPY OF THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST DISCLOSURE POLICY REQUIRES ALL OFFICERS AND BOARD MEMBERS TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. IN ADDITION, SHOULD AN OFFICER OR BOARD MEMBER ASSUME NEW EXTERNAL INTERESTS THAT POTENTIALLY CONFLICT WITH HIS/HER ROLE WITH THE ORGANIZATION, SUCH INDIVIDUAL IS REQUIRED TO DISCLOSE IN WRITING THE NATURE OF SUCH EXTERNAL INTERESTS. THE DISCLOSURE STATEMENT IS PROVIDED TO THE ADMINISTRATOR FOR REVIEW. CONFLICTS ARE RESOLVED BY MAKING A REQUIRED DISCLOSURE, AND MAY RESULT IN RESTRICTING THE OFFICER OR BOARD MEMBER IN ANY RELATED ACTIVITY OR PROCESS AS DETERMINED APPROPRIATE TO THE CIRCUMSTANCES OF THE CONFLICT. FAILURE TO DISCLOSE A CONFLICT OF INTEREST IS IN VIOLATION OF THE ADOPTED POLICY AND CAN RESULT IN DISCIPLINARY ACTION OR REMOVAL. |
| FORM 990, PART VI, SECTION B, LINE 15A | A COMPENSATION POLICY WAS DEVELOPED BY THE BOARD TO GOVERN COMPENSATION ARRANGEMENTS BETWEEN THE ORGANIZATION AND COVERED INDIVIDUALS, DEFINED AS THOSE IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. THE COMPENSATION COMMITTEE CONSISTS OF AT LEAST THREE INDEPENDENT INDIVIDUALS APPOINTED BY THE BOARD, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION FOR COVERED INDIVIDUALS BASED ON RELEVANT DATA INCLUDING COMPARABILITY COMPENSATION FOR SIMILARLY SITUATED ENTITIES AND INDEPENDENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS AS DEEMED NECESSARY. SALARIES WERE LASTED UPDATED IN OCTOBER 2012. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION, FORM 990, FORM 1023, AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. THE ORGANIZATION ALSO FILES AN ANNUAL COST REPORT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH WHICH CONTAINS FINANCIAL STATEMENTS AND RELATED NOTE DISCLOSURES. THIS COST REPORT IS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -222,594. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. |
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