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 | 0 | 0 | 0 | 0 |
| 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...... | 903,275 | 917,125 | 916,893 | 925,906 | 952,364 | 4,615,563 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 12,323 | 9,704 | 12,217 | 12,920 | 12,940 | 60,104 |
| 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. | 915,598 | 926,829 | 929,110 | 938,826 | 965,304 | 4,675,667 |
| 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. | 303,484 | 307,207 | 307,963 | 311,184 | 319,960 | 1,549,798 |
| c | Add lines 7a and 7b.. | 303,484 | 307,207 | 307,963 | 311,184 | 319,960 | 1,549,798 |
| 8 | Public support (Subtract line 7c from line 6.) | 3,125,869 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 915,598 | 926,829 | 929,110 | 938,826 | 965,304 | 4,675,667 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 6,855 | 7,032 | 7,302 | 6,206 | 5,786 | 33,181 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 6,855 | 7,032 | 7,302 | 6,206 | 5,786 | 33,181 |
| 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.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 922,453 | 933,861 | 936,412 | 945,032 | 971,090 | 4,708,848 |
| 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) |
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| 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) |
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| 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 |
|---|
| Return Reference | Explanation |
|---|---|
| PART III, LINES 2,3,&12: | PRIOR YEAR AMOUNTS WERE RESTATED IN THE CURRENT YEAR TO MATCH CHANGES |
| 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 |
|---|---|
| FORM 990, PART I, PRIOR YEAR REVENUES AND EXPENSES: | CERTAIN RECLASSIFICATIONS HAVE BEEN MADE TO 2013 TO BE CONSISTENT WITH CURRENT YEAR FINANCIAL STATEMENT PRESENTATION. THESE RECLASSIFICATIONS HAD NO EFFECT ON THE CHANGE IN NET ASSETS. FORM 990, PART VI, SECTION A, LINE 3: The corporation's parent organization, Mississippi Methodist Senior Services, Inc., provides overall management services including operational management supervision, development and marketing, human resources management, legal and risk management services, and financial and accounting management, for which it is paid a management fee. FORM 990, PART VI, SECTION A, LINE 6: The corporation has one member, Mississippi Methodist Senior Services (MMSS), a non-stock, nonprofit corporation, exempt from federal income taxation under Section 501(c)(3) of the Internal Revenue Code. The board of directors of MMSS shall vote the membership interest of MMSS in the corporation. In all meetings of the membership, the member, MMSS, shall be entitled to one vote, which vote shall constitute the action of the membership. The board of directors of MMSS, at any duly held meeting of directors, shall have the authority to vote the membership interest of MMSS in the corporation. FORM 990, PART VI, SECTION A, LINE 7A: The corporation's nominating committee shall make recommendations to the MMSS nominating committee for persons to serve on the corporation's board of directors. Nominations for persons to serve on the corporation's board of directors shall be made by the MMSS nominating committee. Nominations may also be made by the membership. Any vacancy in the board of directors shall be filled for the unexpired term by the membership, in consultation with the corporation's board of directors. FORM 990, PART VI, SECTION A, LINE 7B: The board of directors of the corporation shall adopt and keep current a statement of the corporation's purposes and major policies which shall be forwarded to the MMSS board of directors for approval and modification. In addition, the board of directors may have delegated to it or rescinded from it by the MMSS board of directors some or all of the following duties, responsibilities, and powers: (a) Make provision for quality residential, long-term health care commensurate with community needs and resources. (b) Recommend and implement board approved changes in bylaws, policies and procedures, for the operation of the corporation's facilities and services. (c) Provide for the preparation of an annual operating and a three-year capital budget to be approved by the MMSS board of directors and regularly review financial budget performance. (d) Work cooperatively with local churches, social welfare and civic agencies, and the community at large to address the problems of the aging. (e) Provide for the development, review and updating of long-range plan relating to needs of the elderly within the area of service. (f) Adopt and implement a community relations and development program compatible with local needs and resources to broaden the local support and financial base of the corporation. (g) Submit to the MMSS board of directors such recommendations and comments as are appropriate regarding the corporation, in support of quality services for the elderly in the local community. (h) Participate in the process of selection, review and retention of the executive director. (i) Work cooperatively with MMSS and its other subsidiary corporations, sharing responsibility for the welfare of the whole. |
| FORM 990, PART VI, SECTION B, LINE 11B: | THE FORM 990 IS PREPARED BY A CPA FIRM AND REVIEWED BY THE VP FOR FINANCE. IT IS THEN POSTED TO THE MISSISSIPPI METHODIST SENIOR SERVICES,INC. INTRA-NET AND MADE AVAILABLE TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C: | A FORM IS COMPLETED ANNUALLY BY OFFICERS, DIRECTORS, AND KEY EMPLOYEES THAT DISCLOSES INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THESE FORMS ARE REVIEWED BY A COMPLIANCE OFFICER. PERSONS WITH CONFLICTS OF INTERESTS ARE EXCLUDED FROM BOARD DELIBERATION AND ABSTAIN FROM ANY DECISIONS WHERE THE CONFLICT EXISTS. Form 990, Part VI, Section B, Line 14: THE ORGANIZATION DOES NOT HAVE A FORMAL WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY, BUT IT DOES FOLLOW INFORMAL PROCEDURES REGARDING SUCH MATTERS. FORM 990, PART VI, SECTION B, LINE 15: THE ORGANIZATION DOES NOT COMPENSATE ANY OFFICERS OR EMPLOYEES. ALL COMPENSATION IS PAID BY THE ORGANIZATION'S PARENT, MISSISSIPPI METHODIST SENIOR SERVICES, INC. |
| FORM 990, PART VI, SECTION B, LINE 19: | All documents are available upon request. |
| FORM 990, PART X, BEGINNING OF YEAR: | CERTAIN ASSETS AND LIABILITIES FOR 2013 HAVE BEEN RECLASSED TO BE CONSISTENT WITH CURRENT YEAR REPORTING. |
| Software ID: | |
| Software Version: |