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 | |||||
| (A)
Blessing Hospital |
370661183 | Yes | 1 | 2,532,072 | ||
| (B)
BLESSING CORPORATE SERVICES INC |
371128706 | Yes | 1 | 475,000 | ||
| (C)
BLESSINGCARE CORPORATION DBA ILLINI |
371396010 | No | 1 | 478,770 | ||
Total 3
|
3 | |||||
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.") . | ||||||
| 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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 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 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 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) |
||||
|
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. |
||||
| 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 IV, Section A, Line 1: Description Of How Supported Organizations Are Desigated | TWO OF THE SUPPORTED ORGANIZATIONS, BLESSING HOSPITAL AND BLESSING CORPORATE SERVICES, INC. ARE DESIGNATED SPECIFICALLY BY NAME IN THE GOVERNING DOCUMENTS OF THE BLESSING FOUNDATION, INC. THE BLESSING FOUNDATION, INC. BYLAWS STATE "...THE CORPORATION SHALL PROMOTE AND SUPPORT...OTHER ORGANIZATIONS WHICH PROVIDE HEALTH CARE..." BLESSINGCARE CORPORATION PROVIDES HEALTH CARE AND THUS, IS DESIGNATED IN THE GOVERNING DOCUMENTS BASED ON ITS PURPOSE, BUT NOT SPECIFICALLY BY NAME. |
| Part IV, Section C, Line 1: Control Or Management Of Supported Orgs. | BLESSING CORPORATE SERVICES, IN. ("BCS") IS THE PARENT COMPANY OF THE BLESSING FOUNDATION, INC. AND ALL OTHER BLESSING ENTITIES, INCLUDING THE OTHER SUPPORTED ENTITIES, BLESSING HOSPITAL AND BLESSINGCARE CORPORATION. AS THE PARENT COMPANY, BCS HAS THE POWER TO APPOINT AND/OR REMOVE ALL TRUSTEES OF EACH OF THESE ENTITIES, APPOINT THE CORPORATION'S PRESIDENT, APPROVE AMENDMENTS TO GOVERNING DOCUMENTS, AS WELL AS APPROVE ANY OTHER MATERIAL DECISIONS OF THE BLESSING ENTITIES AND EXERCISE OTHER RESERVE POWER. THUS, ULTIMATE CONTROL OF THE SUPPORTING ORGANIZATION AND ALL SUPPORTED ORGANIZATIONS IS VESTED IN BCS. |
| Software ID: | 14000265 |
| Software Version: | 2014v6.0 |
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, Line 3: Description of Delegated Duties to Management Company | IN ORDER TO ACHIEVE COST EFFICIENCIES, THE BLESSING FOUNDATION, INC. (CORPORATION) AND ITS SOLE MEMBER, BLESSING CORPORATE SERVICES, INC., HAVE ENTERED AN INTERCOMPANY MANAGEMENT SERVICES AGREEMENT WHEREBY BLESSING CORPORATE SERVICES PROVIDES MANAGEMENT SERVICES TO THE BLESSING FOUNDATION, INC. |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Blessing Corporate Services, Inc., an Illinois not for profit corporation, is the sole voting member of the Blessing Foundation, Inc. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Blessing Corporate Services, Inc. the sole voting member of the Blessing Foundation, Inc., shall appoint and/or remove all the trustees of the corporation and appoint the president of the Blessing Foundation, Inc. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Blessing Corporate Services, Inc., the sole voting member of the Blessing Foundation, Inc. (Corporation), shall approve expressly all amendments to the corporation's articles of incorporation and bylaws before they may become effective, approve long-term debt, long-range plans, and capital and operating budgets, approve the purchase and sale of real and personal property and contracts (other than those providing annuities for donors) entered into by the corporation, not expressly made part of an approved budget, the reasonable value of which exceeds an amount set forth in the bylaws of the voting member, approve of material investment decisions, including without limitation establishment and modification of investment policies, engagement and removal of investment managers and advisors, and changes in investment allocations not permitted by an existing investment policy, approval of the parameters for terms of employment of physicians, including physician compensation plans, and any material variances from such parameters for individual physicians, approval of the selection of auditors and legal counsel, approval of charity care and community benefits-related policies, approval of the formation of subsidiary entities and/or joint ventures, approval of the filing of a petition in bankruptcy, making an assignment for the benefit of creditors, or applying for protection under any insolvency laws, approval of the participation in any merger, combination, consolidation, liquidation, dissolution or other corporate or business entity restructuring, and the power to compel the corporation to enforce and/or perform any contractual obligation. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | FOLLOWING MANAGEMENT AND LEGAL REVIEW, THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES OF THE BLESSING FOUNDATION, INC. FOR REVIEW AND COMMENT PRIOR TO FILING. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | A COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO BE READ, SIGNED, AND RETURNED TO THE BLESSING FOUNDATION, INC. THE SIGNED POLICIES ARE RETAINED IN THE CORPORATE ADMINISTRATIVE FILES OF THE BLESSING FOUNDATION, INC. IN ADDITION, EACH OFFICER, DIRECTOR, OR TRUSTEE IS REQUIRED TO DECLARE ANY CONFLICT OF INTEREST IN REGARDS TO AGENDA ITEMS BEING PRESENTED AT THE START OF EACH MONTHLY BOARD MEETING. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | THESE DOCUMENTS ARE LOCATED IN THE CORPORATE OFFICE OF THE BLESSING FOUNDATION, INC. AND ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. |
| SCHEDULE K, PART I, (F) DESC. OF PURPOSE | TO FINANCE A PORTION OF THE COSTS OF THE ACQUISITION OF A 53,772 SQUARE FOOT MEDICAL OFFICE BUILDING LOCATED AT 927 BROADWAY, QUINCY, ILLINOIS AND PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE REVENUE BONDS, SERIES 2010. |
| Software ID: | 14000265 |
| Software Version: | 2014v6.0 |