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.") . | 1,741 | 4,186 | 5,927 | |||
| 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...... | 2,048,481 | 2,843,713 | 3,928,629 | 5,942,714 | 14,763,537 | |
| 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. | 2,048,481 | 2,843,713 | 3,930,370 | 5,946,900 | 14,769,464 | |
| 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. | 389,850 | 913,421 | 99,891 | 1,403,162 | ||
| c | Add lines 7a and 7b.. | 389,850 | 913,421 | 99,891 | 1,403,162 | ||
| 8 | Public support (Subtract line 7c from line 6.) | 13,366,302 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 2,048,481 | 2,843,713 | 3,930,370 | 5,946,900 | 14,769,464 | |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 7,300 | 9,133 | 13,961 | 4,966 | 35,360 | |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 7,300 | 9,133 | 13,961 | 4,966 | 35,360 | |
| 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.) .. | 510,255 | 510,255 | ||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 2,566,036 | 2,852,846 | 3,944,331 | 5,951,866 | 15,315,079 | |
| 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 |
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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 |
|---|
| Software ID: | 14000292 |
| Software Version: | 14.4.1.0 |
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, Section A, Line 3 and 6 | The board of directors retains Sun Health Senior Living, LLC, a related entitiy, to manage the operation of the facility. Sun Health Senior Living, LLC is member owned by Sun Health Services, Sun Health Colonnades sole member. |
| Form 990, Part VI, Section A, Line 7a | The organization has a board of directors, elected to serve a term of three years or until their resignation or removal. The terms of the directors are staggered such that approximately one-third of the directors are elected each year. Directors are eligible to serve a maximum of three consecutive terms without regard to partial terms due to staggering or filling of vacancies. |
| Form 990, Part VI, Section A, Line 7b | Certain reserve powers are maintained by Sun Health Services as sole member. These reserve powers include the power to elect the board of directors of the organization, to remove any director upon written notice to such director and to the chairman of the board and to hire or terminate the president and chief executive officer of the organization upon written notice to such individual and the chairman. |
| Form 990, Part VI, Section B, Line 11b | The Form 990 is prepared by management and reviewed by the organizations independent accountant, Plante Moran, PLLC. The return is then reviewed by the Audit Committee of the board of directors and provided to the full board of directors for comment prior to the filing of the return. |
| Form 990, Part VI, Section B, Line 12c | On an annual basis board members and management staff are required to submit a conflict of interest questionnaire for board and management approval, as appropriate. The questionnaire provides specific instructions that the form must be updated if any situation arises during the year that might constitute a conflict. The Audit Committee has responsibility for intervening, if necessary, on conflict of interest matters. Any individual found to be in conflict will abstain from the decision making process. |
| Form 990, Part VI, Section B, Line 15 | The Management Review Committee, as provided in the organizations by-laws, has responsibility for the compensation of all senior management. Annually, salaries of senior management are reviewed and approved by the organizations Board of Directors. The deliberation and decision of the compensation arrangements is contemporaneously substantiated in the organizations minutes. Sun Health Services retains an independent consultant, Willis Towers Perrin, in assessing its Executive Compensation policies and practices. The compensation review process was last undertaken in 2015. All compensation is paid by a related organization. |
| Form 990, Part VI, Section C, Line 19 | Governing documents and conflict of interest policies are generally not made available to the public. Financial statements are available upon request. |
| Form 990, Part VII, Section A, Line 1a | These individuals devote weekly time to the following organizations Ronald D. Guziak, 28 hours to Sun Health Services, 20 hours to Sun Health Foundation and 2 hours to Sun Health Partners William T. Sellner, 40 hours to Sun Health Services, 6 hours to Sun Health Partners and 4 hours to Sun Health Foundation Sharon Grambow, 15 hours to La Loma Senior Living Services, 15 hours to Sun Health Colonnade, 15 hours to Sun Health Grandview Terrace and 5 hours to Sun Health Services. Mr. Guziak and Mr. Sellner also contribute time to the other senior living entities Sun Health Grandview Terrace and La Loma Senior Living Services, Inc. All board members devoted time to Sun Health Services, a related organization, with an average of 2 hours per week. The following board members devoted time to Sun Health Foundation, a related organization Sandra L. Foell, 5 hours Darl Bachmann, 5 hours L. Birt Kellam, 2 hours Cathy E. Ross, 2 Hours Michael Mandell, 5 hours R. Jack Stephenson, 2 hours and Janis Ryan, 2 hours. |
| Form 990, Part VII, Section B, Line 1 | Sun Health Colonnade has a management agreement with Sun Health Senior Living, LLC under which the organization pays a percentage of of gross revenues, with a minimum amount established, as defined in the agreement. In addition, Sun Health Senior Living, LLC employs all of the personnel who work for the organization and incurs other direct costs on behalf of the organization for which the organization reimburses Sun Health Senior Living, LLC based on actual costs incurred. During the period, the organization incurred management fees and reimbursable expenses totaling 2,256,146. |
| Form 990, Part XI, Line 9 | Other changes in net assets and fund balance consist of the following capital contribution of land transfer from Sun Health Services, 265,007 and the net effect of adopting Accounting Standards Update ASU No. 2012-01, Health Care Entities Topic 954 Continuing Care Retirement Communities - Refundable Advance Fees, 632,640. |
| Software ID: | 14000292 |
| Software Version: | 14.4.1.0 |