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.") . | 4,403 | 1,647 | 3,631 | 1,092 | 2,987 | 13,760 |
| 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...... | 9,715,739 | 8,599,665 | 8,619,880 | 7,859,228 | 9,007,690 | 43,802,202 |
| 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. | 9,720,142 | 8,601,312 | 8,623,511 | 7,860,320 | 9,010,677 | 43,815,962 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 0 | 0 | 0 | 0 | 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 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public support (Subtract line 7c from line 6.) | 43,815,962 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 9,720,142 | 8,601,312 | 8,623,511 | 7,860,320 | 9,010,677 | 43,815,962 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 584 | 1,217 | 1,701 | 1,339 | 1,102 | 5,943 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 584 | 1,217 | 1,701 | 1,339 | 1,102 | 5,943 |
| 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.) .. | 4,907 | 3,510 | 6,163 | 78,885 | 10,520 | 103,985 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 9,725,633 | 8,606,039 | 8,631,375 | 7,940,544 | 9,022,299 | 43,925,890 |
| 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) |
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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) |
||||
|
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 Other Income | DESCRIPTION - OTHER INCOME, COLUMN A - 4907.0, COLUMN B - 3510.0, COLUMN C - 6163.0, COLUMN D - 78885.0, COLUMN E - 10520.0, COLUMN F - 103985.0; |
| Software ID: | 14000329 |
| Software Version: | 2014v1.0 |
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 6 Classes of members or stockholders | THE ORGANIZATION'S MEMBERS CONSIST OF TRUSTEES OF THE EDWARD MILLER MEMORIAL TRUST. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | AT EACH ANNUAL MEETING, THE MEMBERS SHALL ELECT OFFICERS AND DIRECTORS IN ACCORDANCE WITH THE CORPORATION'S CERTIFICATE OF INCORPORATION AND BYLAWS. |
| Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body | THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES THAT ARE AUTHORIZED TO ACT ON BEHALF OF THE GOVERNING BODY. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE ORGANIZATION PROVIDES A COPY OF THE FORM 990 TO THE BOARD OF DIRECTORS FOR THEIR REVIEW, APPROVAL AND ACCEPTANCE AFTER THE FORM 990 HAS BEEN PREPARED BY AN OUTSIDE CPA FIRM. |
| Form 990, Part VI, Line 12c Conflict of interest policy | EACH DIRECTOR SHALL DISCLOSE TO THE BOARD IMMEDIATELY UPON ELECTION AND, THEREAFTER, ANNUALLY (OR SOONER IF A CONFLICT OF INTEREST SHOULD ARISE) ANY CONFLICT OF INTEREST INVOLVING SUCH DIRECTOR, INCLUDING PERSONS RELATED TO SUCH DIRECTOR, AND THE ACQUISITION OF AN OWNERSHIP INTEREST OR VOTING POWER IN ANY OTHER ENTITY DOING BUSINESS WITH THE ORGANIZATION. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS BASED UPON COMPARABLE INDUSTRY DATA AS PUBLISHED BY INDUSTRY TRADE ASSOCIATIONS. The date of the last compensation review was December 12, 2015. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part IX, Line 11g Other Fees | ANCILLARY SERVICES - Total Expense: 888429, Program Service Expense: 888429, Management and General Expenses: , Fundraising Expenses: ; NURSING - Total Expense: 401817, Program Service Expense: 401817, Management and General Expenses: , Fundraising Expenses: ; DENTAL, MEDICAL, PHARMACIST - Total Expense: 40783, Program Service Expense: 40783, Management and General Expenses: , Fundraising Expenses: ; |
| Form 990, Part X, Line 25 TRANSACTIONS WITH THE EDWARD MILLER MEMORIAL TRUST: | THE ORGANIZATION IS MANAGED ON BEHALF OF THE TRUSTEES OF THE EDWARD MILLER MEMORIAL TRUST, AND THE TRUSTEES OF THE EDWARD MILLER MEMORIAL TRUST ARE THE MEMBERS OF THE ORGANIZATION. THE EDWARD MILLER MEMORIAL TRUST HOLDS TITLE TO LAND AND BUILDINGS WHICH ARE MADE AVAILABLE TO THE ORGANIZATION FREE OF CHARGE. THESE ASSETS ARE ACCOUNTED FOR BY THE ORGANIZATION AS TEMPORARILY RESTRICTED CONTRIBUTIONS IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) 958-605-55-23/24, "CONTRIBUTIONS OF USE OF PROPERTY, UTILITIES, OR ADVERTISING TIME". THE RELEASE FROM RESTRICTION IS RECOGNIZED IN CONJUNCTION WITH THE DEPRECIATION EXPENSE OF THE ASSETS. During the year ended September 30, 2009, Miller Memorial Trust provided the Community with a term loan in the amount of $343,253, which is payable monthly over a five year period and bears interest at a rate of 6.5%. The balance of the loan was paid off during fiscal year 2014. In addition, during the year ended September 30, 2009, Miller Memorial Trust provided the Community with two simple interest loans in the amount of $65,000 and $30,000. The loans bear interest at 6.5% per year and were outstanding as of September 30, 2013. During fiscal year 2014, the $65,000 loan was repaid and the $30,000 loan still remains outstanding, as these loans do not have a specified repayment date. During the year ended September 30, 2010, Miller Memorial Trust provided the Community with five simple interest loans in the amount of $35,000, $185,000, $25,000, $90,000 and $184,000. The loans bear interest at 6.5% per year. During fiscal year 2014, the $35,000, $185,000 and $25,000 loans were repaid and the $90,000 and $184,000 loans still remain outstanding, as these loans do not have a specified repayment date. These outstanding loans have been included in the accompanying balance sheets within long-term liabilities as due to Miller Memorial Trust. During 2010, the Edward Miller Memorial Trust and the Community agreed to suspend principal and interest payment requirements on the simple-interest loans. |
| Form 990, Part XII, Line 2c Change of oversight process or selection process | THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT AND FOR THE OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS. THIS PROCEDURE HAS NOT CHANGED FROM THE PRIOR YEAR. |
| Software ID: | 14000329 |
| Software Version: | 2014v1.0 |