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 (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 6,965 | 6,960 | 42,416 | 1,072,916 | 1,296,279 | 2,425,536 |
| 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...... | 6,940,966 | 6,849,761 | 7,479,787 | 13,177,785 | 12,920,714 | 47,369,013 |
| 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. | 6,947,931 | 6,856,721 | 7,522,203 | 14,250,701 | 14,216,993 | 49,794,549 |
| 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.) | 49,794,549 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 6,947,931 | 6,856,721 | 7,522,203 | 14,250,701 | 14,216,993 | 49,794,549 |
| 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. | 21,765 | 40,035 | 61,800 | |||
| c | Add lines 10a and 10b. | 21,765 | 40,035 | 61,800 | |||
| 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.) .. | 39,235 | 30,220 | 69,116 | 176,670 | 6,944 | 322,185 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 6,987,166 | 6,886,941 | 7,591,319 | 14,449,136 | 14,263,972 | 50,178,534 |
| 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): |
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| 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 | ||||
| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, 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 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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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 | THE SOLE MEMBER OF THE CORPORATION IS HATTIE LARLHAM CARE GROUP. THERE IS ONLY ONE CLASS OF MEMBERS. |
| Form 990, Part VI, Section A, line 7a | ACTION BY THE MEMBER OF THE CORPORATION SHALL BE REQUIRED, AND SHALL BE SUFFICIENT, FOR THE FOLLOWING MATTERS A) TO ELECT THE MEMBERS OF THE BOARD OF DIRECTORS (THE "DIRECTORS") AND TO REMOVE THE DIRECTORS, B) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR THE CODE OF REGULATIONS, C) TO DISSOLVE OR TERMINATE THE EXISTENCE OF THE CORPORATION. THE DIRECTORS SHALL BE RELIEVED FROM LIABILITY FOR MANAGERIAL ACTS OR OMISSIONS IMPOSED UPON DIRECTORS BY LAW, TO THE EXTENT THAT, AND AS LONG AS, ANY DISCRETIONARY POWER IN THE MANAGEMENT OF CORPORATE AFFAIRS OF THE CORPORATION IS EXERCISED BY THE MEMBER PURSUANT TO THE CODE OF REGULATIONS, THE ARTICLES OR INCORPORATION, OR APPLICABLE LAW. |
| Form 990, Part VI, Section A, line 7b | THE MEMBER MUST APPROVE THE FOLLOWING ACTIONS OF THE BOARD OF DIRECTORS BEFORE SUCH ACTIONS BECOME EFFECTIVE A) ANY MERGER OR CONSOLIDATION OF THE CORPORATION AND ANY SALE OF SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS, B) THE CREATION OF ANY SUBSIDIARY ORGANIZATION OR THE AFFILIATION OF THE CORPORATION WITH ANY OTHER ENTITY FOR THE PURPOSE OF THE JOINT CONDUCT OF BUSINESS OR OTHER PROGRAMS, WHETHER IN THE FORM OF PARTICIPATION IN A CORPORATION, PARTNERSHIP, LIMITED LIABILITY COMPANY, JOINT VENTURE, CO-TENANCY OR ANY OTHER FORM OF OWNERSHIP OR CONTROL, C) THE APPROVAL OF THE ANNUAL BUDGET OF THE CORPORATION, D) THE ADOPTION OF ANY NEW OR MATERIALLY REVISED SERVICES TO BE PROVIDED BY THE CORPORATION, E) ANY REQUESTS FOR FUNDING FROM HATTIE LARLHAM FOUNDATION, AND F) ANY OTHER ACT FOR WHICH MEMBERSHIP APPROVAL IS REQUIRED UNDER APPLICABLE LAW, THE ARTICLES OF INCORPORATION, OR THE CODE OF REGULATIONS. |
| Form 990, Part VI, Section B, line 11 | FORM 990 IS REVIEWED BY THE CFO AND PRESENTED TO THE TREASURER'S (FINANCE) COMMITIEE BY THE TAX ACCOUNTANT/PREPARER AND CFO FOR REVIEW AND APPROVAL. THE BOARD OF DIRECTORS THEN RECEIVES A COPY OF FORM 990 TO REVIEW/COMMENT PRIOR TO THE TAX RETURN BEING FILED. |
| Form 990, Part VI, Section B, line 12c | EACH MEMBER OF THE BOARD OF DIRECTORS RECEIVES TRAINING ON ETHICAL CONDUCT BY THE DIRECTOR OF CORPORATE COMPLIANCE DURING THEIR ORIENTATION TO THE BOARD AND ON AN ANNUAL BASIS. HATTIE LARLHAM DISTRIBUTES TO THE BOARD OF DIRECTORS AT THE ANNUAL MEETING AND DURING ORIENTATION THE CONFLICT OF INTEREST POLICY EACH BOARD MEMBER HAS AN OBLIGATION TO MAKE FULL DISCLOSURE OF CONFLICTS OF INTEREST. EACH YEAR THEY RECEIVE THE CONFLICT OF INTEREST POLICY AND A DECLARATION STATEMENT TO READ AND SIGN. IF A CONFLICT OF INTEREST IS REPORTED, THE DISCLOSURE IS PLACED ON THE AGENDA OF A BOARD MEETING WHERE A MOTION IS MADE TO ACKNOWLEDGE THE DISCLOSURE AND VOTE TO DETERMINE IF THE SERVICES ARE APPROPRIATE TO THE NEEDS OF THE ORGANIZATION. HATTIE LARLHAM HAS SPECIFIC POLICIES IN REGARDS TO GIFTS AND GRATUITIES AND EMPLOYMENT OF RELATIVES. THE EXECUTIVE STAFF OF HL AGENCIES MUST ALSO REPORT ANY CONFLICT OF INTEREST TO THE CEO IN REGARDS TO GIFTS, GRATUITIES, AND RELATIVES EMPLOYED AT HL UNDER AN EXECUTIVES SPAN OF CONTROL. IF A CONFLICT OF INTEREST IS REPORTED TO THE CEO, HE/SHE WILL FOLLOW THE SAME POLICY AS IT APPLIES TO THE BOARD OF DIRECTORS UNDER THE CONFLICT OF INTEREST POLICY. HL HAS A CORPORATE COMPLIANCE COMMITIEE WHICH MEETS MONTHLY TO MONITOR ALL CORPORATE COMPLIANCE ACTIVITIES. A CORPORATE COMPLIANCE EVALUATION IS COMPLETED ON AN ANNUAL BASIS BY THE DIRECTOR OF CORPORATE COMPLIANCE, A VICE PRESIDENT OF ONE OF THE HL AGENCIES, AND THE QUALITY IMPROVEMENT COORDINATOR TO DETERMINE WHICH ACTIVITIES NEED TO BE ADDRESSED. |
| Form 990, Part VI, Section B, line 15 | HATTIE LARLHAM CARE GROUP, A RELATED ORGANIZATION, COMPENSATES ORGANIZATION'S CEO, VICE PRESIDENTS, TOP MANAGEMENT AND KEY EMPLOYEES. THE PROCESS OF DETERMINING THE COMPENSATION FOR THE ORGANIZATION'S CEO, VICE PRESIDENTS, TOP MANAGEMENT AND KEY EMPLOYEES INCLUDES A MEETING OF THE COMPENSATION COMMITIEE WITH THE CEO WHERE THE COMMITIEE IS PRESENTED WITH SALARY RECOMMENDATIONS COMPARED TO PRIOR YEAR COMPENSATION AND COMPENSATION SURVEYS/STUDYS WHICH WOULD THEN LEAD TO AN APPROVAL BY THE COMMITIEE OF THE COMPENSATION TO BE PAID. THE LAST COMPENSATION STUDY WAS COMPLETED IN 2015 BY AN OUTSIDE CONSULTANT. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part XII, Line 2c: | THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTATNT HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS FROM THE PRIOR YEAR. |
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