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 | |||||
| (A)
Concordia Lutheran Health and Human Care |
250969458 | 9 | No | 216,924 | 0 | |
| (B)
Good Samaritan Hospice of Pittsburgh |
251818793 | 9 | No | 78,116 | 0 | |
| (C)
Concordia of Monroeville |
251475192 | 9 | No | 39,360 | 0 | |
| (D)
Concordia Lutheran Ministries of Pittsburgh |
270209886 | 9 | No | 20,905 | 0 | |
| (E)
Concordia Tele-Caregivers |
251881783 | 9 | No | 20,828 | 0 | |
| (F)
Concordia Visiting Nurses |
421704067 | 9 | No | 4,550 | 0 | |
| (G)
Rebecca Residence dba Concordia at Rebecca Residence |
250974311 | 9 | No | 3,430 | 0 | |
| (H)
Concordia of Ohio |
611682165 | 9 | No | 1,203 | 0 | |
| (I)
Concordia Physician Practice |
473951584 | 9 | No | 57 | 0 | |
| (J)
Cedars Home Health Services |
251875508 | 9 | No | 0 | 0 | |
| (K)
Concordia of Hospice Washington |
812448411 | 9 | No | 0 | 0 | |
| Total 11 | 385,373 | 0 | ||||
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.") . | ||||||
| 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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 | ||||
| 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 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 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) |
||||
| 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) |
||||
|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part IV, Section A, Line 1 | Concordia Lutheran Ministries Foundation and all supported organizations are subsidiaries of Concordia Lutheran Ministries (EIN 20-5138278). Individual entities are not listed in the governing documents by name but are mentioned in the governing documents as all subsidiary entities. |
| Schedule A, Part IV, Section A, Line 5a | Concordia Physician Practice (EIN 47-3951584) and Concordia Hospice of Washington (EIN 81-2448411) were added to the list of supported organizations. |
| Schedule A, Part IV, Section A, Line 6 | Please refer to Part III Statement of Program Service Accomplishments Line 4a for more information on our Angel Tear program. Also, refer to Schedule I for information on the Angel Tear program policies and details of the individual grants. |
| Schedule A, Part IV, Section C, Line 1 | Concordia Lutheran Ministries (EIN 20-5138278) controls Concordia Lutheran Ministries Foundation and its supported organizations listed on Part I by appointing all of the directors to each board. |
| Software ID: | 15000352 |
| Software Version: | v1.00 |
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 III, Line 1 | In addition to supporting related organizations and supporting outside organizations through the Angel Tear Program, planned giving seminars are offered, free of charge, throughout the year to those in the community wishing to learn more about estate planning. Concordia Lutheran Ministries Foundation (CLMF) also provides Christmas gifts and program supplies to the Unity Lutheran Church After-school Program. Unity After-school Program is an outreach ministry in Homewood/McKees Rocks, PA. In addition to the fifty-five Christmas gifts donated for the children, financial assistance was provided to the program for preparing after-school dinners for the children and one paid chaplaincy staff deaconess volunteers at Unity one-day a week to help/assist with the after-school ministry. CLMF also pays the monthly service charge for Unity's security system and paid for the repairs of the building's roof. Additionally, sponsorships are provided to local organizations for their fund raising events. Donations in the amount of $386,244 were distributed from CLMF to affiliated facilities and service lines during the year ending June 30, 2016, in support of providing quality care for those served by Concordia Lutheran Ministries (EIN 20-5138278) subsidiaries. This included fundraising events that netted over $39,000 for Camp Erin, a bereavement camp for children through Good Samaritan Hospice of Pittsburgh (EIN 25-1818793) and $184,153 in subsidies released from the Good Samaritan Endowment Fund to provide care for those who can no longer afford it at our Concordia Lutheran Health and Human Care facilities (EIN 25-0969458). |
| Form 990, Part VI, Section A, Line 6 | Concordia Lutheran Ministries (EIN 20-5138278) is the sole member of Concordia Lutheran Ministries Foundation. |
| Form 990, Part VI, Section A, Line 7a | The sole member, Concordia Lutheran Ministries (EIN 20-5138278), assigns the board of directors. |
| Form 990, Part VI, Section A, Line 7b | The sole member Concordia Lutheran Ministries (EIN 20-5138278), has final approval over all of the organization's board of directors' decisions and actions. |
| Form 990, Part VI, Section B, Line 11b | The Form 990 is prepared internally. The document is then reviewed by the Chief Financial Officer and others on the accounting management team. The board of directors received draft copies of the 990, prior to filing, in order to provide questions, comments, and feedback. Questions and comments are addressed accordingly. A copy of the final 990 is made available to all board members. |
| Form 990, Part VI, Section B, Line 12c | The corporate compliance officer attends at least one board meeting per year to educate the board members on the compliance policies, including the conflict of interest policy. Board members are required to disclose any potential conflicts of interest prior to discussion on a topic where a conflict may exist. The board will determine if the conflict exists and act accordingly, which may include the conflicted board member recusing himself/herself from discussion and any votes related to the matter. |
| Form 990, Part VI, Section B, Line 15 | Concordia Lutheran Ministries Foundation has no employees. The processes listed on Line 15 are performed by affiliate organization, Concordia Lutheran Health and Human Care , EIN 25-0969458 for those persons listed in Part VIII and on Schedule J. |
| Form 990, Part VI, Section C, Line 19 | Concordia Lutheran Ministries (EIN 20-5138278) publishes an annual report that summarizes the financial operations of the organization and its affiliates which is mailed to all of its constituents and is available to the public upon request. |
| Form 990, Part VII, Section A, Line 1a | All board members of Concordia Lutheran Ministries Foundation serve on a purely volunteer basis. Any compensation to a board member by a related organization, reported on Part VII and Schedule J, is for his/her service as an employee of that organization and not for his/her service as a board member. |
| Form 990, Part XI, Line 9 | ($7,023,904)-Funds transferred to Concordia Lutheran Ministries (EIN 20-5138278). ($75,393)-Reconcile present value of gift annuities. $159,945-Temporarily restricted donations recorded to temporarily restricted net assets. |
| Software ID: | 15000352 |
| Software Version: | v1.00 |