Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 6,000 | 4,199 | 574 | 1,632,449 | 54,278 | 1,697,500 |
| 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 | 1,391,719 | 5,196,670 | 9,489,915 | 12,856,607 | 14,474,992 | 43,409,903 |
| 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 | 1,397,719 | 5,200,869 | 9,490,489 | 14,489,056 | 14,529,270 | 45,107,403 |
| 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.) | 45,107,403 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,397,719 | 5,200,869 | 9,490,489 | 14,489,056 | 14,529,270 | 45,107,403 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 154 | 5,714 | 5,868 | |||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 154 | 5,714 | 5,868 | |||
| 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.).. | 1,397,719 | 5,201,023 | 9,490,489 | 14,489,056 | 14,534,984 | 45,113,271 |
| 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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 1, ITEM C | HURON VALLEY PACE |
| FORM 990, PAGE 2, PART III, LINE 4A | THE WASHTENAW PACE IS A PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE), AN INNOVATIVE MODEL OF LONG-TERM CARE THAT OFFERS DISABLED AND FRAIL OLDER ADULTS THE OPTION OF REMAINING AT HOME WITH DIGNITY AND INDEPENDENCE. THE FOCAL POINT OF THE WASHTENAW PACE IS THE DAY CENTER, WHERE PARTICIPANTS SOCIALIZE AND RECEIVED MANY OF THE SERVICES OFFERED BY THE WASHTENAW PACE. THE MAJOR SERVICES INCLUDE: PRIMARY MEDICAL CARE AND NURSING CARE, ALL MEDICATIONS, REHABILITATIVE THERAPIES, NUTRITION SERVICES, THERAPEUTIC RECREATION, AND MUCH MORE. ADDITIONALLY, THE WASHTENAW PACE OFFERS IN-HOME SERVICES INCLUDING NURSING, PERSONAL CARE, MEAL PREPARATION, LIGHT HOUSEKEEPING, HOME-DELIVERED MEALS, AND CAREGIVER RESPITE. THE WASHTENAW PACE ALSO COVERS ALL MEDICAL SPECIALISTS, LABORATORY AND X-RAY TESTS, AND HOSPITALIZATION WHEN NECESSARY. IN ADDITION, TRANSPORTATION IS PROVIDED TO THE DAY CENTER AND TO MEDICAL APPOINTMENTS AS NEEDED. PARTICIPANTS ARE ASSESSED AS NEEDING NURSING HOME LEVEL CARE, BUT ARE ABLE TO LIVE SAFELY IN THE COMMUNITY WITH PACE SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 6 | UNITED METHODIST RETIREMENT COMMUNITIES AND AREA AGENCY ON AGING 1-B WERE THE CORPORATE MEMBERS OF THE WASHTENAW PACE INC. UNTIL SEPTEMBER 2017 WHEN UNITED METHODIST RETIREMENT COMMUNITIES BECAME THE SOLE CORPORATE MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD OF DIRECTORS SHALL BE ELECTED AT THE ANNUAL MEETING OF THE MEMBERS. EACH MEMBER MAY APPOINT 1 DIRECTOR FOR EVERY FULL 20% MEMBERSHIP INTEREST HELD BY SUCH MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 9 | ANDREW LARSON 2940 ELLSWORTH RD. YPSILANTI, MI 48197 KIM HOPPE 2940 ELLSWORTH RD. YYPSILANTI, MI 48197 |
| FORM 990, PAGE 6, PART VI, LINE 11B | DRAFT OF 990 IS REVIEWED BY EXECUTIVE DIRECTOR OF THE ORGANIZATION. FINALIZED RETURN IS SENT TO THE BOARD OF DIRECTORS FOR COMMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY COVERS THE HURON VALLEY PACE (HVP) BOARD OF DIRECTORS, EXECUTIVE DIRECTOR, AND KEY STAFF. THE POLICY IS DISTRIBUTED ANNUALLY TO THESE INDIVIDUALS. AT THAT TIME EACH INDIVIDUAL IS GIVEN THE OPPORTUNITY TO DISCLOSE REAL OR POTENTIAL CONFLICTS OF INTEREST, WHICH ARE KEPT CONFIDENTIAL. ANY TRANSACTION BETWEEN HVP AND AN ENTITY AFFECTED BY A CONFLICT OF INTEREST OF ANY HVP EMPLOYEE OR DIRECTOR SHALL NOT BE VOID BUT SHALL BE VALID IF 1)THE TRANSACTION IS REASONABLE; 2)THE MATERIAL FACTS OF THE CONFLICT ARE DISCLOSED TO THE BOARD OF DIRECTORS; 3) THE TRANSACTION IS DISCUSSED AND VOTED UPON BY THE BOARD OF DIRECTORS OUTSIDE THE PRESENCE OF THE AFFECTED INDIVIDUAL; 4) THE TRANSACTION IS APPROVED AND 5)THE MINUTES OF THE BOARD REFLECT COMPLIANCE WITH THE POLICY. INDIVIDUALS WITH A CONFLICT ARE NOT PERMITTED TO BE PRESENT DURING DISCUSSIONS OR ANY VOTE REGARDING THE CONFLICTED TRANSACTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE HUMAN RESOURCES DEPARTMENT OF A RELATED TAX EXEMPT ORGANIZATION, UNITED METHODIST RETIREMENT COMMUNITIES, INC. (UMRC), PREPARED A COMPARATIVE ANALYSIS UTILIZING DATA OBTAINED FROM PACE ORGANIZATIONS IN THE STATE OF MICHIGAN. IN ADDITION, THE ORGANIZATION UTILIZES THE NATIONAL PACE ASSOCIATION COMPENSATION SURVEY. ALL FINDINGS ARE REVIEWED BY THE BOARD OF DIRECTORS, ALONG WITH AN ANNUAL EVALUATION OF THE EXECUTIVE DIRECTOR'S PERFORMANCE AND GOALS FOR THE COMING YEAR. THE BOARD OF DIRECTORS THEN SETS THE COMPENSATION. DELIBERATION AND DETERMINATION OF COMPENSATION IS DOCUMENTED IN THE ORGANIZATION'S BOARD MINUTES. |
| FORM 990, PAGE 6, PART VI, LINE 15B | CERTAIN BOARD MEMBERS ARE PAID BY RELATED TAX EXEMPT ORGANIZAITON, UNITED METHODIST RETIREMENT COMMUNITIES, INC. (UMRC). ANNUALLY, UMRC'S HUMAN RESOURCES DEPARTMENT PREPARES A COMPARTIVE ANALYSIS UTILIZING DATA FROM LEADING AGE AND CHEIF EXECUTIVES OF MULTI-FACILITY ORGANIZATIONS (CEMO). IN ADDITION, EVERY THREE YEARS THE ORGANIZATION HIRES AN INDEPENDENT CONSULTANT TO PERFORM A COMPENSATION STUDY (THIS WAS COMPLETED IN 2013). ALL FINDINGS ARE PRESENTED TO THE COMPENSATION EVALUATION COMMITTEE OF THE BOARD OF TRUSTEES, ALONG WITH AN ANNUAL EVALUATION OF THE BOARD MEMBER'S PERFORMANCE AND GOALS FOR THE COMING YEAR. THE EVALUATION COMMITTEE RECOMMENDS A SALARY INCREASE TO THE BOARD OF TRUSTEES FOR APPROVAL. THE DELIBERATION AND DETERMINATION OF COMPENSATION IS DOCUMENTED IN THE ORGANIZATION'S BOARD MINUTES. THIS OVERALL PROCESS WAS LAST CONDUCTED IN 2013. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | MEMBER EQUITY CONTRIBUTIONS 0 |
| Software ID: | |
| Software Version: |