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.") . | 12,808 | 8,609 | 16,929 | 10,019 | 15,616 | 63,981 |
| 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 | 16,424,274 | 16,581,363 | 17,465,039 | 17,780,772 | 17,809,467 | 86,060,915 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 22,322 | 20,600 | 42,922 | |||
| 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 | 16,437,082 | 16,589,972 | 17,481,968 | 17,813,113 | 17,845,683 | 86,167,818 |
| 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.) | 86,167,818 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 16,437,082 | 16,589,972 | 17,481,968 | 17,813,113 | 17,845,683 | 86,167,818 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 153,095 | 265,959 | 260,635 | 237,253 | 290,641 | 1,207,583 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 153,095 | 265,959 | 260,635 | 237,253 | 290,641 | 1,207,583 |
| 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.) .. | 100,598 | 107,443 | 112,308 | 160,498 | 142,908 | 623,755 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 16,690,775 | 16,963,374 | 17,854,911 | 18,210,864 | 18,279,232 | 87,999,156 |
| 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 |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | OTHER INCOME - 2014 AMOUNT: $ 100,598. 2015 AMOUNT: $ 107,443. 2016 AMOUNT: $ 14,408. 2017 AMOUNT: $ 79,415. 2018 AMOUNT: $ 67,862. MEALS - 2016 AMOUNT: $ 21,028. 2017 AMOUNT: $ 21,028. 2018 AMOUNT: $ 24,891. BARBER BEAUTY SHOP - 2016 AMOUNT: $ 76,872. 2017 AMOUNT: $ 60,055. 2018 AMOUNT: $ 50,155. |
| 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, PART VI, SECTION A, LINE 2 | JOHN O'SHAUGHNESSY SERVES AS THE ORGANIZATION'S CORPORATE FINANCIAL OFFICER AND ASSISTANT TREASURER. HE IS EMPLOYED BY THE FRANCISCAN SISTERS OF MARY (FSM) AS ITS CEO/CFO. FSM IS ONE OF THE FIVE COLLABORATING CATHOLIC CONGREGATIONS OF RELIGIOUS WOMEN OF THE SARAH COMMUNITY. THE ORGANIZATION PAID FSM AN HOURLY RATE FOR TIME SPENT BY MR. O'SHAUGHNESSY ATTENDING TO ORGANIZATIONAL BUSINESS. MR. O'SHAUGHNESSY IS NOT DIRECTLY COMPENSATED BY THE ORGANIZATION. IN 2018, THE ORGANIZATION PAID FSM A TOTAL OF $6,585.49 FOR MR. O'SHAUGHNESSY'S SERVICES AND MINOR REIMBURSABLE EXPENSES. SISTERS FRAN HAARMAN AND JUDY BELL ARE CURRENT DIRECTORS OF FSM, AND IN THAT REGARD HAVE A BUSINESS RELATIONSHIP WITH MR. O'SHAUGHNESSY. |
| FORM 990, PART VI, SECTION A, LINE 3 | ST. ANDREWS MANAGEMENT SERVICES, INC IS RESPONSIBLE FOR BOTH ADMINISTRATIVE AND OPERATIONAL LEADERSHIP OF THIS FACILITY. ALL EMPLOYEES ARE EMPLOYEES OF THE SARAH COMMUNITY, EXCEPT FOR FOUR MANAGEMENT POSITIONS THAT INCLUDE: THE EXECUTIVE DIRECTOR, SNF/ALU ADMINISTRATOR, ONBOARDING COORDINATOR, AND PERSON-CENTERED CARE COORDINATOR. IN 2018, EXECUTIVE DIRECTOR MARY BETH HUNT WAS COMPENSATED $123,748 IN WAGES, RETIREMENT MATCHING, AND BENEFITS BY STAMS FOR HER SERVICES TO THE SARAH COMMUNITY. THE ORGANIZATION PAID THE FRANCISCAN SISTERS OF MARY (FSM) AN HOURLY RATE FOR TIME SPENT BY MR JOHN O'SHAUGHNESSY ATTENDING TO ORGANIZATIONAL BUSINESS MATTERS OF THE SARAH COMMUNITY. MR O'SHAUGHNESSY IS NOT DIRECTLY COMPENSATED BY THE ORGANIZATION. IN 2018, THE ORGANIZATION PAID THE FRANCISCAN SISTERS OF MARY A TOTAL OF $6,585.49 FOR MR O'SHAUGHNESSY'S SERVICES AND MINOR REIMBURSABLE EXPENSES. |
| FORM 990, PART VI, SECTION A, LINE 6 | ONLY ONE CLASS OF MEMBERS EXISTS. THE INITIAL MEMBERS ARE PERSONS WHO OCCUPY THE CERTAIN POSITIONS OF THE DAUGHTERS OF CHARITY AND OF THE FRANCISCAN SISTERS OF MARY. ADDITIONAL MEMBERS WHO ARE MEMBERS OF THE ELECTED LEADERSHIP OF RELIGIOUS INSTITUTIONS OF THE ROMAN CATHOLIC CHURCH MAY BE ADDED WITH THE APPROVAL OF THE MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH MEMBER IS ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING ARE THE POWERS RESERVED TO MEMBERS: - TO DETERMINE AND MAINTAIN THE PHILOSOPHY AND IDENTITY OF THE ORGANIZATION, - APPOINTMENT AND REMOVAL OF DIRECTORS OF THE ORGANIZATION,EXCEPT THOSE THAT SERVE EX OFFICIO, - APPROVAL OF AMENDMENTS TO THE ARTICLES OF INCORPORATION, - AMENDMENT OF THE BYLAWS AND APPROVAL OF AMENDMENT TO THE BYLAWS, - APPROVAL OF ANY BORROWING AND GUARANTIES BY THE ORGANIZATION IN ACCORDANCE WITH POLICIES WHICH MAY BE ESTABLISHED BY THE MEMBERS, - APPROVAL OF THE PURCHASE OR SALE OR OTHER ACQUISITION, DISPOSITION OR TRANSFER OF REAL ESTATE, INCLUDING ANY INTEREST THEREIN, BY THE ORGANIZATION, EXCEPT FOR REAL ESTATE RECEIVED AS A BEQUEST OR DONATION AND NOT USED IN THE CHARITABLE ACTIVITIES OF THE ORGANIZATION AND WITH OTHER EXCEPTIONS WHICH MAY BE ESTABLISHED BY THE MEMBERS, - TO INITIATE AND/OR APPROVE ANY MERGER,CONSOLIDATION, ORGANIZATION OR DISSOLUTION OF THE ORGANIZATION, - TO APPROVE THE SALE, TRANSFER OR OTHER DISPOSITION OF THE VOTING STOCK OF THE ORGANIZATION. IF BEFORE THE DISPOSITION THE ORGANIZATION OWNED A MAJORITY OF THE VOTING STOCK OF THE ORGANIZATION AND AFTER SUCH DISPOSITION THE ORGANIZATION SHOULD NOT OWN A MAJORITY OF THE VOTING STOCK OF THE ORGANIZATION, IN ACCORDANCE WITH POLICIES APPROVED BY THE MEMBERS FROM TIME TO TIME, AND - TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED ARE TO BE EXERCISED WITH RESPECT TO ANY STOCK CORPORATIONS OF THE ORGANIZATION OR ANY NON-STOCK CORPORATION OF WHICH THE MEMBER IN ACCORDANCE WITH POLICIES APPROVED BY THE MEMBERS FROM TIME TO TIME. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT FROM 990 IS REVIEWED BY THE MANAGEMENT COMPANY FOR ACCURACY AND MADE AVAILABLE TO THE ENTIRE BOARD. THE FINAL FORM 990 IS MAILED TO THE ASSISTANT TREASURER OF THE BOARD FOR REVIEW AND SIGNATURE. |
| FORM 990, PART VI, SECTION B, LINE 12C | AN ANNUAL CONFLICT OF INTEREST DISCLOSURE IS FILLED OUT BY EACH BOARD MEMBER, SUBMITTED AND REVIEWED BY THE ENTIRE BOARD. THE MEMBER IS THEN EXCLUDED IN ANY VOTING FOR APPLICABLE SUBJECT AREAS. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS OF DETERMINING EXECUTIVE DIRECTOR COMPENSATION: SALARIES ARE REVIEWED ANNUALLY DURING THE BUDGET PROCESS BY THE EXECUTIVE DIRECTOR AND MANAGEMENT COMPANY'S ACCOUNTING AND OPERATIONS PERSONNEL. DURING THIS REVIEW, SALARY RANGES FOR ALL POSITIONS ARE COMPARED WITH SURROUNDING FACILITIES. THE BUDGET IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD. PROCESS OF DETERMINING OFFICER AND/OR KEY EMPLOYEES COMPENSATION: SALARIES ARE REVIEWED ANNUALLY DURING THE BUDGET PROCESS BY THE EXECUTIVE DIRECTOR AND MANAGEMENT COMPANY'S ACCOUNTING AND OPERATIONS PERSONNEL. DURING THIS REVIEW, SALARY RANGES FOR ALL POSITIONS ARE COMPARED WITH SURROUNDING FACILITIES. THE BUDGET IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST BY MAILING A COPY TO THE PERSON MAKING THE REQUEST. |
| FORM 990, PART XII, LINE 2C: | THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. |
| Software ID: | |
| Software Version: |