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.") .. | 847,589 | 1,514,382 | 1,519,967 | 1,063,276 | 1,044,262 | 5,989,476 |
| 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 | 847,589 | 1,514,382 | 1,519,967 | 1,063,276 | 1,044,262 | 5,989,476 |
| 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. | 5,989,476 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 847,589 | 1,514,382 | 1,519,967 | 1,063,276 | 1,044,262 | 5,989,476 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 36,661 | 24,839 | 21,534 | 28,425 | 36,002 | 147,461 |
| 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 | 6,136,937 | |||||
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.") . | ||||||
| 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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) |
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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): |
|||||
| 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 2, PART III, LINE 4A | OUR HOUSE ------------------------------------------- OUR HOUSE PROVIDES 24 HOUR SPECIALIZED NURSING CARE AND SERVICES IN A RESIDENTIAL CARE FACILITY FOR THOSE WITH ADVANCED HIV WHO REQUIRE INTENSIVE CARE. IN ADDITION TO HIV AND RELATED PHYSICAL HEALTH ISSUES, MANY RESIDENTS ALSO SUFFER FROM MENTAL ILLNESS, SUBSTANCE ABUSE AND/OR HISTORIES OF HOMELESSNESS. IN THE PAST YEAR A TOTAL OF 16 RESIDENTS AND THEIR FAMILIES WERE SERVED. RESIDENTS OF OUR HOUSE ARE ENCOURAGED TO ATTEND ACTIVITIES PROVIDED BY OUR STAFF AND COMMUNITY VOLUNTEERS. THESE OPPORTUNITIES INCLUDE SWIMMING, BOWLING, BINGO, CREATIVE WRITING, GARDENING, CRAFTS AND MORE. WE ALSO HAVE FREQUENT OUTINGS TO PARKS, MUSEUMS, MOVIES, THE COAST, AS WELL AS SPECIAL COMMUNITY EVENTS. OUR THERAPEUTIC GARDEN CONTINUES TO THRIVE WITH RESIDENTS PARTICIPATING EVERY THURSDAY AFTERNOON TO PLANT, CULTIVATE AND HARVEST FRUITS AND VEGETABLES THAT ARE THEN PREPARED AND SERVED TO THEM BY OUR KITCHEN VOLUNTEERS. ALL RESIDENTS, INCLUDING THOSE WITH VISUAL AND OTHER PHYSICAL IMPAIRMENTS, ARE ENCOURAGED TO PARTICIPATE. WE MAKE SPECIAL PROVISIONS FOR THEM TO BE INVOLVED IN A MEANINGFUL WAY. GARDENING IS A GREAT WAY TO BUILD COMMUNITY AMONG OUR RESIDENTS AND A SOURCE OF PRIDE AND ACCOMPLISHMENT FOR THOSE THAT ARE INVOLVED. THE WORK AT OUR HOUSE CONTINUALLY EVOLVES, DEPENDING ON THE NATURE OF THE EVER CHANGING HIV VIRUS AND THE COMPLEXITY OF OUR RESIDENTS. MUCH OF OUR RECENT WORK IS CENTERED AROUND ADDRESSING COMPLEX CO-MORBIDITIES, AS WELL AS DIFFICULT BEHAVIORAL AND COGNITIVE ISSUES. OUR CONTINUING EDUCATIONAL PROGRAMS FOR STAFF AND VOLUNTEERS ARE CENTERED AROUND CURRENT ISSUES OF BEHAVIOR, NUTRITION, DIVERSITY AND OTHER IMPORTANT TOPICS. |
| FORM 990, PAGE 2, PART III, LINE 4B | NEIGHBORHOOD HOUSING & CARE PROGRAM (NHCP) ------------------------------------------- THE AWARD-WINNING NEIGHBORHOOD HOUSING & CARE PROGRAM (NHCP) PROVIDES ASSISTANCE WITH HOUSING AS WELL AS SUPPORTIVE SERVICES TO LOW INCOME PEOPLE LIVING WITH HIV WHO WISH TO LIVE INDEPENDENTLY. THE MULTI-DISCIPLINARY, PROFESSIONALLY LICENSED CARE TEAM PROVIDES ASSISTANCE WITH NURSING SERVICES, SOCIAL SERVICES AND OCCUPATIONAL THERAPY. THE NHCP STAFF IS KNOWLEDGEABLE ABOUT ISSUES AFFECTING PEOPLE LIVING WITH HIV, COMMUNITY RESOURCES & NAVIGATING HEALTH CARE SYSTEMS. OUR TEAM WORKS WITH CASCADE AIDS PROJECT TO PROVIDE ASSISTANCE WITH SECURING AND MAINTAINING PERMANENT HOUSING. OUR TEAM PROVIDES HEALTH ASSESSMENTS, EDUCATION AND MEDICATION MANAGEMENT, COORDINATION AND ASSISTANCE TO PERFORM SELF AND HOUSEHOLD CARE, COORDINATION OF HOUSING SUPPORT, COUNSELING AND SOCIAL SUPPORT, HOME SAFETY, AND OPPORTUNITIES FOR ENGAGEMENT AND CONNECTION IN THE COMMUNITY. A STRONG CONNECTION TO COMMUNITY RESOURCES HELPS CLIENTS MEET MATERIAL, EMOTIONAL, HEALTH, VOCATIONAL AND LEISURE NEEDS. WE ALSO PROVIDE CAREGIVER EDUCATION, TRAINING, CONSULTATION AND PRACTICE OF LIFE AND COPING SKILLS. THIS YEAR, A TOTAL OF 41 CLIENTS WERE SERVED. |
| FORM 990, PAGE 2, PART III, LINE 4C | COMMUNITY SERVICES PROGRAM ------------------------------ THE COMMUNITY SERVICES PROGRAM CONSISTS OF TOD'S CORNER AND ESTHER'S PANTRY WHICH PROVIDE VITAL SERVICES TO LOW INCOME INDIVIDUALS IN OUR COMMUNITY LIVING WITH HIV. CLIENTS ACCESSING SERVICES TO ESTHER'S PANTRY MAY VISIT EACH MONTH TO RECEIVE SUPPLEMENTAL FOOD AND PERSONAL CARE ITEMS. ESTHER'S PANTRY WAS ESTABLISHED IN 1985 AND SERVES OVER 200 CLIENTS EACH MONTH. CLIENTS WHO VISIT TOD'S CORNER MAY RECEIVE HOUSEHOLD ITEMS, CLOTHING, AND COMPANION PET SUPPLIES. OTHER SERVICES ARE ALSO PROVIDED UPON REQUEST; THIS MAY INCLUDE COMPANION PET CARE, PERSONAL IDENTIFICATION CARDS, EMERGENCY TRAVEL EXPENSES, CREMATIONS AND MORE. CLIENTS OF ESTHER'S PANTRY AND TOD'S CORNER MUST RECEIVE A REFERRAL FROM A CARE PROVIDER TO ACCESS SERVICES. THIS YEAR, 782 INDIVIDUALS WERE SERVED. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS REVIEWED FIRST BY THE FINANCE COMMITTEE OF OUR HOUSE AND THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL BEFORE THE TAX RETURN IS SUBMITTED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED AND DISCUSSED ANNUALLY AT A BOARD MEETING OR UPON ACCEPTANCE OF A NEW BOARD MEMBER. ANY CONFLICTS ARE DISCUSSED AND DISCLOSED AND DOCUMENTED IN THE BOARD MINUTES. STAFF MEMBERS ARE ALSO REQUIRED TO SIGN THE CONFLICT OF INTEREST POLICY WHICH IS REVIEWED BY THE EXECUTIVE DIRECTOR. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE EXECUTIVE DIRECTOR HAS AN EMPLOYMENT CONTRACT RENEWED ON AN ANNUAL BASIS AT THE BEGINNING OF EACH FISCAL YEAR OF OUR HOUSE. THE BASE SALARY AND BONUS OPPORTUNITIES ARE DEFINED FOR THE NEXT FISCAL YEAR AND INCLUDE A DETAILED COMPUTATION OF THE PRIOR YEAR BONUS PAY AND ACHIEVEMENTS. A FORMAL EVALUATION IS PREPARED INCLUDING BOARD AND STAFF INPUT AND FEEDBACK. THE BOARD CHAIR AND THE EXECUTIVE DIRECTOR SIGN THE CONTRACT. THE CHIEF FINANCIAL OFFICER ALSO RECEIVES AN ANNUAL PERFORMANCE REVIEW AND RECEIVES PEER INPUT. THE SALARY IS COMPARED TO MARKET SALARIES OF SIMILAR POSITIONS AND ORGANIZATIONS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | FORM 990 IS MADE AVAILABLE FOR PUBLIC INSPECTION THROUGH GUIDESTAR AND OTHER WEBSITES. OTHER GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE SELECTIVELY AVAILABLE ON WEBSITES OR UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | EVENT EXPENSES 172,178 EVENT EXPENSES -172,178 |
| Software ID: | |
| Software Version: |