Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 58,877 | 56,119 | 38,413 | 28,586 | 212,612 | 394,607 |
| 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 | 1,668,412 | 1,816,283 | 1,005,111 | 1,915,923 | 1,808,432 | 8,214,161 |
| 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 | 1,727,289 | 1,872,402 | 1,043,524 | 1,944,509 | 2,021,044 | 8,608,768 |
| 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.) | 8,608,768 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,727,289 | 1,872,402 | 1,043,524 | 1,944,509 | 2,021,044 | 8,608,768 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 227 | 540 | 838 | 1,605 | ||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 227 | 540 | 838 | 1,605 | ||
| 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.).. | 1,727,516 | 1,872,942 | 1,043,524 | 1,944,509 | 2,021,882 | 8,610,373 |
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, 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 2019. 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 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| 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 - ORGANIZATION'S MISSION | COMMUNITY CARE PROMOTES LIFELONG INDEPENDENCE BY PROVIDING COMPASSIONATE, SUPPORTIVE CARE TO THE HOMEBOUND IN A FAITHFUL AND PROFESSIONAL MANNER. A HOME CARE AGENCY LICENSED BY THE STATE BOARD OF HEALTH, OFFICE OF LONG TERM LIVING (OLTL), AND THE OFFICE OF DEVELOPMENTAL PROGRAMS (ODP), COMMUNITY CARE HAS SERVED THE COMMUNITY SINCE 1985 |
| FORM 990, PAGE 2, PART III, LINE 4A | IN-HOME SUPPORT SERVICES, INCLUDING HOME HEALTH AIDE, HOMEMAKER/COMPANION, LIVE-IN CARE, COMPANION AIDE FOR SHORT MEDICAL PROCEDURES, AND TRAINING/EDUCATION. SPECIFICALLY, THE RANGE OF COMMUNITY CARE'S IN-HOME SERVICE DELIVERY INCLUDES: -SENIORS AND PERSONS WITH DEVELOPMENT DISABILITIES ARE ABLE TO REMAIN IN THEIR HOMES BECAUSE OF SUPPORTIVE SERVICES FROM HOME HEALTH AIDES. THESE PARAPROFESSIONALS ARE TRAINED, CERTIFIED AND SUPERVISED BY COMMUNITY CARE'S PROFESSIONAL NURSES TO PROVIDE BATH SERVICES, PERSONAL CARE, MEAL PLANNING AND PREPARATION, AND ASSISTANCE WITH DAILY LIVING. -FOR SENIORS AND PERSONS WITH DISABILITIES WHO NEED ASSISTANCE WITH MEAL PREPARATION, LIGHT HOUSEKEEPING, LAUNDRY, FOOD SHOPPING AND COMPANIONSHIP,COMMUNITY CARE PROVIDES A TRAINED HOMEMAKER/COMPANION. FAMILIES ALSO ARRANGE FOR THESE QUALIFIED CAREGIVERS TO STAY WITH LOVED ONES ON WEEKENDS,HOLIDAYS AND VACATIONS, PROVIDING THE FAMILY A BREAK FROM CARE-GIVING DUTIES -WHEN THE HOSPITAL OR MEDICAL STAFF REQUIRES THAT ANOTHER INDIVIDUAL BE PRESENT IN THE BUILDING DURING CATARACT SURGERY, ENDOSCOPY, COLONOSCOPY, OR OTHER SHORT-TERM PROCEDURES THE PATIENT MAY ARRANGE WITH COMMUNITY CARE FOR A COMPANION/AIDE FOR SHORT MEDICAL PROCEDURES. THIS AIDE CAN ALSO PROVIDE FOLLOW-UP IN THE HOME, SUCH AS HELP WITH EYE OR EAR DROPS. -COMMUNITY CARE'S PROFESSIONAL NURSE SERVICES UTILIZE REGISTERED NURSES AS THE VIGILANT OVERSEERS OF PATIENT CARE AND TREATMENT, ADVOCATING FOR PATIENTS AND ASSISTING WITH COORDINATION OF CARE BY ALL PARTICIPATING PROVIDERS. -OTHER IN-HOME SUPPORTIVE SERVICES INCLUDE: ~ASSESSMENT & MANAGEMENT OF CASES TO DETERMINE THE LEVEL OF CARE NEEDED ~SUPERVISION OF ALL DIRECT CARE WORKERS ~EDUCATION ABOUT THE PROCESS OF DISEASES SUCH AS DIABETES AND HYPERTENSION ~NUTRITIONAL COUNSELING/ EMERGENCY CARE VISITS/ SOCIAL SERVICE REFERRALS ~REGISTERED NURSE ON-CALL 24/7 ~NURSES OVERSEE THE CARE OF PATIENTS AND ADVOCATE ON THEIR BEHALF WITH PROVIDERS |
| FORM 990, PAGE 2, PART III, LINE 4B | CARING TRANSPORTATION IS PROVIDED TO HOMEBOUND SENIORS AND PERSONS WITH DISABILITIES WHO PAY A FEE TO BE A MEMBER OF THE WHEELS FOR INDEPENDENCE PROGRAM. - THE SERVICE IS SAFE, RELIABLE, AND AFFORDABLE, AND THE DRIVERS GIVE PERSONAL ATTENTION TO EACH CLIENT. - CLIENTS MUST BE ABLE TO WALK INDEPENDENTLY OR WITH THE AID OF A CANE OR WALKER. - WHEELS IS UTLIZED FOR RIDES TO MEDICAL APPOINTMENTS, GROCERY STORES, THE HAIRDRESSER, SUPPORTED EMPLOYMENT, AND SOCIAL GATHERINGS AND MEETINGS. - WHEELS DRIVERS ARE SELECTED WITH BACKGROUND CHECKS AND EVALUATED FOR PERSONAL INTEGRITY. - THE CURRENT SERVICE AREAS INCLUDE ZIP CODES 19111, 19114, 19115, 19116, 19135, 19136, 19149, 19152 AND 19154, AND PORTIONS OF BUCKS AND MONTGOMERY COUNTIES. - WHEELS DRIVERS ARE TRAINED TO TRANSPORT SENIORS AND PERSONS WITH DISABILITES, AND RECEIVE DIRECT ON GOING SUPERVISION FROM THE COORDINATOR OF TRANSPORTATION SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 6 | BAYADA HOME CARE, A NONPROFIT ORGANIZATION, IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE SOLE MEMBER CAN APPROVE THE ELECTION OF PERSONS TO THE GOVERNING BODY. HOWEVER, THE MEMBER HAS AGREED NOT TO EXERCISE THIS RIGHT UNLESS THE GOVERNING BODY IS DEADLOCKED ON THE ISSUE OF ELECTION OF A PERSON OR PERSONS TO THE GOVERNING BODY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS REVIEWED BY NANCY STEINKE, ADMINISTRATOR, AND MADE AVAILABLE TO THE GOVERNING BOARD FOR ADDITIONAL COMMENTS, BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CONDUCTING PERIODIC REVIEW, EACH "INTERESTED PERSON" SIGNS A STATEMENT WHICH AFFIRMS THAT THEY HAVE RECIEVED A COPY OF THE CONFLICT OF INTEREST POLICY, READ THE POLICY AND HAVE AGREED TO COMPLY WITH THE TERMS OF THE POLICY. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE COMPENSATION IS REVIEWED BY THE EXECUTIVE BOARD UPON THE ANNIVERSARY DATE OF EACH EMPLOYEE. BOARD PRESIDENT REVIEWS CFO, AND HAS EXECUTIVE BOARD SIGN-OFF ON THE EVALUATION |
| FORM 990, PAGE 6, PART VI, LINE 15B | CEO REVIEWS AND EVALUATES THE BUSINESS COORDINATOR ON ANNIVERSARY DATE AND HAS EXECUTIVE BOARD DETERMINE THE SALARY |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THESE ARE MADE AVAILABLE TO INDIVIDUALS THAT MAKE A REQUEST IN PERSON IMMEDIATELY AFTER COMPLETING AND SIGNING A FORMAL REQUEST FORM IDENTIFYING THEMSELVES AND PROVIDING THEIR ADDRESS. ALL OTHER WRITTEN REQUESTS FROM INDIVIDUALS, FOUNDATIONS, OR GOVERNMENT AGENCIES ARE HONORED WITHIN THIRTY DAYS OF RECEIPT. A NOTICE OF ANNUAL PUBLIC MEETING OF THE ORGANIZATION IS ADVERTISED IN LOCAL NEWSPAPERS |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES 900,884 0 0 |
| Software ID: | |
| Software Version: |