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.") . | 1,771,000 | 4,614,527 | 4,530,986 | 10,916,513 | ||
| 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 | 5,783,648 | 11,650,598 | 11,539,433 | 28,973,679 | ||
| 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 | 7,554,648 | 16,265,125 | 16,070,419 | 39,890,192 | ||
| 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.) | 39,890,192 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 7,554,648 | 16,265,125 | 16,070,419 | 39,890,192 | ||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 15,970 | 51 | 50 | 16,071 | ||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 15,970 | 51 | 50 | 16,071 | ||
| 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.) .. | 30,780 | 313 | 31,093 | |||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 7,570,618 | 16,295,956 | 16,070,782 | 39,937,356 | ||
| 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) |
||||
| 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 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, PART VI, SECTION A, LINE 3 | IHM SLC HAS A MANAGEMENT AGREEMENT WITH TRINITY HEALTH SENIOR COMMUNITIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS OF THE CORPORATION ARE THOSE PERSONS DULY CONSTITUTED IN OFFICE ACCORDING TO THE PROPER LAW WHO SERVE AS THE PRESIDENT AND THE MEMBERS OF THE LEADERSHIP COUNCIL OF THE CONGREGATION. THE CONGREGATION REFERENCED HERE REFERS TO THE CONGREGATION OF THE SISTERS, SERVANTS OF THE IMMACULATE HEART OF MARY, MONROE, MICHIGAN. |
| FORM 990, PART VI, SECTION A, LINE 7A | WITH THE EXCEPTION OF THE FIRST BOARD OF DIRECTORS, NO FEWER THAN ONE (1) OR MORE THAN ONE-THIRD (1/3) OF THE TOTAL NUMBER OF DIRECTORS MAY BE APPOINTEES OF THE MEMBERS, ONE OF WHOM SHALL BE A MEMBER OF THE CORPORATION. NOMINEES SHALL BE ELECTED BY THE BOARD OF DIRECTORS AND SUBMITTED TO THE MEMBERS FOR APPROVAL AT THE ANNUAL MEETING OF THE MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING POWERS ARE RESERVED EXCLUSIVELY TO THE MEMBERS AND NO ATTEMPTED EXERCISE OF ANY SUCH POWERS BY ANYONE OTHER THAN THE MEMBERS SHALL BE VALID OR OF ANY FORCE OR EFFECT WHATSOEVER: 1. TO CHANGE THE PHILOSOPHY, OBJECTIVES AND PURPOSES OF THE CORPORATION FOR WHICH IT WAS AND IS FORMED AND EXISTS; 2. TO AMEND, ALTER, MODIFY OR REPEAL THE ARTICLES OF INCORPORATION; 3. TO AMEND, ALTER, MODIFY, REPEAL OR TO APPROVE THE AMENDING OF THESE BYLAWS BY THE BOARD OF DIRECTORS; 4. TO APPOINT THE FIRST BOARD OF DIRECTORS; 5. THEREAFTER, ON AN ANNUAL BASIS, TO APPOINT UP TO ONE-THIRD (1/3) OF THE DIRECTORS AND APPROVE THE REMAINING DIRECTORS; 6. TO REMOVE ANY OR ALL OF THE DIRECTORS WITH OR WITHOUT CAUSE; 7. TO MERGE OR TO CONSOLIDATE THIS CORPORATION WITH ANOTHER CORPORATION, ORGANIZATION OR PROGRAM, OR TO AFFILIATE THIS CORPORATION WITH ANOTHER CORPORATION, ORGANIZATION OR PROGRAM WHERE THE AFFILIATION INVOLVES IN ANY WAY THE EXERCISE OF THE POWERS RESERVED TO THE MEMBERS; 8. TO DISSOLVE OR TERMINATE THE EXISTENCE OF THIS CORPORATION AND TO DETERMINE THE DISTRIBUTION OF ASSETS UPON SUCH TERMINATION OR DISSOLUTION IN ACCORDANCE WITH THE PROVISIONS OF THE ARTICLES OF INCORPORATION AND THESE BYLAWS; 9. TO REQUIRE A CERTIFIED AUDIT OF CORPORATION FUNDS AT ANY TIME AND TO REQUIRE AN ANNUAL AUDIT; 10. TO APPROVE THE CORPORATION'S LONG-RANGE PLAN; AND 11. TO APPROVE THE BUDGET OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION PROVIDES A COPY OF THE 990 TO THE BOARD FOR REVIEW BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | IHM SLC REQUIRES A DISCLOSURE FORM TO BE COMPLETED BY THE BOARD MEMBERS AND BOARD MEMBERS ARE REQUESTED TO SIGN A CONFLICT-OF-INTEREST POLICY ON AN ANNUAL BASIS WHICH ARE THEN REVIEWED AS A MEANS OF IDENTIFYING POSSIBLE CONFLICTS. EMPLOYEES: NEW EMPLOYEES ARE TRAINED ON CONFLICT OF INTEREST AND CORPORATE COMPLIANCE AT NEW HIRE ORIENTATION AND THEN YEARLY THROUGH RELIAS. EMPLOYEES ARE TRAINED THAT IF THEY SEE A CONCERN, THEY ARE TO REPORT IT TO THEIR MANAGER, CORPORATE COMPLIANCE OFFICER AND/OR THROUGH THE CORPORATE COMPLIANCE HOTLINE. IF IHM SLC IS NOTIFIED OF A CONCERN, IT IS INVESTIGATED WITHIN 5 BUSINESS DAYS AND THE IHM SLC BOARD AND IHM LEADERSHIP ARE NOTIFIED OF THE CONCERN. |
| FORM 990, PART VI, SECTION B, LINE 15 | EXECUTIVE COMPENSATION IS DETERMINED AND REVIEWED BY TRINITY HEALTH SENIOR COMMUNITIES' HUMAN RESOURCES TEAM AS PART OF THE MANAGEMENT SERVICES AGREEMENT. HUMAN RESOURCES OBTAINS MARKET DATA FOR SIMILARLY SIZED, GEOGRAPHICALLY COMPARABLE SENIOR CARE COMMUNITIES. USING THIS DATA, AND ADJUSTING FOR FACTORS OF DIFFERENTIATION SUCH AS LEVELS OF CARE, EXPERIENCE, JOB RESPONSIBILITIES, ETC., THE COMPENSATION RANGE FOR BASE SALARY, BENEFITS, AND OTHER COMPENSATION FOR THE EXECUTIVE DIRECTOR POSITION IS DETERMINED. COMPENSATION RATES ARE REVIEWED REGULARLY BY HUMAN RESOURCES AND SIGNIFICANT ADJUSTMENTS WOULD BE COMMUNICATED TO THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 849,577. MANAGEMENT AND GENERAL EXPENSES 559,141. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,408,718. PHARMACY COSTS: PROGRAM SERVICE EXPENSES 217,793. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 217,793. CONSULTING: PROGRAM SERVICE EXPENSES 1,535. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,535. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 308,307. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 308,307. OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 229,977. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 229,977. SPEECH THERAPY: PROGRAM SERVICE EXPENSES 100,492. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 100,492. |
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| Software Version: |