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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 1,858,527 | 1,848,738 | 2,464,942 | 3,028,279 | 5,863,568 | 15,064,054 |
| 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 | 3,633,795 | 3,777,661 | 3,895,581 | 4,300,278 | 3,695,805 | 19,303,120 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | |||||
| 6 | Total. Add lines 1 through 5 | 5,492,322 | 5,626,399 | 6,360,523 | 7,328,557 | 9,559,373 | 34,367,174 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 68,900 | 852,364 | 921,264 | |||
| 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. | 330,062 | 260,602 | 63,931 | 654,595 | ||
| c | Add lines 7a and 7b.. | 330,062 | 260,602 | 63,931 | 68,900 | 852,364 | 1,575,859 |
| 8 | Public support. (Subtract line 7c from line 6.) | 32,791,315 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 5,492,322 | 5,626,399 | 6,360,523 | 7,328,557 | 9,559,373 | 34,367,174 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 32,100 | 34,305 | 2,239 | 39 | 30 | 68,713 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 32,100 | 34,305 | 2,239 | 39 | 30 | 68,713 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 5,250 | 1,558 | 30,359 | 6,777 | 7,883 | 51,827 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 5,529,672 | 5,662,262 | 6,393,121 | 7,335,373 | 9,567,286 | 34,487,714 |
| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| 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 III, LINE 1 | LITTLE SISTERS OF THE POOR OPERATEs THE JEANNE JUGAN CENTER WHICH PROVIDES NURSING AND RESIDENTIAL CARE FOR THE NEEDY, ELDERLY and Poor. THE HOME IS PART OF THE INTERNATIONAL CONGREGATION OF LITTLE SISTERS OF THE POOR, WHICH WAS FOUNDED IN FRANCE IN 1839, AND SERVES THE ELDERLY IN 31 COUNTRIES. |
| FORM 990, PART III, LINE 3 | NURSING CARE PROVIDED TO RESIDENTS CONTINUED TO BE DISRUPTED BY ROUTINE COVID TESTING OF RESIDENTS, NURSING STAFF, ADMIN STAFF, PROCUREMENT OF COVID TESTING SUPPLIES, PPE, AND THE CONTINUED REPORTING TO THE HEALTH DEPARTMENT. RESIDENTS TESTING POSITIVE TO COVID HAD TO BE QUARANTINED WITHIN THE FACILITY, WHILE STAFF PROVIDED STRICTLY-FOLLOWED COVID INFECTION CONTROLS WITH FOCUS ON HAND HYGIENE. |
| FORM 990, PART III, LINE 4A | A. PHYSICAL CARE - LITTLE SISTERS OF THE POOR PROVIDE LICENSED NURSING CARE, MEDICAL, DENTAL AND PODIATRY CARE, PHYSICAL THERAPY AND PHARMACEUTICAL SERVICES. THE CHALLENGES OF AGING ARE MYRIAD AND MANAGING THE PHYSICAL NEEDS OF THE ELDERLY IS A MONUMENTAL TASK. AS LITTLE SISTERS, WE ARE COMMITTED TO PROMOTING THE DIGNITY OF HUMAN LIFE OF EACH AND EVERY ONE OF OUR RESIDENTS. MEDICAL DOCTORS VISIT THE HOME SEVERAL TIMES A WEEK. DENTAL AND PODIATRY CARE, AS WELL AS PHYSICAL THERAPY, ARE PROVIDED WITHIN THE HOME. IN A SPIRIT OF HUMBLE SERVICE AND HOSPITALITY, THE LITTLE SISTERS PROVIDE NURSING CARE TO THE RESIDENTS WITH UTMOST RESPECT FOR THE DIGNITY OF THE INDIVIDUAL PERSON. THE SISTERS, THROUGH A PRAYERFUL, BEDSIDE PRESENCE, PROVIDE SPIRITUAL CARE TO DYING RESIDENTS. B. SPIRITUAL CARE - LITTLE SISTERS ACCEPT ELDERLY PEOPLE INTO THEIR HOME WITHOUT REGARD TO RELIGION OR RACE. HAVING A FAITH THAT SUSTAINS AND COMFORTS IN HARD TIMES IS A PARTICULAR BLESSING AS WE MOVE TOWARD THE END OF LIFE. WHEN ELDERLY PEOPLE ARE OFFERED THE BENEFITS OF A SPIRITUAL PROGRAM, THEIR LIVES BECOME MORE COMPLETE AND SECURE. LITTLE SISTERS FOSTER THEIR RESIDENTS' FAITH BY OFFERING DAILY MASS BY A RESIDENT CHAPLAIN AND OTHER SPIRITUALLY RELATED PROGRAMS. MANY OF THE RESIDENTS ATTEND MASS ON A REGULAR BASIS AND FIND COMFORT AND HOPE IN THE TRADITIONS OF THE CATHOLIC CHURCH. OTHER RESIDENTS GO INTO THE CHAPEL TO PRAY AND MEDITATE while OTHERS ATTEND THE CHURCH OF THEIR CHOICE. EACH RESIDENT IS ENCOURAGED TO PRACTICE HIS/HER FAITH. WHEN IT IS CLEAR THAT ONE OF THE RESIDENTS IS DYING, THE SISTERS TAKE TURNS (ALONG WITH FAMILY MEMBERS) BEING WITH THE RESIDENT, MAKING HIM OR HER AS COMFORTABLE AS POSSIBLE, PRAYING AND READING COMFORTING SCRIPTURES. THEY REMAIN BY THE RESIDENT'S SIDE UNTIL DEATH COMEs BECAUSE THEY BELIEVE THAT NO ONE SHOULD DIE ALONE. C. ACTIVITIES - THE PHILOSOPHY OF LITTLE SISTERS IS THAT SPIRITUAL WELL-BEING, SOCIAL INTERACTION AND LOVING CARE, ARE THE KEYS TO LIVING A LONG AND FRUITFUL LIFE. MEANINGFUL ACTIVITY IS THE CORNERSTONE OF A HOLISTIC MODEL OF CARE. HAVING A CENTER OF INTEREST, DOING SOMETHING THEY LIKE TO DO, FEELING USEFUL, BEING ABLE TO TAKE INITIATIVES, TO COMMUNICATE AND FORM FRIENDSHIPS, MAINTAINING A RELATIONSHIP WITH THE FAMILY, HAVING CONTACTS WITH YOUTH. THESE ARE THE FACTORS WHICH PROVIDE JOY AND HAPPINESS. LITTLE SISTERS OFFER MANY ACTIVITIES - EXERCISE PROGRAMS, ARTS/CRAFTS, BAKING, BOWLING, CARD GAMES, MUSIC APPRECIATION, GAMES, GROUP DISCUSSIONS, AND OUTINGs TO RESTAURANTS, SHOP, and CULTURAL EVENTS. ALSO AVAILABLE ARE A BEAUTY PARLOR, COFFEE SHOP, GIFT SHOP, LIBRARY, AND CRAFT ROOM. MANY RESIDENTS PARTICIPATE AT THE HOME BY FOLDING CLOTHES IN THE LAUNDRY, HELPING IN THE DINING ROOM OR SELLING ITEMS TO OTHER RESIDENTS IN THE SWEET PEA CONVENIENCE SHOP, WHICH IS SPECIALLY DESIGNED FOR RESIDENTS' NEEDS. RESIDENTS WHO TAKE PART IN THE VARIOUS ACTIVITIES FORM MORE MEANINGFUL RELATIONSHIPS AND HAVE A BETTER PERSPECTIVE ON THE AGING PROCESS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION'S BOARD OF DIRECTORS ARE APPOINTED BY AND SERVE AT THE WILL OF THE SUPERIORESS GENERAL BY AND WITH THE CONSENT OF HER COUNCIL. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BUSINESS MANAGER GATHERS INFORMATION TO PREPARE THE FORM 990 TAX RETURN. THIS INFORMATION IS THEN GIVEN TO AN INDEPENDENT ACCOUNTING FIRM WHO PREPARES AND REVIEWS THE FORM 990. THE INDEPENDENT ACCOUNTING FIRM THEN PROVIDES THE BUSINESS MANAGER WITH A DRAFT OF THE FORM 990 FOR COMMENTS AND APPROVAL. ONCE THE BUSINESS MANAGER AND THE CPA FIRM APPROVE THE 990, A COPY OF THE 990 IS THEN PROVIDED TO ALL GOVERNING BOARD MEMBERS ALONG WITH A RESPONSE TIME FOR QUESTIONS AND COMMENTS. ALL ISSUES ARE RESOLVED AND THE FORM 990 IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTORS, OFFICERS, AND ALL EMPLOYEES WHO INFLUENCE THE ACTIONS OF LITTLE SISTERS OF THE POOR ARE COVERED UNDER THE POLICY. CONFLICT OF INTEREST MAY BE DEFINED AS AN INTEREST, DIRECT OR INDIRECT WITH ANY PERSONS OR FIRMS INVOLVED WITH LITTLE SISTERS OF THE POOR. TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTERESTS EXISTS MAY BE UNDERTAKEN ONLY IF THE CONFLICTING INTEREST IS FULLY DISCLOSED, THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION, A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS AND THE BOARD OR A DULY CONSTITUTED COMMITTEE THEREOF HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINES 15A & B | THE OFFICERS, DIRECTORS, AND TRUSTEES ARE MEMBERS OF THE CONGREGATION OF THE LITTLE SISTERS OF THE POOR AND TAKE A VOW OF POVERTY RENDERING THEM INELIGIBLE FOR COMPENSATION BENEFITS. |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON APPOINTMENT, THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS, CAN BE REVIEWED ON SITE OR BY REQUEST IN WRITING. THE INFORMATION WILL BE DISTRIBUTED ACCORDINGLY. |
| FORM 990, PART XI, LINE 9 | Transfer to Province ($ 300,000) |
| FORM 990, PART XII, LINES 2B & C | THE ORGANIZATION'S FINANCIAL STATEMENTS WERE AUDITED BY AN INDEPENDENT ACCOUNTANT. THE ORGANIZATION DOES NOT HAVE A FORMAL COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS OR SELECTION OF AN INDEPENDENT ACCOUNTANT. HOWEVER, THE GOVERNING BOARD OF SISTERS, WITH ASSISTANCE FROM A FINANCIAL ADVISOR, DOES OVERSEE THE AUDIT PROCESS AND REVIEWS AND APPROVES THE AUDITED FINANCIAL STATEMENTS. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:756692 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:SISTERS' SERVICES TOTAL FEES:53250 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED POOL SERVICES TOTAL FEES:36085 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE CONSULTANTS TOTAL FEES:27025 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:STIPENDS TOTAL FEES:10560 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER FUNDRAISING FEES TOTAL FEES:2000 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BACKGROUND CHECK FEES TOTAL FEES:1219 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER MISCELLANEOUS FEES TOTAL FEES:525 |
| Software ID: | |
| Software Version: |