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)
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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.") . | 8,239,784 | 9,469,942 | 9,641,261 | 1,232,923 | 6,432,926 | 35,016,836 |
| 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 | 30,147,164 | 32,198,468 | 29,752,074 | 39,730,290 | 42,402,369 | 174,230,365 |
| 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 | 38,386,948 | 41,668,410 | 39,393,335 | 40,963,213 | 48,835,295 | 209,247,201 |
| 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.) | 209,247,201 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 38,386,948 | 41,668,410 | 39,393,335 | 40,963,213 | 48,835,295 | 209,247,201 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 588,671 | 623,718 | 678,308 | 436,343 | 1,016,768 | 3,343,808 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 588,671 | 623,718 | 678,308 | 436,343 | 1,016,768 | 3,343,808 |
| 11 | Net income from unrelated business activities not included on 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.) .. | 1,250 | 1,100,000 | 1,101,250 | |||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 38,975,619 | 42,292,128 | 40,072,893 | 41,399,556 | 50,952,063 | 213,692,259 |
| 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 VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE SHALL BE A STANDING COMMITTEE OF THE CORPORATION AND SHALL CONSIST OF THE CHAIR/PRESIDENT/CEO, VICE CHAIR/VICE PRESIDENT, SECRETARY AND TREASURER OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL STUDY, ADVISE, AND MAKE RECOMMENDATIONS TO THE BOARD ON MATTERS RELATED TO LEGAL AND EXECUTIVE MANAGEMENT AND PROVIDE THE EXECUTIVE STAFF WITH ADVICE, COUNSELING, AND THE OPPORTUNITY FOR CONFIDENTIAL COMMUNICATION. BETWEEN BOARD MEETINGS, THE EXECUTIVE COMMITTEE IS AUTHORIZED TO TAKE ANY REQUIRED ACTION OF THE CORPORATION WHEN CALLING A SPECIAL MEETING OF THE BOARD IS NOT REASONABLY PRACTICAL GIVEN THE CIRCUMSTANCES OF THE REQUIRED ACTION AND TO TAKE ANY ACTION SPECIFICALLY DELEGATED TO IT BY THE BOARD. THE EXECUTIVE COMMITTEE SHALL REPORT THOSE ACTIONS TAKEN PURSUANT TO THE PRECEDING SENTENCE TO THE BOARD AT THE NEXT BOARD MEETING. ADDITIONALLY, THE EXECUTIVE COMMITTEE SHALL RECOMMEND TO THE FULL BOARD, ANY ACTIONS OR CHANGES DEEMED BENEFICIAL TO THE CORPORATION REGARDING ITS OPERATIONAL, LEGAL, AND ADMINISTRATIVE STRUCTURE OR FUNCTIONS INCLUDING, BUT NOT LIMITED TO, CHANGES TO CORPORATE MANAGEMENT AGREEMENTS AND COMPENSATION. |
| FORM 990, PART VI, SECTION A, LINE 3 | MANAGEMENT DELEGATED LEE FP. INC. (DBA CYPRESS LIVING), A RELATED ORGANIZATION DELEGATED AS THE MANAGEMENT COMPANY OF CYPRESS COVE. THE BOARD MEMBERS OF CYPRESS COVE ARE APPOINTED BY THE BOARD OF LEE HEALTHCARE RESOURCES, THE PARENT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD MEMBERS OF LEE MEMORIAL HOSPITAL, INC D/B/A LEE HEALTHCARE RESOURCES (A 501(C)(3) CORPORATION) SELECT THE MEMBERS OF THE BOARD OF DIRECTORS UNDER ALL CIRCUMSTANCES INCLUDING, BUT NOT LIMITED TO: (I) THE ANNUAL ELECTION, (II) IN THE EVENT THERE IS AN INCREASE IN THE SIZE OF THE BOARD, OR (III) IN THE EVENT THERE IS A VACANCY IN THE MEMBERSHIP OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED BY OUR OUTSIDE TAX ADVISOR/CPA FROM INFORMATION PROVIDED. THE 990 IS PRESENTED IN DRAFT FORM TO THE AUDIT COMMITTEE. UPON COMMITTEE APPROVAL THE 990 IS SENT TO ALL BOARD MEMBERS, DISCUSSED AND APPROVED AT A BOARD MEETING PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ENFORCEMENT OF CONFLICTS OF INTEREST POLICY ALL DIRECTORS, OFFICERS AND COMMITTEE MEMBERS WITH BOARD-DELEGATED POWERS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST AT THE TIME THE BOARD MAY BE CONSIDERING A RELATED TRANSACTION OR ARRANGEMENT. THE INDIVIDUAL WITH THE CONFLICT IS PRECLUDED FROM VOTING ON MATTERS TO WHICH THE CONFLICT PERTAINS. IN ADDITION, ON AN ANNUAL BASIS, EACH DIRECTOR IS REQUIRED TO SIGN A STATEMENT AFFIRMING THEY HAVE READ AND UNDERSTAND THE POLICY AND HAVE NOT BEEN INVOLVED IN ANY CONFLICTS OF INTEREST. CYPRESS COVE ALSO PERFORMS PERIODIC REVIEWS TO ENSURE COMPLIANCE WITH THIS POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION PROCESS FOR TOP OFFICIAL AN INDEPENDENT COMPENSATION CONSULTANT IS ENGAGED BY THE BOARD'S HUMAN RESOURCES COMMITTEE AND MANAGEMENT COMPANY (LEE FP INC) TO REGULARLY CONDUCT A FORMAL EXECUTIVE COMPENSATION STUDY. NO MEMBER OF THE COMMITTEE HAS ANY CONFLICT OF INTEREST WITH RESPECT TO THE EXECUTIVE DIRECTOR'S COMPENSATION. THE COMMITTEE AND MANAGEMENT COMPANY UTILIZE THE STUDY'S RESULTS WITH OTHER RELATED INDUSTRY DATA (SUCH AS INFORMATION REPORTED ON FORMS 990 FILED BY COMPARABLE ORGANIZATIONS) AS A BASIS FOR COMPARISON PURPOSES OF OVERALL EXECUTIVE COMPENSATION. THE STUDY FINDINGS AND APPROVED RECOMMENDATIONS FROM THE COMMITTEE MEETINGS ARE DOCUMENTED IN THE MINUTES TO THE COMMITTEE MEETING AND DELEGATED TO THE MANAGEMENT COMPANY TO IMPLEMENT AND OVERSEE. COMPENSATION PROCESS FOR OFFICERS AN INDEPENDENT COMPENSATION CONSULTANT IS ENGAGED BY THE BOARD'S HUMAN RESOURCES COMMITTEE AND MANAGEMENT COMPANY (LEE FP INC) TO REGULARLY CONDUCT A FORMAL EXECUTIVE COMPENSATION STUDY. NO MEMBER OF THE COMMITTEE HAS ANY CONFLICT OF INTEREST WITH RESPECT TO THE EXECUTIVE DIRECTOR'S COMPENSATION. THE COMMITTEE AND MANAGEMENT COMPANY UTILIZE THE STUDY'S RESULTS WITH OTHER RELATED INDUSTRY DATA (SUCH AS INFORMATION REPORTED ON FORMS 990 FILED BY COMPARABLE ORGANIZATIONS) AS A BASIS FOR COMPARISON PURPOSES OF OVERALL EXECUTIVE COMPENSATION. THE STUDY FINDINGS AND APPROVED RECOMMENDATIONS FROM THE COMMITTEE MEETINGS ARE DOCUMENTED IN THE MINUTES TO THE COMMITTEE MEETING AND DELEGATED TO THE MANAGEMENT COMPANY TO IMPLEMENT AND OVERSEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT THE OFFICE OF THE EXECUTIVE DIRECTOR UPON REQUEST. IN ADDITION, THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED ANNUALLY WITH THE CYPRESS COVE RESIDENT FINANCIAL COMMUNICATIONS COMMITTEE. QUARTERLY FINANCIAL UPDATES ARE ALSO PROVIDED IN PUBLIC FORUM FOR ALL RESIDENTS. |
| FORM 990, PART XI, LINE 9: | UNREALIZED GAIN ON INTEREST RATE SWAP 11,831,530. |
| Software ID: | |
| Software Version: |