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.") . | 24,021 | 13,061 | 1,391,770 | 966,637 | 1,234,683 | 3,630,172 |
| 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 | 26,622,167 | 27,401,239 | 23,962,216 | 20,971,909 | 21,891,677 | 120,849,208 |
| 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 | 26,646,188 | 27,414,300 | 25,353,986 | 21,938,546 | 23,126,360 | 124,479,380 |
| 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.) | 124,479,380 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 26,646,188 | 27,414,300 | 25,353,986 | 21,938,546 | 23,126,360 | 124,479,380 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 48,949 | 58,395 | 54,967 | 34,987 | 36,628 | 233,926 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 48,949 | 58,395 | 54,967 | 34,987 | 36,628 | 233,926 |
| 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.) .. | 114,911 | 153,219 | 68,858 | 102,570 | 59,309 | 498,867 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 26,810,048 | 27,625,914 | 25,477,811 | 22,076,103 | 23,222,297 | 125,212,173 |
| 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 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 |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS - 2017 AMOUNT: $ 69,642. 2018 AMOUNT: $ 105,995. 2019 AMOUNT: $ 33,212. 2020 AMOUNT: $ 72,067. 2021 AMOUNT: $ 36,709. INSURANCE PROCEEDS - 2019 AMOUNT: $ 8,245. BEAUTY - 2017 AMOUNT: $ 33,592. 2018 AMOUNT: $ 33,285. 2019 AMOUNT: $ 13,686. 2020 AMOUNT: $ 22,781. 2021 AMOUNT: $ 10,749. MEALS - 2017 AMOUNT: $ 6,497. 2018 AMOUNT: $ 8,070. 2019 AMOUNT: $ 8,470. 2020 AMOUNT: $ 5,074. 2021 AMOUNT: $ 3,238. TRANSPORTATION - 2017 AMOUNT: $ 5,180. 2018 AMOUNT: $ 5,869. 2019 AMOUNT: $ 5,245. 2020 AMOUNT: $ 2,648. 2021 AMOUNT: $ 8,613. |
| 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 | THE ORGANIZATION DELEGATES CONTROL OVER MANAGEMENT DUTIES TO AMERICAN BAPTIST HOMES OF THE MIDWEST. THE TOTAL MANAGEMENT FEES PAID FOR FY 2022 WERE $1,114,000. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS BAPTIST HOME ASSOCIATION OF THE ROCKY MOUNTAINS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER APPOINTS ALL MEMBERS OF THE BOARD OF TRUSTEES. THE PRESIDENT OF THE SOLE MEMBER IS ALSO A VOTING TRUSTEE OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE POWERS, DUTIES, AND RIGHTS RESERVED TO THE MEMBER SHALL BE, BUT ARE NOT LIMITED TO, THE FOLLOWING: A. THE ADOPTION OR AMENDMENT OF MISSION, PHILOSOPHY AND PURPOSE STATEMENTS OF THIS CORPORATION AND ITS SUBSIDIARY CORPORATIONS; B. AMENDMENT, REVISION OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR BY-LAWS OF THIS CORPORATION AND ANY SUBSIDIARY CORPORATIONS; C. MERGER OR CONSOLIDATION OF THIS CORPORATION OR ANY OF ITS SUBSIDIARY CORPORATIONS, INTO OR WITH ANY OTHER CORPORATION OR ASSOCIATION, AND THE DISSOLUTION OR OTHERWISE WINDING UP OF THE AFFAIRS OF THIS CORPORATION AND/OR ITS SUBSIDIARY CORPORATIONS; D. SALE, LEASE, EXCHANGE, PLEDGE, ENCUMBRANCE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THIS CORPORATION'S ASSETS OR THE ASSETS OF ANY OF ITS SUBSIDIARY CORPORATIONS; E. THE ESTABLISHMENT OR INCORPORATION OF ANY NEW ENTITIES, ORGANIZATIONS, OR ASSOCIATIONS OF THIS CORPORATION OR ANY OF ITS SUBSIDIARY CORPORATIONS; F. THE INCURRING OF LONG-TERM DEBT (DEBT WHICH WILL NOT BE TOTALLY REPAID WITHIN A PERIOD OF 12 MONTHS FROM THE DATE SUCH DEBT IS FIRST INCURRED) BY THIS CORPORATION OR ANY OF ITS SUBSIDIARIES IN AMOUNTS IN EXCESS OF THOSE LIMITS ESTABLISHED BY THE CORPORATE MEMBER; G. THE ELECTION OR REMOVAL, WITH OR WITHOUT CAUSE, OF TRUSTEES OF THIS CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S PUBLIC ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY THE ORGANIZATION'S MANAGEMENT. ONCE A DRAFT OF THE FILING BECAME AVAILABLE, THE FINANCE COMMITTEE OF AMERICAN BAPTIST HOMES OF THE MIDWEST REVIEWED THE FORM 990 AT THEIR QUARTERLY MEETING PRIOR TO FILING. THEY RECEIVED COPIES OF THE DRAFT AND THE DETAIL WAS REVIEWED AT THAT TIME. COPIES OF THE 990 WERE THEN PROVIDED TO THE BOARD MEMBERS OF BAPTIST HOME ASSOCIATION OF THE MIDWEST - AFFILIATES. |
| FORM 990, PART VI, SECTION B, LINE 12C | A CONFLICT OF INTEREST FORM IS SIGNED BY ALL BOARD TRUSTEES, ADMINISTRATORS, HOME OFFICE DIRECTORS AND VICE PRESIDENTS. AT THAT TIME, ANY POTENTIAL CONFLICT OF INTEREST IS NOTED ON THE FORM. THE INFORMATION IS GIVEN TO THE CEO, BOARD PRESIDENT AND AUDIT COMMITTEE CHAIR. AT THAT TIME, ANY POTENTIAL CONFLICTS ARE REVIEWED. IF A CONFLICT EXISTS, THE CONFLICTED INDIVIDUAL EITHER HAS TO CORRECT THE CONFLICT OF INTEREST OR MUST ABSTAIN FROM PARTICIPATION REGARDING THE CONFLICT OF INTEREST TOPIC. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS HAS A MANAGEMENT REVIEW COMMITTEE THAT REVIEWS THE CEO'S COMPENSATION. THE COMMITTEE DETERMINES ANY COMPENSATION ADJUSTMENTS TO THE CEO. THE CEO, EXECUTIVE DIRECTORS AND OTHER TOP MANAGEMENT POSITIONS ARE COMPARED TO THE MOST RECENT CEMO STUDY TO DETERMINE HOW THEIR COMPENSATION COMPARES TO PEER ORGANIZATIONS. THIS PROCESS LAST INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN 2022. THE CEO DETERMINES ANY COMPENSATION ADJUSTMENTS TO THE SENIOR MANAGEMENT. THIS PROCESS LAST INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION IN 2022. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OTHER SERVICES: PROGRAM SERVICE EXPENSES 4,421,232. MANAGEMENT AND GENERAL EXPENSES 191,681. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,612,913. |
| FORM 990, PART XII, LINE 2C | THE PROCESS FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. |
| Software ID: | |
| Software Version: |