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.") . | 169,210 | 98,694 | 1,013,447 | 3,361,787 | 79,314 | 4,722,452 |
| 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 | 44,416,948 | 47,303,802 | 48,609,222 | 48,181,612 | 44,426,687 | 232,938,271 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 198,093 | 198,093 | ||||
| 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 | 44,586,158 | 47,402,496 | 49,622,669 | 51,543,399 | 44,704,094 | 237,858,816 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 23,300 | 20,100 | 43,400 | |||
| 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.. | 23,300 | 20,100 | 43,400 | |||
| 8 | Public support. (Subtract line 7c from line 6.) | 237,815,416 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 44,586,158 | 47,402,496 | 49,622,669 | 51,543,399 | 44,704,094 | 237,858,816 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 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.) .. | 540,707 | 443,793 | 323,627 | 174,068 | 55,479 | 1,537,674 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 45,126,865 | 47,846,289 | 49,946,296 | 51,717,467 | 44,759,573 | 239,396,490 |
| 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 |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS INCOME - 2017 AMOUNT: $ 20,484. 2018 AMOUNT: $ 18,465. 2019 AMOUNT: $ 18,549. 2020 AMOUNT: $ 19,372. 2021 AMOUNT: $ 55,479. BARBER AND BEAUTY - 2017 AMOUNT: $ 162,019. 2018 AMOUNT: $ 159,394. 2019 AMOUNT: $ 99,992. 2020 AMOUNT: $ 26,809. LAUNDRY - 2017 AMOUNT: $ 95,193. 2018 AMOUNT: $ 122,021. 2019 AMOUNT: $ 113,526. 2020 AMOUNT: $ 78,907. TRANSPORTATION - 2017 AMOUNT: $ 2,645. 2018 AMOUNT: $ 1,653. 2020 AMOUNT: $ 886. ADULT DAY CARE - 2017 AMOUNT: $ 72,067. MEAL INCOME - 2017 AMOUNT: $ 188,299. 2018 AMOUNT: $ 142,260. 2019 AMOUNT: $ 91,560. 2020 AMOUNT: $ 48,094. |
| 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 V, LINE 2A AND PART IX, LINE 7 | BETHESDA HEALTH GROUP, INC, A RELATED ORGANIZATION, ISSUES THE W-2S FOR ALL EMPLOYEES. |
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASURER OF THE BOARD OF DIRECTORS AND ANY OTHER DIRECTORS APPOINTED BY THE CHAIRMAN SUBJECT TO THE APPROVAL OF THE DIRECTORS. THE CHAIRMAN OF THE EXECUTIVE COMMITTEE SHALL BE THE CHAIRMAN OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER AND AUTHORITY TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS AND SHALL SUBMIT MINUTES OF ITS MEETINGS TO THE BOARD OF DIRECTORS AT THE NEXT MEETING OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WILL BE PROVIDED TO THE FINANCE AND EXECUTIVE COMMITTEES OF THE BOARD OF DIRECTORS FOR DETAIL REVIEW PRIOR TO FILING. IN ADDITION TO THESE DETAILED REVIEWS, A COPY OF THE FORM 990 WILL ALSO BE PROVIDED TO THE ENTIRE BOARD FOR THEIR REVIEW. UPON REQUEST, A PDF COPY OF THE RETURN WILL ALSO BE E-MAILED TO MEMBERS OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL DIRECTORS, OFFICERS, BOARD COMMITTEE MEMBERS AND OPERATING OFFICERS ("INSIDERS") OF THE ORGANIZATION ARE REQUIRED TO COMPLETE A "CONFLICT OF INTEREST" FORM ANNUALLY. EACH INSIDER SHALL PROMPTLY AND FULLY DISCLOSE THE EXISTENCE OF ANY POTENTIAL CONFLICTS OF INTEREST. ALL "CONFLICT OF INTEREST" FORMS ARE REPORTED TO THE CEO, CHAIRMAN OF THE BOARD ("CHAIRMAN"), AND THE BOARD. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS FOR A CONSUMMATED TRANSACTION OR ARRANGEMENT, THE BOARD SHALL INVESTIGATE APPROPRIATE STEPS TO MITIGATE OR ELIMINATE THE CONFLICT OF INTEREST. IF IT IS DETERMINED A CONFLICT OF INTEREST EXISTS FOR A PROPOSED TRANSACTION OR ARRANGEMENT, WHICH HAS NOT YET BEEN CONSUMMATED, THE BOARD SHALL AUTHORIZE THE TRANSACTION OR ARRANGEMENT ONLY IF IT IS APPROVED IN ACCORDANCE WITH BETHESDA'S POLICY ON CONFLICTS OF INTEREST ("POLICY"). IF THE CHAIRMAN OR CEO HAS REASONABLE CAUSE TO BELIEVE THAT AN INSIDER HAS FAILED TO COMPLY WITH THE POLICY, THE CHAIRMAN OR CEO SHALL MEET WITH THE INSIDER TO DISCUSS THE ALLEGED FAILURE AND PROVIDE THE INSIDER THE OPPORTUNITY FOR EXPLANATION. IF, AFTER HEARING THE RESPONSE OF THE INSIDER AND MAKING FURTHER INVESTIGATION DEEMED NECESSARY, THE CHAIRMAN OR CEO BELIEVES THAT THE INSIDER VIOLATED THE POLICY, THE MATTER SHALL BE PRESENTED TO THE BOARD TO CONSIDER CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION DOES NOT COMPENSATE ANY OFFICERS, DIRECTORS OF KEY EMPLOYEES. A RELATED ORGANIZATION, BETHESDA HEALTH GROUP, INC COMPENSATES THESE INDIVIDUALS WHICH USES THE FOLLOWING PROCESSES: THE HUMAN RESOURCES COMMITTEE OF THE BOARD REGULARLY ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW AND ANALYZE THE COMPENSATION AND BENEFITS OF OUR EXECUTIVES COMPARED TO THEIR PEERS IN THE BUSINESS COMMUNITY. THE RESULTS ARE REVIEWED AND APPROVED, WHEN APPROPRIATE, BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 112,051. MANAGEMENT AND GENERAL EXPENSES 115,696. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 227,747. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 2,456,933. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,456,933. DIETARY SERVICES: PROGRAM SERVICE EXPENSES 4,563,631. MANAGEMENT AND GENERAL EXPENSES 596,955. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,160,586. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 261,961. MANAGEMENT AND GENERAL EXPENSES 227,913. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 489,874. TEMP AGENCIES: PROGRAM SERVICE EXPENSES 2,828,738. MANAGEMENT AND GENERAL EXPENSES 1,087. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,829,825. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 6,370. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,370. |
| FORM 990, PART XI, LINE 9: | TRANSFER OF UNRESTRICTED NET ASSETS - INTERCOMPANY ACCOUNT ELIMINATIONS -784,020. |
| FORM 990, PAGE 12, PART XII, LINE 2C | PROCESSES HAVE NOT CHANGED FROM PRIOR YEARS |
| Software ID: | |
| Software Version: |