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.") . | 2,035,912 | 22,966 | 2,058,878 | |||
| 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 | 16,268,597 | 17,617,867 | 20,018,559 | 19,234,152 | 19,850,607 | 92,989,782 |
| 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 | 16,268,597 | 17,617,867 | 20,018,559 | 21,270,064 | 19,873,573 | 95,048,660 |
| 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.) | 95,048,660 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 16,268,597 | 17,617,867 | 20,018,559 | 21,270,064 | 19,873,573 | 95,048,660 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 263,480 | 385,334 | 382,368 | 297,333 | 209,450 | 1,537,965 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 263,480 | 385,334 | 382,368 | 297,333 | 209,450 | 1,537,965 |
| 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.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 16,532,077 | 18,003,201 | 20,400,927 | 21,567,397 | 20,083,023 | 96,586,625 |
| 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 3 | GREYSTONE MANAGEMENT IS AN UNRELATED BUSINESS ORGANIZATION ENGAGED BY THE CATHOLIC CARE CAMPUS, INC. BOARD OF DIRECTORS TO PROVIDE MANAGEMENT SERVICES. CHESTER SURMACZEWICZ IS EMPLOYED BY GREYSTONE AND SERVES AS PRESIDENT OF CATHOLIC CARE CAMPUS. MANAGEMENT DUTIES INCLUDE HIRING AND RECRUITING QUALIFIED PERSONNEL, PREPARING ANNUAL OPERATING BUDGETS FOR SUBMISSION TO THE BOARD OF DIRECTORS, AND ASSISTING IN THE PREPARATION OF MONTHLY AND ANNUAL FINANCIAL REPORTING DISCLOSURES. THE BOARD OF DIRECTORS HAVE FINAL AUTHORITY OVER THE APPROVAL OF THE ANNUAL OPERATING BUDGET, APPROVAL OF MONTHLY AND ANNUAL FINANCIAL REPORTING DISCLOSURES, AND OVERSIGHT OF THE MANAGEMENT COMPANY. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION CHANGED THE CONDITIONS OF MEMBERSHIP IN THE ARTICLES OF INCORPORATION AND BYLAWS FUTHER EXPLAINED IN LINE 6 EXPLANATION. THE ORGANIZATION ALSO CHANGED TERM OF SERVICE OF DIRECTORS INCLUDING LIMITS. THE ORGANIZATION UPDATED VOTING RIGHTS OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE NUMBER OF MEMBERS ALLOWED SHALL BE UNLIMITED, AND ALL MEMBERS SHALL HAVE ONE VOTE ON ALL ACTIONS TO BE TAKEN BY THE MEMBERS. MEMBERS OF THE CORPORATION, AS NAMED IN THE ARTICLES OF INCORPORATION, INCLUDE THE FOLLOWING: (A) THE PERSON HOLDING THE POSITION OF ROMAN CATHOLIC ARCHBISHOP OF THE ARCHDIOCESE OF KANSAS CITY IN KANSAS ("ARCHDIOCESE"); (B) THE PERSON (OR PERSON(S)) HOLDING THE OFFICE (OR OFFICES) FOR THE ARCHDIOCESE OF VICAR GENERAL OF ADMINISTRATION AND/OR CHANCELLOR. IF ONE PERSON HOLDS BOTH TITLES, THEN THIS SUBPARAGRAPH REFERS TO ONE MEMBER. IF ONE PERSON IS VICAR GENERAL OF ADMINISTRATION AND ANOTHER PERSON IS CHANCELLOR, THEN THIS SUBPARAGRAPH REFERS TO TWO MEMBERS; (C) THE PERSON HOLDING THE OFFICE FOR THE ARCHDIOCESE OF CHIEF FINANCIAL OFFICER; (D) THE HEALTHCARE PROFESSIONAL WHO IS DESIGNATED BY THE ARCHBISHOP TO SERVE AS A MEMBER OF THIS CORPORATION; AND (E ) ANY OTHER ELIGIBLE PERSON OR PERSONS DESIGNATED BY UNANIMOUS ACTION OF ALL MEMBERS OF THE CORPORATION AT ANY REGULAR OR SPECIAL MEETING OF THE MEMBERS DULY CALLED AND HELD. IF THE MEMBERS DESIGNATE AN ADDITIONAL MEMBER UNDER THIS SUBSECTION, THE ARCHBISHOP SHALL IDENTIFY SUCH PERSON TO THE CHAIR OF THE BOARD OF DIRECTORS IN WRITING WITHIN TEN (10) DAYS OF THE DESIGNATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT THE BOARD OF DIRECTORS AT EACH ANNUAL MEETING OR AT A SPECIAL MEETING IF A VACANCY OCCURS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBERS MUST PROVIDE WRITTEN APPROVAL FOR ACTIONS BY THE GOVERNING BODY INVOLVING: AMENDING THE ARTICLES OF INCORPORATION; TRANSACTIONS INVOLVING THE PURCHASE, EXCHANGE OR DISPOSITION OF REAL ESTATE OR ENCUMBERING REAL PROPERTY; ANY MERGER, CONSOLIDATION, DISSOLUTION, LIQUIDATION OR TERMINATION OF THE CORPORATION; OR MAKING ANY EXPENDITURE, INVESTMENT, PURCHASE OF PERSONAL PROPERTY OR BORROWING FUNDS IN EXCESS OF STATED AMOUNTS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. MEMBERS OF THE ORGANIZATION'S FINANCE COMMITTEE REVIEW THE FORM 990 AND ASSOCIATED SCHEDULES FOR ACCURACY AND COMPLETENESS. THE ORGANIZATION'S BOARD MEMBERS WILL BE PROVIDED COPIES OF THE FORM 990. THIS WILL ALL OCCUR PRIOR TO THE FORM BEING FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH NEW DIRECTOR, TRUSTEE OR MANAGER SHALL, UPON JOINING HIS OR HER RESPECTIVE BOARD, AND ANNUALLY THEREAFTER, BE GIVEN A COPY OF THE CONFLICT OF INTEREST POLICY AND SHALL ACKNOWLEDGE, IN WRITING, RECEIPTS OF THE POLICY AND COMPLIANCE THEREWITH. ANY DIRECTOR WHO BELIEVES HE OR SHE MAY BE IN VIOLATION OR POTENTIAL VIOLATION, HAS A DUTY TO REPORT THAT FACT TO THE CHAIR OF THE BOARD IMMEDIATELY UPON BECOMING AWARE OF THE RELEVANT FACTS. ANY DIRECTOR MAY RECUSE HIMSELF OR HERSELF AT ANY TIME FROM INVOLVEMENT IN ANY DECISION OR DISCUSSION IN WHICH THE DIRECTOR BELIEVES S/HE HAS OR MAY HAVE CONFLICT OF INTEREST, WITHOUT GOING THROUGH THE PROCESS FOR DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS. ANY ACTION TAKEN BY THE SANTA MARTA BOARD WHICH INVOLVES AN "INTERESTED DIRECTOR" MUST, TO BE VALID, MEET THE FOLLOWING TESTS: A. IT MUST BE FOR SANTA MARTA'S BENEFIT; AND B. IT MUST BE FAIR AND REASONABLE AT THE TIME SANTA MARTA ENTERED INTO IT; AND C. IT MUST BE APPROVED BY A MAJORITY OF THE BOARD WITHOUT CONSIDERING THE VOTE, IF CAST, OF THE INTERESTED DIRECTOR AND ONLY AFTER DISCLOSURE OF ALL MATERIAL FACTS BY THE INTERESTED DIRECTOR; AND D. PRIOR TO AUTHORIZING THE ACTION THE BOARD MUST HAVE DETERMINED, AFTER REASONABLE INVESTIGATION, THAT SANTA MARTA COULD NOT OBTAIN A MORE ADVANTAGEOUS ARRANGEMENT WITH REASONABLE EFFORT, THAN THE ARRANGEMENT BEING APPROVED. |
| FORM 990, PART VI, SECTION B, LINE 15 | GREYSTONE MANAGEMENT REVIEWS THE ANNUAL SALARIES AND BONUSES FOR THE PRESIDENT AND DIRECTOR. FOR THE ANNUAL SALARY REVIEW, EACH INDIVIDUAL COMPLETES A SELF-APPRAISAL WHICH IS THEN REVIEWED BY THE GREYSTONE MANAGEMENT OPERATIONS REGIONAL. THEN, THE RESULTS ARE REVIEWED WITH THE CHAIR OF THE BOARD OF DIRECTORS FOR FEEDBACK AND DISCUSSIONS REGARDING PRIOR YEAR PERFORMANCE AND FUTURE YEARS' GOALS. TO DETERMINE REASONABLENESS OF SALARY INCREASES, FROM TIME TO TIME BALANCES ARE COMPARED TO LEADING AGE INDUSTRY STANDARDS. BONUSES ARE DETERMINED BASED ON 60% FINANCIAL MEASUREMENT AND 40% SUBJECTIVE MEASUREMENT. GREYSTONE MANAGEMENT OPERATIONS REGIONAL REVIEWS THE BONUSES. FURTHER, BONUSES ARE DISCUSSED WITH THE CHAIR OF THE BOARD OF DIRECTORS, WHO PROVIDES FEEDBACK REGARDING PRIOR YEAR PERFORMANCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | CATHOLIC CARE CAMPUS, INC.'S ANNUAL AUDITED FINANCIAL STATEMENT AND CONFLICTS OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE SET FORTH IN SECTION 6104(D). |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. |
| Software ID: | |
| Software Version: |