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 | |||||
| (A)
ST ANN'S HOME FOR THE AGED CORP |
222823794 | 10 | No | 0 | 42,628 | |
| (B)
MARGARET ANNA CUSACK CARE CENTER INC |
760847915 | 10 | No | 0 | 42,628 | |
|
Total 2
|
0 | 85,256 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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 | 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 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 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.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 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) |
||||
| 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 2023 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-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, LINE 1 | THE ORGANIZATION'S GOVERNING DOCUMENTS DO NOT IDENTIFY THE SUPPORTED ORGANIZATIONS BY NAME; HOWEVER THE ARTICLES OF INCORPORATION DO SPECIFY A "SIMILAR PURPOSE OR CHARITABLE CLASS OF BENEFICIARIES", AND SPECIFICALLY MENTIONS HOMES AND PROTECTIVE SERVICES FOR THE ELDERLY, ILL OR AGED. BY ITS POSITION AS THE SOLE MEMBER OF ST. ANN'S HOME FOR THE AGED CORP. AND MARGARET ANNA CUSACK CARE CENTER, INC., THE ORGANIZATION OVERSEES HOMES AND PROTECTIVE SERVICES FOR THE ELDERLY AND AGED. BY PROVIDING ADMINISTRATIVE AND OTHER NECESSARY SERVICES TO THE SUPPORTED ORGANIZATIONS, THE ORGANIZATION PROMOTES THESE CHARITABLE MINISTRIES AND INCREASES THEIR SUSTAINABILITY TO PROVIDE HOMES AND PROTECTIVE SERVICES FOR THE ELDERLY, ILL OR AGED. |
| SCHEDULE A, PART IV, SECTION D, QUESTION 3 | As a supporting organization, Peace Care, Inc. is responsive to the needs and demands of its supported organizations. At least one member of the governing body of each of Peace Care, Inc.'s supported organizations also serve as a trustee of Peace Care, Inc. As the sole member of each of its supported organizations, Peace Care, Inc. has reserved powers described in each supported organization's bylaws. There is also significant direction over programs and policies exercised by the Chief Operating Officer charged with the execution of the integration plan for the two supported organizations. Because of this relationship, the supported organizations have a significant voice in Peace Care, Inc.'s investment policies, timing of grants, manner of making grants, selection of grant recipients, and other use of income or assets. |
| SCHEDULE A, PART IV, SECTION E; QUESTIONS 3A & 3B | Peace Care, Inc. is the sole member of St. Ann's Home for the Aged Corp. and Margaret Anna Cusack Care Center, Inc. Peace Care, Inc. is the parent of each of these supported organizations, and maintains the power to appoint the governing body and officers of each organization. As the sole member of each of its supported organizations, Peace Care, Inc. has reserved powers described in each supported organization's bylaws. There is also significant direction over programs and policies exercised by the Chief Operating Officer charged with the execution of the integration plan for the two supported organizations. |
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| Return Reference | Explanation |
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| CORE FORM, PART VI, SECTION A; QUESTION 3 | This organization is the tax-exempt parent entity of Peace Care, Inc. and affiliates. Peace Care, Inc. has a financial management services agreement with Holy Name Medical Center, Inc.; an internal revenue code section 501(c)(3) tax-exempt hospital organization. Through this agreement, Holy Name provides Peace Care with certain back office financial support services and financial management services. |
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | Peace Ministries, Inc. is the sole member of this organization. Peace Ministries, Inc. has the ultimate authority and right to elect the members of this organization's board of trustees and has certain reserved powers as defined in this organization's bylaws. |
| CORE FORM, PART VI, SECTION B; QUESTION 11B | The organization is the tax-exempt parent organization of Peace Care, Inc. and affiliates ("system"). The organization's federal form 990 was provided to each voting member of the organization's governing body prior to filing of the form 990 with the internal revenue service ("irs"). As part of the tax return preparation process the organization hired a professional certified public accounting ("CPA") firm with experience and expertise in both healthcare and not-for-profit tax return preparation to prepare the federal form 990. The CPA firm's tax professionals worked closely with the system's finance personnel and various other system individuals ("internal working group") to obtain the information needed in order to prepare a complete and accurate tax return. The CPA firm prepared a draft federal form 990 and furnished it to the system's internal working group for their review. The internal working group reviewed the draft federal form 990 and discussed questions and comments with the CPA firm. Revisions were made to the draft federal form 990 where necessary and a final draft was furnished by the CPA firm to the internal working group for final review. Following this review, the form 990 was then presented to the organization's audit and compliance committee and provided to the organization's governing body prior to filing with the irs. |
| CORE FORM, PART VI, SECTION B, LINE 12C | The organization is the tax-exempt parent organization of Peace Care, Inc. and affiliates ("system"). The organization and system regularly monitor and enforce compliance with its conflict of interest policy. The primary purpose of the policy is to ensure that the board and executive staff can make decisions in an objective manner without undue influence by interested persons and to ensure that the center fulfills its charitable purposes. Each board member and principal officer with board delegated power shall annually sign a statement which affirms that such persons have complied with the following: 1) received a copy of this policy, 2) read and understand this policy, 3) agreed to comply with this policy, 4) understand that the center is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes and, 5) disclosed activities and financial interests which may result in a conflict of interest. Potential conflicts are discussed at the appropriate audit committee meeting and a decision on how to handle is voted on in the absence of the individual who has a conflict. |
| CORE FORM, PART VI, SECTION B, LINE 15A | THE ORGANIZATION IS THE TAX-EXEMPT PARENT ORGANIZATION OF PEACE CARE, INC. AND AFFILIATES ("SYSTEM"). THE ORGANIZATION HAS A COMPENSATION COMMITTEE ("COMMITTEE") OF THE BOARD OF TRUSTEES. THE COMPENSATION AND BENEFITS OF THIS ORGANIZATION'S OFFICER(S) ARE REVIEWED BY THE COMMITTEE ON AN ANNUAL BASIS TO ENSURE FAIR MARKET VALUE COMPENSATION IS PAID. WHERE APPROPRIATE, THE COMMITTEE ALSO REVIEWS EXTERNAL COMPARABLE DATA AND SEEKS ADVICE FROM EXTERNAL INDUSTRY CONSULTANTS. |
| CORE FORM, PART VI, SECTION C; QUESTION 19 | The organization's filed certificate of incorporation and any amendments can be obtained and reviewed through the State of New Jersey Department of the Treasury. In addition, the organization's conflict of interest policy and audited financial statements are available upon request. |
| CORE FORM, PART VII AND SCHEDULE J | Core form, part vii and schedule j reflect certain board members and officers receiving compensation and benefits from this organization or a related organization. Please note that this remuneration was for services rendered as full-time employees of the organization or a related organization and not for services rendered as a voting member or officer of this organization's board of trustees. |
| CORE FORM, PART XII; QUESTION 2 | The organization is the tax-exempt parent organization of Peace Care, Inc. and affiliates. An independent CPA firm audited the consolidated financial statements of Peace Care, Inc. and affiliates, for the years ended December 31, 2023 and December 31, 2022; respectively. The audited consolidated financial statements contain consolidating schedules on an entity by entity basis. The independent CPA firm issued an unmodified opinion with respect to the audited consolidated financial statements each year. Peace Care, Inc.'s audit and compliance committee has assumed responsibility for the oversight of the audit of the consolidated financial statements, which includes this organization and the selection of an independent auditor. |
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