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)
Agrace Health Inc |
993390141 | 9 | Yes | 0 | 0 | |
| (B)
Agrace Hospicecare Inc |
391319537 | 9 | Yes | 0 | 0 | |
|
Total 2
|
0 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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 2024 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-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2025. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part I, Line 11 SUPPORT TO RELATED TAX-EXEMPT ORGANIZATION | HOLDINGS PROVIDES THE USE OF THEIR FACILITIES AND FIXED ASSETS TO AGRACE HEALTH, INC. and its affliates, RELATED TAX-EXEMPT ORGANIZATIONs, TO SUPPORT THE MISSION OF ENHANCING THE QUALITY OF LIFE AT THE END OF LIFE. |
| Schedule A, Part IV, Section A, Line 1 Supported Orgs Listed By Name | IN NOVEMBER 2024, AGRACE HEALTH, INC. (EIN 99-3390141) BECAME THE SOLE MEMBER OF AGRACE HOSPICECARE HOLDINGS, INC., SUBSTITUTING AGRACE HOSPICECARE, INC. (EIN 39-1319537) AS THE SUPPORTED ORGANIZATION. DUE TO THIS SUBSTITUTION, AGRACE HOSPICECARE, INC. IS NO LONGER LISTED BY NAME IN THE ORGANIZATION'S GOVERNING DOCUMENTS |
| Schedule A, Part IV, Section A, Line 5a Added, Substituted, or Removed Sup. Org. | In 2024, Agrace Health, Inc. (EIN 99-3390141) became the sole member of Agrace HospiceCare Holdings, Inc., substituting Agrace HospiceCare, Inc. (EIN 39-1319537) as the supported organization. This substitution was made pursuant to the amended bylaws of Agrace HospiceCare Holdings, Inc. In 2024, Agrace Health, Inc. was established to isolate non-tax operational liabilities, in furtherance of its charitable mission. Concurrently, Agrace Health, Inc. was named the sole member of Agrace HospiceCare, Inc., replacing the prior membership structure. The bylaws of both Agrace HospiceCare Holdings, Inc. and Agrace HospiceCare, Inc. were amended to reflect these organizational changes, which were implemented in accordance with the organizations' governance procedures. |
| Software ID: | 24020961 |
| Software Version: | 2024v5.1 |
| Return Reference | Explanation |
|---|---|
| Form 990, Part V, Line 2a REPORTING OF EMPLOYEES COMPENSATION | THE ORGANIZATION SHARES EMPLOYEES WITH AGRACE HOSPICECARE, INC. (AHI), A RELATED TAX-EXEMPT ORGANIZATION. NONE OF THE EMPLOYEES SPEND THE MAJORITY OF THEIR TIME WORKING FOR THE ORGANIZATION; THEREFORE, NO EMPLOYEES ARE REPORTED ON FORM 990, PART V, LINE 2A. THE ORGANIZATION DOES REIMBURSE AHI FOR THE TIME THE SHARED EMPLOYEES SPEND WORKING AT THE ORGANIZATION. THIS COMPENSATION EXPENSE IS REPORTED ON FORM 990, PART IX, LINE 11G. |
| Form 990, Part VI, Line 15a PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | THE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS OTHER OFFICERS AND KEY EMPLOYEES. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THEGANIZATION'S TOP MANAGEMENT OFFICIAL. EACH YEAR THE ORGANIZATION GATHERS MARKET DATA FOR DETERMINING COMPENSATION OF THE CHIEF EXECUTIVE OFFICER. THIS INCLUDES BENCHMARKS OF NATIONAL, REGIONAL, AND LOCAL COMPENSATION THAT ARE PROVIDED FROM INDEPENDENT COMPENSATION SURVEYS. THE VP, HUMAN RESOURCES PRESENTS THIS INFORMATION TO THE EXECUTIVE COMMITTEE OF THE BOARD, ALONG WITH PERTINENT 990 COMPENSATION REPORTING BY SIMILAR SIZED NON-PROFIT HOSPICES BASED ON THIS INFORMATION, THE EXECUTIVE COMMITTEE SETS AND APPROVES THE COMPENSATION PACKAGE FOR THE CHIEF EXECUTIVE OFFICER FOR THE YEAR AND CONTEMPORANEOUSLY DOCUMENTS THEIR APPROVAL IN WRITING. THIS PROCESS OCCURS ANNUALLY IN FEBRUARY. |
| Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMP OF OTHER OFFICERS AND KEY EMPLOYEES | THE ORGANIZATION RELIED ON AGRACE HOSPICECARE, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE THE COMPENSATION OF ITS OTHER OFFICERS. BELOW IS THE PROCESS USED BY AGRACE HOSPICECARE FOR DETERMINING COMPENSATION OF THEGANIZATION'S OTHER OFFICERS. Every other year the organization gathers market data for compensation of the executive leadership team. This data includes benchmarks of national, regional, and local compensation that are provided from independent compensation surveys. Executive leadership pay is adjusted based on: 1) years of experience; 2) performance; and 3) market data for the 65th percentile of total compensation for the position. The VP, Human Resources presents the market data information to the executive committee of the board. Based on this information, the executive committee of the board approves the compensation package for the executive leadership team and documents their approval in writing. This process occurs biennially in February. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | The Executive Committee is composed of 5 members of the board. The committee has the authority to review and establish the CEO contract, executive level compensation and supplemental retirement plans, assess board and officer composition, recruitment and performance, and update board policies and procedures. |
| Form 990, Part VI, Line 4 Significant changes to organizational documents | Agrace Health, Inc. became the sole member of Agrace Hospicecare Holdings, Inc. effective November 1, 2024. Prior to this, Agrace Hospicecare, Inc. was the sole member. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Agrace Health, Inc., a related 501(c)(3) organization, is the sole member of Agrace Holdings and has the authority to appoint, remove, and replace any director on Agrace Holdings board. Agrace Health, Inc. also has the sole authority to amend the Holdings' bylaws and articles of incorporation. Agrace Health, Inc. has no other responsibilities or voting rights with respect to the operations of Agrace Holdings. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Pursuant to the bylaws of the organization, Agrace Health, Inc., the sole member of the organization, has the authority to, at any time, appoint and re-appoint Directors of the Corporation, fill vacancies on the board of directors, and remove any director of the corporation, with or without cause. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The Controller and CFO performed a detailed review of Form 990 and the related schedules prior to filing the return. This included verification of all amounts for accuracy and completeness. The form and schedules were also reviewed for content, presentation and reasonableness. The entire Form 990 is made available to the entire executive leadership team and an entity specific highlights summary is provided. The entire Form 990 is provided to the entire Board of Directors prior to filing and is accompanied by a 990 highlight summary. The audit committee reviewed the Form 990 and related schedules for reasonableness. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Directors, officers, community committee members, and key employees (interested persons) are required to annually review the organization's Code of Conduct, including the conflict-of-interest policy/statement. Interested persons are required to disclose potential or actual conflicts with the organization in writing via the annual questionnaire distributed electronically to each interested person. When a disclosure arises, the person shall promptly make disclosure of the interest to the governing board or committee. After disclosure and discussion, the interested person shall leave the governing board or committee meeting while the determination of a conflict of interest is further discussed and voted upon by the remaining disinterested governing board or committee members. Once an actual conflict of interest exists with respect to a particular contract, transaction, or arrangement the disinterested members of the board exercise due diligence to determine whether said contract, transaction or arrangement is reasonable. The conflict-of-interest questionnaires are reviewed by the Controller and Governance Manager. The Controller and Governance Manager determine whether a potential conflict exists based on the completed questionnaires submitted by each interested person. The result of that determination is reviewed with the CFO and CEO and approved by the Agrace Board. |
| Form 990, Part VI, Line 19 Required documents available to the public | These documents may be made available to the public upon receipt of a written request. |
| Software ID: | 24020961 |
| Software Version: | 2024v5.1 |