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ObjectId: 201613199349305511 - Submission: 2016-11-14
TIN: 87-0511961
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Information about Schedule R (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
15
Open to Public Inspection
Name of the organization
ROCKY MOUNTAIN CARE - HOLLADAY INC
Employer identification number
87-0511961
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
HOLLADAY ROCKY MTN PROP LLC
5242 SO COLLEGE DRIVE SUITE 340
MURRAY
,
UT
84123
20-2856920
SUPPORT SERVICES
UT
ROCKY MOUNTAIN CARE HOLLADAY INC
(2)
RMC PROPERTY HOLDINGS LLC
5242 SO COLLEGE DRIVE SUITE 340
MURRAY
,
UT
84123
26-4314165
SUPPORT SERVICES
UT
900,000
13,144,929
ROCKY MOUNTAIN CARE HOLLADAY INC
(3)
RMC AUTOS LLC
5242 SO COLLEGE DRIVE SUITE 340
MURRAY
,
UT
84123
26-4769136
SUPPORT SERVICES
UT
142,800
588,696
ROCKY MOUNTAIN CARE HOLLADAY INC
(4)
ASPEN TECHNOLOGY GROUP LLC
5242 SO COLLEGE DRIVE SUITE 340
MURRAY
,
UT
84123
26-4768961
SUPPORT SERVICES
UT
1,094,402
1,094,887
ROCKY MOUNTAIN CARE HOLLADAY INC
(5)
Rocky Mountain Care - Murray
835 East Vine Street
Murray
,
UT
84107
27-1568057
Nursing Facility
UT
2,583,824
1,199,385
ROCKY MOUNTAIN CARE HOLLADAY INC
(6)
Cypress Healthcare LLC
5242 S COLLEGE DRIVE Suite 340
Murray
,
UT
84123
20-2060276
SUPPORT SERVICES
UT
382,428
1,118,881
ROCKY MOUNTAIN CARE HOLLADAY INC
(7)
Rocky Mountain Care - Riverton LLC
3419 West 12600 So
Riverton
,
UT
84093
27-1568138
Nursing Facility
UT
5,595,699
1,318,181
ROCKY MOUNTAIN CARE HOLLADAY INC
(8)
Yellowstone Care LLC
5242 S COLLEGE DR Suite 340
Murray
,
UT
84123
26-0502703
SUPPORT SERVICES
UT
515,000
5,936,288
ROCKY MOUNTAIN CARE HOLLADAY INC
(9)
RMC - CLEARFIELD OPERATING LLC
5242 SO COLLEGE DRIVE SUITE 340
MURRAY
,
UT
84123
46-4743398
Manage Nursing Facility
UT
840,358
Rocky Mountain Care - Holladay Inc
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
BCVV Inc
5242 SOUTH COLLEGE DRIVE 340
Murray
,
UT
84123
87-0468703
Provides heatlh care for the elderly
UT
501(c)(3)
9
NA
No
(2)
BCCU Inc
5242 SOUTH COLLEGE DRIVE 340
Murray
,
UT
84123
74-2715684
Provides Health care for the Elderly
UT
501(c)(3)
9
NA
No
(3)
Vali Division of Wasatch
5242 SOUTH COLLEGE DRIVE 340
MURRAY
,
UT
84123
95-3723933
PROVIDES HEALTH CARE FOR THE ELDERLY
UT
501(c)(3)
9
NA
No
(4)
BCBU INC
5242 SOUTH COLLEGE DRIVE 340
MURRAY
,
UT
84123
87-0468543
PROVIDES HEALTH CARE FOR THE ELDERLY
UT
501(C)(3)
9
NA
No
(5)
ROCKY MOUNTAIN CARE-TOOELE
5242 SOUTH COLLEGE DRIVE 340
MURRAY
,
UT
84123
31-1757966
PROVIDES HEALTH CARE FOR THE ELDERLY
UT
501(C)(3)
9
NA
No
(6)
ROCKY MOUNTAIN CARE - EVANSTON
5242 SOUTH COLLEGE DRIVE 340
MURRAY
,
UT
84123
83-0301302
PROVIDES HEALTH CARE FOR THE ELDERLY
UT
501(C)(3)
9
NA
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Page 2
Schedule R (Form 990) 2015
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
Schedule R (Form 990) 2015
Page 3
Schedule R (Form 990) 2015
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
No
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
No
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
No
q
Reimbursement paid by related organization(s) for expenses
............................
1q
No
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
BCVV Inc
j
113,483
FMV
(2)
BCCU Inc
j
199,728
FMV
(3)
Vali Division of Wasatch
j
169,661
FMV
(4)
BCBU INC
j
148,739
FMV
(5)
ROCKY MOUNTAIN CARE-TOOELE
j
73,291
FMV
(6)
ROCKY MOUNTAIN CARE - EVANSTON
j
61,520
FMV
Schedule R (Form 990) 2015
Page 4
Schedule R (Form 990) 2015
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2015
Page 5
Schedule R (Form 990) 2015
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2015
Additional Data
Software ID:
15000324
Software Version:
2015v2.0