SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
THE PRESBYTERIAN HOME AT 58TH
STREET INC
Employer identification number

23-1352513
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 3 PHILADELPHIA PRESBYTERY HOMES, INC., A RELATED PARTY, PROVIDES MANAGEMENT AND OTHER SUPPORTIVE SERVICES TO THE ORGANIZATION UNDER A MANAGEMENT AGREEMENT.
FORM 990, PART VI, SECTION A, LINE 7A PARENT ENTITY PHILADELPHIA PRESBYTERY HOMES AND SERVICES FOR THE AGING (EIN 23-2828862) HAS THE RIGHT TO ELECT THE FILING ORGANIZATION'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B PARENT ENTITY PHILADELPHIA PRESBYTERY HOMES AND SERVICES FOR THE AGING (EIN 23-2828862) MUST APPROVE ACTIVITIES OF THE FILING ORGANIZATION SUCH AS THE FOLLOWING: -APPROVAL OF THE ANNUAL BUDGETS, OR DEVIATIONS, FROM -INCURRENCE OF DEBT NOT INCLUDED IN AN APPROVED BUDGET -PURCHASE, SALE, ENCUMBRANCE, OR LEASE BY OR TO THE CORPORATION -FORM OF CONTRACTS WITH RESIDENTS AND OTHER USERS OF THE CORPORATION'S SERVICES -APPOINTMENT OF AUDIT COMMITTEE OR STANDING COMMITTEE MEMBERS
FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT PERFORMS AN INTERNAL REVIEW OF THE RETURN. ONCE ALL MANAGEMENT COMMENTS HAVE BEEN CLEARED, THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE FORM 990. THE FORM 990 IS THEN SENT TO ALL BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FINALIZING AND FILING THE TAX RETURN.
FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST VIA COMPLETION OF A CONFLICTS FORM. THOSE INDIVIDUALS ARE REQUIRED TO DISCLOSE ANY AND ALL ONGOING ISSUES THAT ARISE DURING THE COURSE OF THE YEAR. SIGNED CONFLICT OF INTEREST STATEMENTS ARE GIVEN TO THE BOARD AND REVIEWED AND MAINTAINED BY THE ORGANIZATION'S COMPLIANCE OFFICER (THE VP OF HUMAN RELATIONS). ANY INDIVIDUAL WITH A CONFLICT OF INTEREST MUST ABSTAIN FROM VOTING ON THE MATTER. THE CONFLICT OF INTEREST POLICY INCLUDES LANGUAGE ON FAMILY AND BUSINESS RELATIONSHIPS THAT INDICATE THESE RELATIONSHIPS MAY BE THE SOURCE OF CONFLICTS AND SHOULD BE REPORTED.
FORM 990, PART VI, SECTION B, LINE 15 PHILADELPHIA PRESBYTERY HOMES AND SERVICES FOR THE AGING (THE PARENT ENTITY) HAS AN EXECUTIVE COMPENSATION PROGRAM DEVELOPED BY MEMBERS OF THE EXECUTIVE COMPENSATION COMMITTEE WHICH IS COMPRISED OF BOARD MEMBERS. THE COMMITTEE CONTRACTS WITH A THIRD PARTY CONSULTANT FOR EXECUTIVE COMPENSATION ADVISORY SERVICES AS NEEDED. ANNUAL MARKET STUDIES ARE USED TO ENSURE THAT SALARIES OF KEY EMPLOYEES ARE COMMENSURATE WITH SIMILARLY SIZED SENIOR LIVING ORGANIZATIONS. THE COMPENSATION PROGRAM HAS BEEN DEVELOPED TO COMPLY WITH ALL REGULATORY AND STATUTORY REQUIREMENTS AFFECTING EXECUTIVE COMPENSATION IN A NOT-FOR-PROFIT CONTEXT. ALL COMPENSATION RECOMMENDATIONS AND PROGRAM DESIGN ELEMENTS FOR THE EXECUTIVES AND KEY EMPLOYEES ARE REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE TO ENSURE FULL COMPLIANCE WITH REQUIREMENTS. LEGAL COUNSEL WAS RETAINED IN 2016 TO REVIEW EXECUTIVE COMPENSATION ARRANGEMENTS AND PROVIDE AN OPINION AND REASONABLENESS LETTER. THIS REVIEW WILL BE DONE EVERY 3 TO 5 YEARS. THE EXECUTIVE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT PERSONS, AND DECISIONS OF THE COMMITTEE ARE DOCUMENTED IN COMMITTEE MINUTES, WHICH ARE INCLUDED WITH BOARD MATERIALS.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL EXPENSE: PROGRAM SERVICE EXPENSES 40,394. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,394.
FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 6,473. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 60,919. TRANSFER TO AFFILIATES -92,817.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


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