TY 2020 Form 990 Schedule O

efile Public Visual Render ObjectId: 202143149349302209 - Submission: 2021-11-10 TIN: 16-1489340

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.
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Attach to Form 990 or 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

CHAPEL OAKS INC

Employer identification number

16-1489340

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	THE INFORMATION FOR THE REPORT IS PREPARED BY ST. ANN'S STAFF, PROVIDED AND REVIEWED BY BONADIO & CO., LLP. FINAL REPORTS ARE REVIEWED BY THE ST. ANN'S ACCOUNTING TEAM, INCLUDING THE DIRECTOR OF FINANCE AND CFO, AND PROVIDED TO THE CEO AND BOARD MEMBERS PRIOR TO REVIEW AT THE BOARD MEETING. COPIES OF THE REPORTS ARE DISTRIBUTED AT A SUBSEQUENT BOARD MEETING AT WHICH TIME THE REPORTS ARE APPROVED.
FORM 990, PART VI, SECTION B, LINE 12C	ALL BOARD MEMBERS (INCLUDING THE PRESIDENT AND CEO) ARE REQUIRED TO ANNUALLY COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE FORMS ARE THEN REVIEWED BY THE VP OF ORGANIZATIONAL DEVELOPMENT AND ANY POTENTIAL CONFLICTS ARE DEALT WITH AS NEEDED INCLUDING ABSTAINING FROM VOTING ON MATTERS RELATED TO SUCH CONFLICTS. ANY PERSON COVERED BY THE POLICY SHALL NOT KNOWINGLY USE HIS OR HER POSITION FOR PERSONAL GAIN, TO COMPROMISE ST. ANN'S INTERESTS, OR TO ALLOW A CONFLICT TO ARISE BETWEEN ST. ANN'S INTEREST AND HIS OR HER PERSONAL INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	EACH YEAR AN INDEPENDENT WAGE STUDY IS CONDUCTED BY A CONSULTANT. DIRECTORS AND ABOVE, EXCEPT CEO, ARE REVIEWED BY VP OF HR AND CEO WITH ADJUSTMENTS MADE AS NEEDED TO MAINTAIN COMPETITIVENESS. CEO DATA IS REVIEWED BY A COMMITTEE INCLUDING THE BOARD CHAIR, PAST BOARD CHAIR, AND HR COMMITTEE CHAIR. ADJUSTMENTS MADE AS NEEDED TO MAINTAIN MARKET COMPETITIVENESS.
FORM 990, PART VI, SECTION C, LINE 19	FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILBALE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 4,900. PENSION LIABILITY ADJUSTMENT -148,826.
FORM 990, PART XII, LINE 2C:	NO CHANGE FROM PRIOR YEAR.
FORM 990, PART V, LINE 2A:	ALL INDIVIDUALS WORKING AT CHAPEL OAKS, INC. ("CO") ARE EMPLOYEES OF ST. ANN'S HOME FOR THE AGED ("SAH") AND ARE REPORTED ON ITS FORM 941 UNDER EIN 16-0743146. THE SALARY AND BENEFIT EXPENSES REPORTED ON FORM 990, PART IX ARE CO'S ALLOCATED PAYROLL COSTS BASED ON TIME SPENT BY THE SHARED EMPLOYEES. SAH IS AN AFFILIATED TAX-EXEMPT ORGANIZATION.

Return Reference

Explanation

FORM 990, PART VI, SECTION B, LINE 11B

THE INFORMATION FOR THE REPORT IS PREPARED BY ST. ANN'S STAFF, PROVIDED AND REVIEWED BY BONADIO & CO., LLP. FINAL REPORTS ARE REVIEWED BY THE ST. ANN'S ACCOUNTING TEAM, INCLUDING THE DIRECTOR OF FINANCE AND CFO, AND PROVIDED TO THE CEO AND BOARD MEMBERS PRIOR TO REVIEW AT THE BOARD MEETING. COPIES OF THE REPORTS ARE DISTRIBUTED AT A SUBSEQUENT BOARD MEETING AT WHICH TIME THE REPORTS ARE APPROVED.

FORM 990, PART VI, SECTION B, LINE 12C

ALL BOARD MEMBERS (INCLUDING THE PRESIDENT AND CEO) ARE REQUIRED TO ANNUALLY COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE FORMS ARE THEN REVIEWED BY THE VP OF ORGANIZATIONAL DEVELOPMENT AND ANY POTENTIAL CONFLICTS ARE DEALT WITH AS NEEDED INCLUDING ABSTAINING FROM VOTING ON MATTERS RELATED TO SUCH CONFLICTS. ANY PERSON COVERED BY THE POLICY SHALL NOT KNOWINGLY USE HIS OR HER POSITION FOR PERSONAL GAIN, TO COMPROMISE ST. ANN'S INTERESTS, OR TO ALLOW A CONFLICT TO ARISE BETWEEN ST. ANN'S INTEREST AND HIS OR HER PERSONAL INTEREST.

FORM 990, PART VI, SECTION B, LINE 15

EACH YEAR AN INDEPENDENT WAGE STUDY IS CONDUCTED BY A CONSULTANT. DIRECTORS AND ABOVE, EXCEPT CEO, ARE REVIEWED BY VP OF HR AND CEO WITH ADJUSTMENTS MADE AS NEEDED TO MAINTAIN COMPETITIVENESS. CEO DATA IS REVIEWED BY A COMMITTEE INCLUDING THE BOARD CHAIR, PAST BOARD CHAIR, AND HR COMMITTEE CHAIR. ADJUSTMENTS MADE AS NEEDED TO MAINTAIN MARKET COMPETITIVENESS.

FORM 990, PART VI, SECTION C, LINE 19

FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILBALE TO THE PUBLIC UPON REQUEST.

FORM 990, PART XI, LINE 9:

CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 4,900. PENSION LIABILITY ADJUSTMENT -148,826.

FORM 990, PART XII, LINE 2C:

NO CHANGE FROM PRIOR YEAR.

FORM 990, PART V, LINE 2A:

ALL INDIVIDUALS WORKING AT CHAPEL OAKS, INC. ("CO") ARE EMPLOYEES OF ST. ANN'S HOME FOR THE AGED ("SAH") AND ARE REPORTED ON ITS FORM 941 UNDER EIN 16-0743146. THE SALARY AND BENEFIT EXPENSES REPORTED ON FORM 990, PART IX ARE CO'S ALLOCATED PAYROLL COSTS BASED ON TIME SPENT BY THE SHARED EMPLOYEES. SAH IS AN AFFILIATED TAX-EXEMPT ORGANIZATION.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

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