SCHEDULE O
(Form 990)

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.
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OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
NATIONAL CHURCH RESIDENCES AT HOME HOSPICE
 
Employer identification number

20-3070796
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6: THE SOLE MEMBER OF THE CORPORATION SHALL, AT ALL TIMES, BE NATIONAL CHURCH RESIDENCES.
FORM 990, PART VI, SECTION A, LINE 7A: MEMBERS OR TRUSTEES SHALL HAVE THE APPROVAL OF THE BOARD OF TRUSTEES OF NATIONAL CHURCH RESIDENCES.
FORM 990, PART VI, SECTION A, LINE 7B: NATIONAL CHURCH RESIDENCES IS REQUIRED TO APPROVE THE SELECTION OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11B: THE 990 RETURN IS MADE AVAILABLE TO THE BOARD PRIOR TO FILING. AN OFFICER REVIEWS THE 990 RETURN PRIOR TO SIGNATURE.
FORM 990, PART VI, SECTION B, LINE 12C: TWO CONFLICT OF INTEREST POLICIES EXIST FOR NATIONAL CHURCH RESIDENCES. ONE POLICY IS A GENERAL STAFF POLICY, PUBLISHED IN THE EMPLOYEE INFORMATION GUIDE AND IS AVAILABLE TO THE STAFF THROUGH THE INTRANET. THE SECOND POLICY APPLIES TO NATIONAL CHURCH RESIDENCES AND ITS AFFILIATES' OFFICERS, DIRECTORS, AND MEMBERS OF COMMITTEES COMPOSED PRIMARILY OF DIRECTORS AND OFFICERS. THE POLICY FOR OFFICERS AND DIRECTORS IS REVIEWED REGULARLY BY THE BOARD, AND OFFICERS AND DIRECTORS REVIEW AND SIGN AN ATTESTATION RELATED TO THE POLICY ANNUALLY AND ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS. THE POLICY CONTAINS A PROCESS FOR REPORTING CONFLICTS, DETERMINING WHETHER A CONFLICT EXISTS, AND APPROPRIATE PROCEDURES FOR ADDRESSING CONFLICTS.
FROM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST.
FORM 990, PART XI, LINE 9: TRANSFER TO NATIONAL CHURCH RESIDENCES $1,400,000
FORM 990, PART XII, LINE 2C: NATIONAL CHURCH RESIDENCES, THE PARENT ORGANIZATION, HAS AN AUDIT COMMITTEE WHICH OVERSEES THE REVIEW OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE REVIEW. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, SCHEDULE R, PART II: THE ORGANIZATION REPORTS RELATED TAX EXEMPT ORGANIZATIONS ON SCHEDULE R PART II THAT ARE NOT INCLUDED WITHIN THE NATIONAL CHURCH RESIDENCES GROUP EXEMPTION #5048. ALL OTHER RELATED TAX EXEMPT ORGANIZATIONS ARE ALL MEMBERS OF GROUP EXEMPTION # 5048 AND ARE NOT REPORTED ON SCHEDULE R PART II.
FORM 990, PAGE 1, ITEM C: THE ORGANIZATION CONDUCTS BUSINESS UNDER THE NAME: NATIONAL CHURCH RESIDENCES HOME AND COMMUNITY SERVICES SOUTHERN OHIO HOSPICE.
FORM 990, PART VI, SECTION B, LINE 15B: FOLLOWING AN ESTABLISHED EXECUTIVE COMPENSATION POLICY, THE HUMAN RESOURCE COMMITTEE REVIEWS AND APPROVES SALARIES OF ALL OFFICERS AND REPORTS TO THE EXECUTIVE COMMITTEE ON THEIR ACTION. THE COMMITTEES BASE THE SALARY DECISIONS ON SURVEY DATA FROM COMPARABLE ORGANIZATIONS, USE OF AN INDEPENDENT COMPENSATION CONSULTANT AND ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE. THIS PROCESS WAS LAST COMPLETED IN MAY 2021.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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