efile Public Visual Render
ObjectId: 202321229349301432 - Submission: 2023-05-02
TIN: 25-1468529
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.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
21
Open to Public Inspection
Name of the organization
HOSPICE SERVICES INC
Employer identification number
25-1468529
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
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)
LUTHERAN SENIORLIFE
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-1527666
TO PROVIDE SUPPORT AND MANAGEMENT TO EXEMPT AFFILIATES
PA
501(C)(3)
LINE 12A, I
N/A
No
(2)
ST JOHN LUTHERAN CARE CENTER
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-0969478
SKILLED NURSING AND PERSONAL CARE FACILITY SERVICING MORE THAN 300 RESIDENTS
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(3)
LUTHER COURT INC
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-1527660
TO PROVIDE LOW INCOME HOUSING FOR THE ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(4)
PASSAVANT RETIREMENT AND HEALTH CENTER
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-0986051
PROVIDER OF RESIDENTIAL, PERSONAL CARE AND SKILLED NURSING CARE TO ELDERS
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(5)
LAS GERIATRIC CARE SERVICES INC
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-1738347
PROVIDER OF MEDICAL GERIATRIC THERAPY SERVICES TO ITS EXEMPT AFFILIATES
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(6)
LUTHERAN SENIORLIFE FOUNDATION
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-1705233
ORGANIZATION THAT PROMOTOES THE CHARITABLE INTERESTS OF ITS EXEMPT AFFILIATE
PA
501(C)(3)
LINE 7
LUTHERAN SENIORLIFE
No
(7)
SAMARITAN HEALTHCARE INC
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-1527663
TO PROVIDE HEALTH CARE SERVICES TO THE ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(8)
VIECARE INC
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-5900922
PROVIDER OF HOME AND COMMUNITY BASED HEALTHCARE TO LOW INCOME ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(9)
VIECARE BEAVER LLC
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
26-0363509
PROVIDER OF HOME AND COMMUNITY BASED HEALTHCARE TO LOW INCOME ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(10)
VIECARE BUTLER LLC
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
20-8512169
PROVIDER OF HOME AND COMMUNITY BASED HEALTHCARE TO LOW INCOME ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(11)
MARS HOLDING INC
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-1883384
PROVIDER OF DEMENTIA ASSISTED LIVING AND RESIDENTIAL
PA
501(C)(3)
LINE 12A, I
LUTHERAN SENIORLIFE
No
(12)
BEHOME PARTNERS
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
20-2932676
PROVIDER OF HOME HEALTH SERVICES IN SKILLED NURSING, THERAPY & PRIVATE DUTY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(13)
VISITING NURSES ASSOCIATION OF BUTLER COUNTY INC
154 HINDMAN ROAD
BUTLER
,
PA
16001
23-7040715
TO OPTIMIZE HEALTH AND INDEPENDENCE AND TO KEEP RESIDENTS OF OUR COMMUNITY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(14)
VALLEY CARE ASSOCIATION
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-1349943
TO PROVIDE DAY CARE SERVICES FOR OLDER AULTS TO ENHANCE QUALITY OF LIFE
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(15)
THE LUTHERAN SERVICE SOCIETY OF W PA
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
25-0965419
PROVIDE PROGRAMS AND SERVICES FOR PEOPLE TO LEAD INDEPENDENT DIGNIFIED LIVES
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(16)
VIECARE ARMSTRONG LLC
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
46-3692084
PROVIDER OF HOME AND COMMUNITY BASED HEALTHCARE TO LOW INCOME ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(17)
CHIPPEWA LUTHERAN HOUSING CORP
440 LINCOLN AVENUE
PITTSBURGH
,
PA
15202
20-8314767
TO PROVIDE LOW INCOME HOUSING FOR THE ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(18)
GIRARD LUTHERAN HOUSING CORPORATION
440 LINCOLN AVENUE
PITTSBURGH
,
PA
15202
03-0596955
TO PROVIDE LOW INCOME HOUSING FOR THE ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(19)
JAMESTOWN LUTHERAN HOUSING CORPORATION
440 LINCOLN AVENUE
PITTSBURGH
,
PA
15202
20-8315015
TO PROVIDE LOW INCOME HOUSING FOR THE ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(20)
LUTHERAN HOUSING CORP OF OIL CITY
440 LINCOLN AVENUE
PITTSBURGH
,
PA
15202
25-1699268
TO PROVIDE LOW INCOME HOUSING FOR THE ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
(21)
TITUSVILLE SENIOR HOUSING CORPORATION
440 LINCOLN AVENUE
PITTSBURGH
,
PA
15202
27-0115829
TO PROVIDE LOW INCOME HOUSING FOR THE ELDERLY
PA
501(C)(3)
LINE 10
LUTHERAN SENIORLIFE
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Page 2
Schedule R (Form 990) 2021
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
(1)
TIMON PROPERTY DEVELOPMENT COMPANY
1323 FREEDOM ROAD
CRANBERRY TOWNSHIP
,
PA
16066
20-5133658
PROVIDER OF SENIOR HOUSING
PA
N/A
C
No
Schedule R (Form 990) 2021
Page 3
Schedule R (Form 990) 2021
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
Yes
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
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
No
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
Schedule R (Form 990) 2021
Page 4
Schedule R (Form 990) 2021
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) 2021
Page 5
Schedule R (Form 990) 2021
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) 2021
Additional Data
Software ID:
Software Version: