Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
WHEEL CHAIR HOME INC
Employer identification number
16-0743225
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
36,096
39,345
25,293
5,096
4,011
109,841
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
12,833,948
13,514,345
16,442,927
16,759,760
17,264,189
76,815,169
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
12,870,044
13,553,690
16,468,220
16,764,856
17,268,200
76,925,010
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
76,925,010
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
12,870,044
13,553,690
16,468,220
16,764,856
17,268,200
76,925,010
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
275,443
329,711
107,438
213,057
225,893
1,151,542
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
275,443
329,711
107,438
213,057
225,893
1,151,542
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
207,854
224,777
243,687
205,674
41,887
923,879
13
Total support (Add lines 9, 10c, 11 and 12.).
13,353,341
14,108,178
16,819,345
17,183,587
17,535,980
79,000,431
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
97.373 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
96.922 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
1.458 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
1.569 %
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Other Income Part III, Line 12 Description: Line 12 col (a) Description: Line 12 col (b) Description: Line 12 col (c) Description: Line 12 col (d) Description: Line 12 col (e) 2006: 207854 2007: 224777 2008: 243687 2009:205674 2010: 41887
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000077
Software Version:
v1.00
-
TIN:
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 to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
WHEEL CHAIR HOME INC
Employer identification number
16-0743225
Identifier
Return Reference
Explanation
F990_P01_S00_L01
Form 990, Part I, Line 1
As part of our services to the community Schofield provides: -Community health and wellness education programs through our Adult Wellness Clinic. -Blood pressure screenings at Senior Citizen Apartment buildings by our community health nurses. -Information tables and blood pressure screenings at community health fairs. -Hosting "Powerful Tools for Caregivers" classes yearly to assist family caregivers to learn selfcare skills. These classes are taught by Schofield's Director of Community Relations. -Health education and informational programs on long term care services to community organizations. -Internships, clinical skills development and service learning sites for college and high school students.
F990_P06_S0B_L11a
Form 990, Part VI, Section B, Line 11a
The process used by the Wheel Chair Home Inc dba Schofield Residence to review form 990 is as follows: -The form 990 is prepared by the Finance Department. -The form 990 draft is then reviewed by the organization's indpendent auditors who the propose changes. -The final form 990 is then reviewed by the Finance Committee of the Board of Directors. -A copy of the form 990 is provided to all Board Members prior to the filing.
F990_P06_S0B_L12c
Form 990, Part VI, Section B, Line 12c
The Wheel Chair home Inc dba Schofield Residence regularly and consistently monitors and enforces compliance of its written conflict of interest policy through Corpoate Compliance policies and procedures. All employees, agents, and members of the Board of Directors are required to abide by the organization's conflict of interest party. The Corporate Compliance Manual identifies specific situations, as examples, to assist in identifying situations that would represent conflicts of interest. All employees are required to report any potential conflicts of intrerst concerns to management. All potential conflicts of interest situtations are then brought to the attention of the Corporate Compliance committee, which reviews the specifics of each situation, and determines if any risks exist and what actions would be appopriate. The Board if Directors on an annual basis, must sign a statement which affirms that they have reviewed and understand the By-Laws article regarding conflict of interest and agree to comply with the policy. All potential and actual conflict of interest situations that involve a Board Member are brought to the attention of the Board of Directors at a governing board meeting. After presentation of the information, the director involved will leave the meeting and the Board of Directors will then discuss and vote on the risks involved and what actions would be appropriate.
F990_P06_S0B_L15
Form 990, Part VI, Section B, Line 15
The process for determining compensation of the President consists of the Board of Directos delegating to the Personnel/Pension Committee the responsibility to review the compensation package for the President, using comparability data in establishing appropriate compensation. The Personnel/Pension committee provides a report to the Board of Directors. The compensation of other officers and key employeed of the organization are established by the President.
F990_P06_S0C_L19
Form 990, Part VI, Section C, Line 19
The governing document of the Wheel Chair Home Inc dba Schofield Residence which is made available to the public is the organization's original and amended Certificate of Incorporation of the Corporation which is filed withe the New York State Secretary of State. The financial statements are also available to the public via the IRS, form 990, and copies are available through the Administration department upon request.
F990_P11_S00_L05
Form 990, Part XI, Line 5
Other changes in net asssets or fund balances includes the unrealized gains related to non-operating income investments and temporarily restricted investments, as reported in the audited financial statements of Wheel Chair Home Inc dba Schofield Residence.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.