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
INVERNESS VILLAGE AN OKLAHOMA NOT-FOR-P
Employer identification number
73-1539802
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.") .
97,505
338,934
20,000
187,731
644,170
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......
13,457,820
15,869,248
17,031,767
17,507,972
17,344,163
81,210,970
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.
13,555,325
16,208,182
17,051,767
17,695,703
17,344,163
81,855,140
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
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.
0
c
Add lines 7a and 7b..
0
8
Public Support (Subtract line 7c from line 6.)
81,855,140
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...
13,555,325
16,208,182
17,051,767
17,695,703
17,344,163
81,855,140
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
647,667
505,807
38,559
27,978
26,509
1,246,520
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
647,667
505,807
38,559
27,978
26,509
1,246,520
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.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14,202,992
16,713,989
17,090,326
17,723,681
17,370,672
83,101,660
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
98.500 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
97.680 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
1.500 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
2.320 %
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
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
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
INVERNESS VILLAGE AN OKLAHOMA NOT-FOR-P
Employer identification number
73-1539802
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 1
EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS CAN ACT IN PLACE OF THE BOARD BETWEEN MEETINGS. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 1
WE HAVE REPORTED 9 INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY. THE NON-INDEPENDENT BOARD MEMBERS CONSIST OF ONE EMPLOYEE OF INVERNESS AND TWO RESIDENTS OF INVERNESS.
FORM 990, PART VI, SECTION A, LINE 6
INVERNESS VILLAGE HAS ONE MEMBER, THE SOLE MEMBER IS ASBURY COMMUNITIES, INC.
FORM 990, PART VI, SECTION A, LINE 7A
ASBURY COMMUNITIES, INC. IS THE SOLE MEMBER OF INVERNESS VILLAGE AND ELECTS THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B
ONLY CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO ASBURY COMMUNITIES INC.'S APPROVAL. THESE DECISIONS INCLUDE (1) MANAGEMENT SERVICES RELATIONSHIPS AND CONTRACTS; (2) ANY ORGANIZATIONAL CHANGE IN GENERAL, INCLUDING MERGERS, SALES, LEASES, ETC, OF SUBSTANTIALLY ALL OF THE ASSETS AND THE CREATION OF NEW ENTITIES; (3) AMENDEMENTS TO MISSION OR VISION STATEMENTS; (4) AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11
ASBURY COMMUNITIES IS THE SOLE MEMBER OF ASBURY ATLANTIC, ASBURY SOLOMONS, AND INVERNESS VILLAGE, AN OKLAHOMA NOT FOR PROFIT CORPORATION. ASBURY COMMUNITIES HAS A SYSTEM WIDE AUDIT COMMITTEE. THE INVERNESS VILLAGE BOARD OF DIRECTORS HAS DELEGATED A REVIEW OF THE FORM 990 TO THE SYSTEM AUDIT COMMITTEE. A COPY OF THE FORM 990 WILL BE MAILED TO COMMITTEE MEMBERS BEFORE THE MEETING. IN ADDITION, THE FORM HAS BEEN POSTED ON THE INVERNESS VILLAGE BOARD OF DIRECTORS' INTRANET SITE, AND IS AVAILABLE FOR REVIEW BY ALL DIRECTORS. ALL DIRECTORS MAY POSE QUESTIONS OR ASK FOR CLARIFICATION FROM THE STAFF AUDIT COMMITTEE. ANY BOARD MEMEBER INTERESTED IN ATTENDING THE AUDIT COMMITTEE MEETING VIA TELECONFERENCE IS INVITED TO DO SO AND WILL BE PROVIDED A DIAL-IN NUMBER.
FORM 990, PART VI, SECTION B, LINE 12C
THE ASBURY COMMUNITIES CONFLICT OF INTEREST POLICY WAS APPROVED BY THE BOARD OF DIRECTORS. THE COMPLIANCE OFFICER IS GENERALLY RESPONSIBLE FOR THE POLICY PROCESS. ALL THE ENTITIES WITHIN THE ASBURY COMMUNITIES GROUP ARE SUBJECT TO THE POLICY. ANNUALLY, THE COMPLIANCE OFFICER CONDUCTS A COMPREHENSIVE CONFLICT DISCLOSURE PROCESS COVERING ALL MEMBERS OF THE GOVERNING BOARDS, SYSTEM WIDE COMMITTEES, AND INDIVIDUALS IN MANAGEMENT POSITIONS. ANNUALLY, EACH MEMBER OF THE GOVERNING BODY COMPLETES A DETAILED QUESTIONNAIRE DESIGNED TO IDENTIFY ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. A FULL REPORT OF RESPONSES TO THIS QUESTIONNAIRE IS REVIEWED BY THE COMPLIANCE OFFICER AND PROVIDED TO THE AUDIT COMMITTEE. IN CASE THE CONFLICT OF INTEREST ARISE, THE MEMBER OF THE GOVERNING BODY WILL BE ASKED TO RESIGN FROM THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15
THE SYSTEM WIDE COMPENSATION COMMITTEE MEETS WITH THE INDEPENDENT COMPENSATION CONSULTANT, AND BASED ON INFORMATION PROVIDED TO THE COMMITTEE MAKES RECOMMENDATIONS REGARDING COMPENSATION AND BENEFITS TO THE EXECUTIVE COMMITTEE WHICH IS CHARGED WITH MAKING DECISIONS REGARDING COMPENSATION. THE FULL BOARD OF ASBURY COMMUNITIES, THE SOLE MEMBER OF INVERNESS, HAS A PRESENTATION ONCE EACH YEAR ON EXECUTIVE COMPENSATION AND BENEFITS. THE CHIEF PEOPLE OFFICER IS PRESENT TO GIVE BOARD MEMBERS AN OPPURTUNITY TO ASK QUESTIONS AND TO PROVIDE SALARIES AND GRADE LEVELS FOR THEIR REVIEW. THE SYSTEM WIDE COMPENSATION COMMITTEE IS COMPOSED OF 5 VOTING MEMBERS, THE CHIEF PEOPLE OFFICER (NON-VOTING), A RETAINED ATTORNEY (NON-VOTING; RECORDS PROCEEDINGS IN MINUTES), AND IS ADVISED BY TOWER WATSON (A COMPENSATION CONSULTING FIRM). THE SYSTEM WIDE COMPENSATION COMMITTEE HOLDS 4 MEETINGS EACH YEAR (JAN, MARCH, JULY, AND NOV). IN THE NOVEMBER MEETING THEY REVIEW TOWER WATSON DATA AND REPORTS IN ORDER TO MAKE RECOMMENDATIONS REGARDING SALARIES AND BENEFITS. THE EXECUTIVE COMMITTEE OF ASBURY COMMUNITIES ULTIMATELY REVIEWS/APPROVES/AND OR ADJUSTS RECOMMENDATIONS FROM THE SYSTEM WIDE COMPENSATION COMMITTEE AND SETS COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19
THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS ARE AVAILABLE IN THE RESIDENT LIBRARIES. THE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC VIEWING ON OUR WEBSITE.
FORM 990, PART VII, SECTION A
THE OFFICERS THAT HAVE COMPENSATION FROM RELATED ORGANIZATIONS REPORTED IN PART VII, SECTION A, COLUMN E OF THE FORM 990 PROVIDE EXECUTIVE MANAGEMENT SUPPORT AND OVERALL GUIDANCE TO INVERNESS VILLAGE, AN OKLAHOMA NOT-FOR-PROFIT CORPORATION AS WELL AS THE OTHER RELATED ORGANIZATIONS OF ASBURY COMMUNITIES, INC. THERE ARE OVER 1,900 TOTAL EMPLOYEES IN THE ASBURY COMMUNITIES, INC. SYSTEM. THE 2010 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR ASBURY COMMUNITIES, INC. HAD TOTAL REVENUES OF $162.1 MILLION AND TOTAL ASSETS IN EXCESS OF $540 MILLION.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
TRANSFER OF CAPITAL TO ACOMM 750,000. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 10,885. UNREALIZED GAIN ON CHANGE IN MARKET VALUE OF THE SWAP 750,639. TRANSFERS FROM ASBURY FOUNDATION 50,604. TOTAL TO FORM 990, PART XI, LINE 5: 1,562,128.
FORM 990, PART XII, LINE 2C
THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
COMMUNITY BENEFITS
FORM 990, PART III, LINE 4
INVERNESS VILLAGE CONTRIBUTES TIME, SPACE AND MANPOWER BACK TO THE GREATER COMMUNITY IN WHICH ITS CONTINUING CARE RETIREMENT COMMUNITY IS LOCATED. INVERNESS DIVIDES ITS COMMUNITY BENEFIT ACTIVITIES INTO FIVE CATEGORIES: BENEVOLENT CARE, TRAINING THE NEXT GENERATION OF LEADERS FOR SENIOR CARE, SUPPORTING OTHER LOCAL SENIOR SERVICES, GOING GREEN AND SUSTAINABLE, AND OTHER. INVERNESS VILLAGE PROVIDES CHARITY CARE TO THOSE RESIDENTS WHOSE NEEDS EXCEED THEIR FUNDS, AND NO RESIDENT HAS EVER BEEN ASKED TO LEAVE INVERNESS BECAUSE OF A LACK OF FUNDS THROUGH NO FAULT OF THEIR OWN. HIGHLIGHTS OF THIS YEAR'S COMMUNITY BENEFIT ACCOMPLISHMENTS INCLUDE THE FOLLOWING: IN THE AREA OF TRAINING THE NEXT GENERATION OF SENIOR CARE LEADERS, INVERNESS VILLAGE STAFF COORDINATED OBSERVATIONS OF WELLNESS CLASSES FOR SEVERAL EMPLOYEES FROM CHEROKEE ELDER CARE AND PROVIDED ANALYSIS OF HOW TO MAKE THAT ORGANIZATION'S WELLNESS PROGRAMS MORE SUCCESSFUL. THREE STUDENTS FROM THE FIRST PRESBYTERIAN CHURCH OF TULSA HIGH SCHOOL CONSIDERING THE MINISTRY AS A CAREER WERE SUPERVISED WHILE PROVIDING SERVICES IN INVERNESS'S ASSISTED LIVING AND SKILLED NURSING CENTERS. TWO HIGH SCHOOL STUDENTS CONSIDERING THE FIELD OF NURSING ALSO VISITED INVERNESS, SPENDING TIME WITH A CHARGE NURSE, DIRECTOR OF NURSING, THE ADMISSIONS COORDINATOR AND HEALTH CARE CENTER ADMINISTRATOR. FOR TWO WEEKS IN JULY, INTERNS IN THE GEORGE WASHINGTON UNIVERSITY AND GEORGETOWN UNIVERSITY'S MASTER'S IN HEALTH ADMINISTRATION PROGRAMS WERE SUPERVISED BY INVERNESS STAFF WHILE THEY COMPLETED INDIVIDUALIZED PROJECTS IN VARIOUS AREAS OF THE COMMUNITY. IN ADDITION, THE CAMPUS'S SKILLED NURSING FACILITY SERVED AS A CLINICAL ROTATION TRAINING SITE FOR FIVE STUDENTS FROM THE TULSA COMMUNITY COLLEGE REGISTERED NURSING PROGRAM FROM JANUARY THROUGH APRIL AND IN SEPTEMBER AND DECEMBER. THE CAMPUS'S WELLNESS DIRECTOR WROTE FIVE ARTICLES ON SENIOR WELLNESS ISSUES FOR VINTAGE MAGAZINE. THE COMMUNITY RAISED OVER $9,000 FOR THE ALZHEIMER'S ASSOCIATION'S MEMORY WALK, PURCHASED MATERIAL FOR AND MADE HATS AND SUPPORT BAGS FOR THE AMERICAN CANCER SOCIETY AND HELD A BLOOD DRIVE FOR THE OKLAHOMA BLOOD INSTITUTE. FOR THE CHRISTMAS HOLIDAY, THE COMMUNITY COLLECTED ITEMS FOR AND STUFFED STOCKINGS FOR SENIORS IN NEED IN THE REGION. INVERNESS VILLAGE DONATED $200 AND PARTICIPATED IN UNITED WAY'S DAY OF CARING BY PRESENTING PROGRAMS FOR SENIORS IN THE REGION IN CONJUNCTION WITH LEGAL AID. THROUGHOUT THE YEAR, SEVERAL EDUCATIONAL LUNCHEON PRESENTATIONS ON BEHALF OF THE AMERICAN HEART ASSOCIATION WERE GIVEN BY INVERNESS VILLAGE'S DIRECTOR OF WELLNESS. THE COMMUNITY HELD THREE FOOD DRIVES IN 2010, COLLECTING 500 POUNDS OF FOOD, AND DONATED MEDICATIONS TO INDIGENT POPULATIONS IN THE TULSA AREA THROUGH THE TULSA COUNTY PHARMACY IN FEBRUARY, APRIL, MAY, JUNE, AUGUST AND SEPTEMBER. ENVIRONMENTAL INITIATIVES INCLUDED THE DISTRIBUTION OF RECYCLED MATERIAL REUSABLE GROCERY BAGS TO EVERY INVERNESS VILLAGE RESIDENT AND PARTICIPATION IN A PRESENTATION WITH THE NATURE CONSERVANCY ON THE MANAGEMENT OF FISH POPULATIONS, LAKES AND PONDS. DONATED MEDICATIONS TO TULSA COUNTY PHARMACY FOR INDIVIDUALS WITHOUT INSURANCE. WELLNESS DIRECTOR WROTE SEVEN "AGING WELL" SENIOR ARTICLES FOR VINTAGE MAGAZINE. PROVIDED BUS TRANSPORTATION FOR OUTINGS FOR SENIORS LIVING AT VINTAGE HOUSING PROPERTIES.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.