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
TARRANT COUNTY SENIOR LIVING CENTER INC
Employer identification number
20-8068602
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.") .
0
0
0
0
0
0
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......
0
0
0
0
0
0
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.
0
0
0
0
0
0
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.)
0
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...
0
0
0
0
0
0
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
0
0
0
0
957,592
957,592
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
0
0
0
0
957,592
957,592
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.)
0
0
0
2,500
2,500
5,000
13
Total support (Add lines 9, 10c, 11 and 12.).
0
0
0
2,500
960,092
962,592
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
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
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
TARRANT COUNTY SENIOR LIVING CENTER INC
Employer identification number
20-8068602
Identifier
Return Reference
Explanation
MANAGEMENT COMPANY
FORM 990, PART VI, SECTION A, LINE 3
Greystone Management is an unrelated business organization engaged by THE BOARD OF DIRECTORS OF TARRANT COUNTY SENIOR LIVING CENTER, INC. to provide management services. Management duties include hiring and recruiting qualified personnel, preparing annual operating budget for submission to the Board of Directors, and assisting in the preparation of monthly and annual financial reporting disclosures. The Board of Directors have final authority over the approval of the annual operating budget, approval of monthly and annual financial reporting disclosures, and oversight of the management company.
CORPORATE MEMBER
FORM 990, PART VI, SECTION A, LINES 6 & 7(A)
SENIOR QUALITY LIFESTYLES CORPORATION (SQLC) is the Organization's sole member. SQLC acts as a supporting organization, providing oversight, direction, and governance support, and will make grants and/or provide other forms of financial assistance as needed. SQLC, AS THE SOLE MEMBER, HAS AUTHORITY TO ELECT BOARD MEMBERS OF THE ORGANIZATION.
DOCUMENTATION OF COMMITTEE MEETINGS
FORM 990, PART VI, SECTION A, LINE 8B
LINE 8B IS ANSWERED NO BECAUSE THERE ARE NO COMMITTEES IN PLACE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY at this time.
FORM 990 REVIEW PROCESS
FORM 990, PART VI, SECTION B, LINE 11
THE BOARD MEMBERS OF TARRANT COUNTY SENIOR LIVING CENTER, INC. AND GREYSTONE COMMUNITIES, THE MANAGEMENT COMPANY, REVIEW THE FORM 990 UPON COMPLETION. The board review and approval of the Form 990 is COMPLETED prior to filing.
COMPENSATION REVIEW
FORM 990, PART VI, SECTION B, LINE 15
THE CEO OF SENIOR QUALITY LIFESTYLES CORPORATION, ALONG WITH THE MANAGEMENT COMPANY, GREYSTONE, AND MERIT, AN INDEPENDENT PAYROLL PROCESSOR, SET THE SALARY FOR THE EXECUTIVE DIRECTOR. BOTH GREYSTONE AND MERIT PROVIDE COMPARATIVE SALARY DATA. THE EXECUTIVE DIRECTOR, GREYSTONE REGIONALS, AND MERIT SET OTHER TOP MANAGEMENT RATES BASED ON MARKET WAGES AND YEARS OF EXPERIENCE.
DOCUMENTS AVAILABLE TO PUBLIC
FORM 990, PART VI, SECTION C, LINE 19
GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE POSTED TO NATIONALLY Recognized ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AND ARE ALSO AVAILABLE UPON REQUEST.
Business Relationships
Form 990, Part VI, Section A, Line 2
THE FOLLOWING BOARD MEMBERS MAINTAIN A BUSINESS RELATIONSHIP WITH EACH OTHER DUE TO COMMON PARTICIPATION AS OFFICERS OR DIRECTORS OF VARIOUS OTHER RELATED NOT-FOR-PROFIT ENTITIES BY WHICH ONE OR MORE OF THE INDIVIDUALS IS COMPENSATED: CHARLES B. BREWER C. SCOTT SYKES BERNIE FRANCIS CARY CLAYBORN
EMPLOYEES REPORTED THROUGH OUTSOURCED PROFESSIONAL EMPLOYER ORGANIZATION
FORM 990, PART V, LINE 2(A)
The organization did not issue Form W2s directly. THE INDIVIDUALS THAT COMPRISE THE TOTAL LISTED ON LINE 2(A) ARE CONSIDERED EMPLOYEES OF THE ORGANIZATION FOR THE PURPOSES OF PART V. HOWEVER, THE ORGANIZATION UTILIZES A PROFESSIONAL EMPLOYER ORGANIZATION, MERIT RESOURCES, INC. (EIN: 42-1368750), WHICH IS THE EMPLOYER OF RECORD, ISSUES ALL W-2S AND ACTS AS AN OUTSOURCED HUMAN RESOURCES AND PAYROLL DEPARTMENT FOR THE ORGANIZATION.
TOP MANAGEMENT AND FINANCIAL OFFICIAL
FORM 990, PART VII
The executive director is the top management OFFICIAL AND TOP FINANCIAL official. Per the form instructions, THE TOP MANAGEMENT AND FINANCIAL OFFICIALS ARE deemed to be officerS.
CONFLICT OF INTEREST POLICY ENFORCEMENT AND MONITORING
FORM 990, PART VI, SECTION B, LINE 12(C)
Annually the conflict of interest policy is reviewed during a board meeting, in addition to having the necessary individuals sign the disclosure statement on an annual basis. It is the expectation that management staff (community and corporate) in addition to the Management Company will bring any questionable activity to the attention of the board or AN officer.
OTHER CHANGES IN NET ASSETS
FORM 990, PART XI, LINE 5
NET ASSETS DECREASED $912,034 FOR NET UNREALIZED GAINS ON INVESTMENTS CARRIED AT MARKET VALUE. NET ASSETS INCREASED FOR INTEREST INCOME OF $7,834 AND INTEREST INCOME FROM TAX-EXEMPT BOND PROCEEDS OF $837,174 THAT WERE CAPITALIZED FOR GAAP PURPOSES BUT REPORTED AS PART OF REVENUE FOR TAX PURPOSES. NET ASSETS DECREASED FOR INVESTMENT MANAGEMENT FEES OF $236,515 THAT WERE CAPITALIZED FOR GAAP PURPOSES BUT REPORTED AS PART OF FUNCTIONAL EXPENSES FOR TAX PURPOSES. NET ASSETS DECREASED FOR OTHER SALARIES AND WAGES OF $467,564 AND PAYROLL TAXES OF $36,811 THAT WERE CAPITALIZED FOR GAAP PURPOSES BUT REPORTED AS PART OF FUNCTIONAL EXPENSES FOR TAX PURPOSES. TOTAL CHANGES IN NET ASSETS EQUAL $807,916.
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:CHARLES B. BREWER TITLE:DIRECTOR HOURS:48
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:C. SCOTT SYKES TITLE:DIRECTOR HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:BERNIE FRANCIS TITLE:DIRECTOR/SECRETARY HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:CARY CLAYBORN TITLE:DIRECTOR HOURS:8
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:JOHN JUSTIN SPOONER TITLE:EXECUTIVE DIRECTOR HOURS:30
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:KRISTEN MCCAIG TITLE:VP - MARKETING HOURS:26
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:DAVID BROWN TITLE:VP - DEVELOPMENT HOURS:26
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.