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
ARDEN WOOD INC
Employer identification number
23-7334055
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.") ....
1,779,985
2,344,149
2,354,390
1,846,037
919,356
9,243,917
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3..
1,779,985
2,344,149
2,354,390
1,846,037
919,356
9,243,917
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)..
3,514,762
6
Public Support. Subtract line 5 from line 4.
5,729,155
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..
1,779,985
2,344,149
2,354,390
1,846,037
919,356
9,243,917
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
221,100
193,024
134,776
93,850
69,528
712,278
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
0
11
Total support (Add lines 7 through 10).
9,956,195
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
57.540 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
50.740 %
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.") .
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......
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.
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.)
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...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
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
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:
10000105
Software Version:
2010v3.2
-
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
ARDEN WOOD INC
Employer identification number
23-7334055
Identifier
Return Reference
Explanation
RECONCILIATION OF CHANGE IN NET ASSETS:
THE ORGANIZATION INCURRED UNREALIZED LOSSES ON ITS INVESTMENTS DURING THE FISCAL YEAR IN THE AMOUNT OF $25,141. THE RECONCILIATION OF THE CHANGE IN NET ASSETS FROM FORM 990 TO THE FINANCIAL STATEMENTS, AND EFFECT ON CURRENT YEAR NET ASSETS, IS AS FOLLOWS: EXPENSES OVER REVENUES PER FORM 990, PAGE 1, PART I, LINE 19 (2,359,934) UNREALIZED LOSSES (25,141) ----------- EXPENSES OVER REVENUES PER FINANCIAL STATEMENTS (2,385,075) BEGINNING NET ASSETS 17,893,153 ----------- ENDING NET ASSETS, FORM 990, PAGE 1, PART I, LINE 22 15,508,078 ===========
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
THE ORGANIZATION PROVIDES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
COMPENSATION PROCESS FOR OTHER OFFICERS OR KEY EMPLOYEES:Upon completion of a key employee's initial six months, there is a formal written review consisting of a self-assessment by the employee which is reviewed and added to by the EXECUTIVE DIRECTOR/CEO; this is then followed up with a meeting and discussion between the EXECUTIVE DIRECTOR/CEO and the key employee. Subsequent evaluations of the employee's performance are on-going and informal during regular and frequent communication between the EXECUTIVE DIRECTOR/CEO and the employee. Generally, the organization engages an independent consultant EVERY OTHER YEAR to perform a comparative survey of employees' salaries.
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
ALL EMPLOYEES MUST DISCLOSE TO THE ORGANIZATION CONFLICTS OF INTEREST. THE BOARD AUTHORIZES AND OVERSEES AN ANNUAL REVIEW OF THE ADMINISTRATION OF THE CONFLICT OF INTEREST POLICY. IF POTENTIAL CONFLICTS ARISE, IT IS THE RESPONSIBILITY OF THE EXECUTIVE DIRECTOR/CEO OR THE BOARD TO ADDRESS THE POTENTIAL CONFLICT OF INTEREST DEPENDING ON THE PERSON (I.E. EMPLOYEE OR DIRECTOR) INVOLVED.WITH REGARD TO AN EMPLOYEE WHO IS NOT AN INSIDER (A PERSON WITH SUBSTANTIAL INFLUENCE OVER THE ORGANIZATION), THE EXECUTIVE DIRECTOR/CEO SHALL ASCERTAIN THAT ALL MATERIAL FACTS REGARDING THE TRANSACTION AND THE EMPLOYEE'S CONFLICT OF INTEREST HAVE BEEN DISCLOSED, AND DECIDE THE APPROPRIATE RESPONSE BY THE ORGANIZATION ONCE A CONFLICT OF INTEREST HAS BEEN DETERMINED TO EXIST.WITH REGARD TO AN INSIDER, THE BOARD OR A BOARD COMMITTEE SHALL FOLLOW PROCEDURES (I.E. DELIBERATE ON THE TRANSACTION IN THE ABSENCE OF THE INTERESTED PERSON, ASCERTAIN ALL MATERIAL FACTS REGARDING THE TRANSACTION, AND COMPILE APPROPRIATE DATA TO ASCERTAIN WHETHER THE PROPOSED TRANSACTION WAS FAIR OR IN FUTHERANCE OF THE ORGANIZATION'S PURPOSES AND WHETHER PAYMENT OR COMPENSATION IS EXCESSIVE FOR COMPARABLE SERVICES) IN ORDER TO DECIDE WHETHER TO ENTER INTO THE TRANSACTION AND, IF SO, TO ENSURE THAT THE TERMS OF THE TRANSACTION ARE REASONABLE. IN THE CASE OF AN INSIDER WHO IS A DIRECTOR, THE DIRECTOR SHALL NOT VOTE ON ANY TRANSACTION IN WHICH THE DIRECTOR HAS AN INTEREST, AND SHALL NOT BE PRESENT DURING BOARD OR BOARD COMMITTEE DISCUSSIONS OR DETERMINATION.
Form 990, Part VI, Line 11
Form 990, Part VI, Line 11: Form 990 Review Process
THE DIRECTOR OF FINANCE REVIEWS THE FORM 990, ALL RELATED SCHEDULES AND ATTACHMENTS AND PROVIDES COPIES OF THE RETURN TO EACH TRUSTEE AND THE EXECUTIVE DIRECTOR PRIOR TO IT BEING FILED WITH THE RESPECTIVE TAXING AUTHORITY.
Form 990, Part III, Line 4d
Form 990, Part III, Line 4d : Other Program Services Description
OTHER PROGRAM SERVICES 4: Nurses Training Program: Since our founding in 1930, Arden Wood has actively trained Christian Science Nurses for our facility as well as other Christian Science facilities and for those serving as private duty CS nurses. Arden Wood instructs its trainees in the Christian Science Nursing Arts-an extensive, three-year, four-part course curriculum of the highest quality in partnership with the Chestnut Hill Benevolent Association which includes thorough classroom instruction (two courses taught at Arden Wood) and on-the-job mentoring on both campuses. Training provides in-depth study of the principles, ethics and practical skills necessary to ensure excellent Christian Science nursing care. Trainees are salaried and receive full employment benefits. OTHER PROGRAM SERVICES 5: HOUSEKEEPING AND MAINTENANCE SERVICES AND DEPRECIATION PROVIDED FOR THE BENEFIT OF CHRISTIAN SCIENCE NURSING PATIENTS AND RESIDENTIAL LIVING RESIDENTS. (EXPENSES = $1,928,172) OTHER PROGRAM SERVICES 6: OTHER PROGRAM SERVICES 7: OTHER PROGRAM SERVICES 8: OTHER PROGRAM SERVICES 9: OTHER PROGRAM SERVICES 10: OTHER PROGRAM SERVICES 11: OTHER PROGRAM SERVICES 12: OTHER PROGRAM SERVICES 13:
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.