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
FSL HOME IMPROVEMENTS
Employer identification number
38-3649930
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.") .
65,602
46,999
37,721
29,475
9,259
189,056
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......
3,288,594
3,831,331
4,296,558
6,766,730
9,618,272
27,801,485
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.
3,354,196
3,878,330
4,334,279
6,796,205
9,627,531
27,990,541
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.
51,132
45,569
96,701
c
Add lines 7a and 7b..
51,132
45,569
96,701
8
Public Support (Subtract line 7c from line 6.)
27,893,840
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...
3,354,196
3,878,330
4,334,279
6,796,205
9,627,531
27,990,541
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.).
3,354,196
3,878,330
4,334,279
6,796,205
9,627,531
27,990,541
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
99.650 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
99.740 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
0 %
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
FSL HOME IMPROVEMENTS
Employer identification number
38-3649930
Identifier
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 1B:
THE BOARD MEMBERS ARE NOT INDEPENDENT AS THEY ARE COMPENSATED BY FOUNDATION FOR SENIOR LIVING (FSL) RELATED ORGANIZATIONS FOR THEIR SERVICES PROVIDED TO THE FSL ORGANIZATION AS A WHOLE. FOUNDATION FOR SENIOR LIVING HAS AN INDEPENDENT BOARD AND THEY ELECT THE BOARD MEMBERS FOR FSL HOME IMPROVEMENTS.
FORM 990, PART VI, SECTION A, LINE 2
DAVID PADDISON AND RICH ARMSTRONG HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 3
FSL HOME IMPROVEMENTS PAYS FSL MANAGEMENT, AN AFFILIATE, A MANAGEMENT FEE. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, FINANCIAL, HUMAN RESOURCES, AND RISK MANAGEMENT OVERSIGHT.
FORM 990, PART VI, SECTION A, LINE 6
THE SOLE MEMBER OF THIS ORGANIZATION IS FOUNDATION FOR SENIOR LIVING.
FORM 990, PART VI, SECTION A, LINE 7A
THE FOUNDATION FOR SENIOR LIVING APPOINTS THE DIRECTORS. DIRECTORS MAY BE REMOVED AT ANY TIME WITHOUT CAUSE BY THE FOUNDATION FOR SENIOR LIVING.
FORM 990, PART VI, SECTION A, LINE 8B
FSL HOME IMPROVEMENTS DOES NOT HAVE A COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11
THE CONTROLLER OF THE ORGANIZATION'S PARENT, FOUNDATION FOR SENIOR LIVING (FSL), WILL REVIEW THE RETURN PRIOR TO BEING SUBMITTED TO THE GOVERNING BOARD. THE RETURN WILL ALSO BE PROVIDED TO THE FSL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12
EVERYONE ON BOARDS OR WORKING FOR THE FOUNDATION AND ITS AFFILIATES ARE COVERED UNDER THE POLICY. FOR FOUNDATION, CONFLICTS ARE DETERMINED AT THE FSL BOARD LEVEL. FOR AFFILIATE CORPORATIONS, CONFLICTS ARE DETERMINED EITHER AT THE FSL LEADERSHIP COUNCIL LEVEL OR THE AFFILIATE BOARD LEVEL FOR BOTH THE LEVEL AT WHICH DETERMINATIONS OF WHETHER A CONFLICT EXISTS ARE MADE AND THE LEVEL AT WHICH ACTUAL CONFLICTS ARE REVIEWED. ALL POTENTIAL CONFLICTS OF INTEREST, REGARDLESS OF HOW SMALL OR INSIGNIFICANT, ARE TO BE REPORTED TO THE PRESIDENT OF THE BOARD OF DIRECTORS (OR COMMITTEE CHAIR) PRIOR TO ENGAGING IN A CONFLICT OF INTEREST BOARD OR COMMITTEE ACTION. THE PRESIDENT WILL ASK THE BOARD OF DIRECTORS TO MAKE A DECISION AS TO WHETHER THE RELATIONSHIP IS AN APPROPRIATE ONE FOR FSL. THE BOARD MEMBER DECLARING THE CONFLICT WILL HAVE NO VOTE ON THE MATTER. MOREOVER, THE PERSON HAVING A CONFLICT SHALL RETIRE FROM THE ROOM IN WHICH THE BOARD (OR ITS COMMITTEE) IS MEETING AND SHALL NOT PARTICIPATE IN THE FINAL DELIBERATION REGARDING THE MATTER UNDER CONSIDERATION. HOWEVER, THE PERSON SHALL BE PERMITTED TO PROVIDE THE BOARD OR COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION PRIOR TO LEAVING THE MEETING.
FORM 990, PART VI, LINE 15A: GUY MIKKELSEN IS COMPENSATED BY A RELATED ORGANIZATION, FSAL MANAGEMENT (FSAL), FOR HIS SERVICES PROVIDED TO FSAL AND ITS RELATED ORGANIZATIONS. HIS COMPENSATION IS APPROVED BY THE GOVERNING BOARD OF FSAL. ON AN ANNUAL BASIS, THEY ARE PROVIDED WITH COMPARABILITY DATA/COMPENSATION STUDIES TO DETERMINE HIS COMPENSATION. OTHER OFFICERS AND DIRECTORS ARE PROVIDED COMPENSATION FROM FSL AND OTHER RELATED ORGANIZATIONS FOR THEIR SERVICES, BEYOND BEING ON THE GOVERNING BOARD, PROVIDED TO THAT ENTITY AND OTHER RELATED ORGANIZATIONS. THEIR COMPENSATION IS APPROVED BY GUY MIKKELSEN, PRESIDENT AND CEO. THE ORGANIZATION EXPANDED THE REVIEW BY INDEPENDENT PERSONS FOR THE FISCAL YEAR. DURING THE YEAR, FSL AND ITS RELATED ORGANIZATIONS USED AN INDEPENDENT CONSULTANT TO PERFORM A MARKET STUDY ANAYLSIS ON COMPENSATION ACROSS SEVERAL INDUSTRIES.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
PART VII, SECTION A
THE FOLLOWING OFFICERS, DIRECTORS AND HIGHEST COMPENSATED EMPLOYEES SERVED FOUNDATION FOR SENIOR LIVING AND ALL OTHER RELATED ORGANIZATIONS THE FOLLOWING HOURS PER WEEK. GUY MIKKELSEN - 37 HOURS LINDA MARTIN - 38.5 HOURS BLANCA RUIZ - 35 HOURS STEVE HASTINGS - 37 HOURS CARRIE SMITH - 20 HOURS JOSEPH SWITALSKI - 39.5 HOURS CAROLYN HILL - 39.5 HOURS DAVID PADDISON - 39.5 HOURS RICHARD ARMSTRONG - 38 HOURS
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.