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
St Francis Life Care Corporation
Employer identification number
22-2536017
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.") .
29,720
29,720
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......
20,952,263
15,831,369
22,647,915
22,505,396
21,222,924
103,159,867
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.
20,981,983
15,831,369
22,647,915
22,505,396
21,222,924
103,189,587
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.)
103,189,587
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...
20,981,983
15,831,369
22,647,915
22,505,396
21,222,924
103,189,587
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
985,784
1,403,924
1,095,279
47,195
533,897
4,066,079
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
985,784
1,403,924
1,095,279
47,195
533,897
4,066,079
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
0
731,597
731,597
13
Total support (Add lines 9, 10c, 11 and 12.).
21,967,767
17,235,293
23,743,194
22,552,591
22,488,418
107,987,263
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
95.557 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
95.400 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
3.765 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
4.600 %
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
St Francis Life Care Corporation
Employer identification number
22-2536017
Identifier
Return Reference
Explanation
PROGRAM SERVICE ACCOMPLISHMENTS
Form 990, Part III, q. 4a
St. Francis Life Care Corporation (operating as Franciscan Oaks) is a 501(c)(3) Continuing Care Retirement Community (CCRC) with 286 independent living units, 34 Assisted Living units and 84 skilled nursing beds. Franciscan Oaks offers a variety of different programs that are designed to meet the physical, emotional, recreational and social needs of the elderly. The organization gives back to the community through such programs as food and clothing drives. Franciscan Oaks operates at the lowest feasible cost taking into account cash flow requirements such as payment of indebtedness. Its entrance fees and monthly charges are set at rates that are generally affordable in the community, with certain entrance fees being refundable. This pricing structure ensures that Franciscan Oaks reaches the broadest portion of the community possible. Franciscan Oaks is committed to the established policy of maintaining, in residence, any person who becomes unable to pay their regular charges by using the organization's own reserves or soliciting funds from its sponsoring organization or the general public.
Organization's Corporate Members/ Stockholders
FORM 990, PART VI, Q. 6
ACCORDING TO THE BYLAWS, THE ENTITY'S SOLE MEMBER IS SAINT CLARE'S HEALTH SERVICES, INC. D/B/A SAINT CLARE'S HEALTH SYSTEM, A NEW JERSEY NONPROFIT CORPORATION.
Members/Stockholders Electing Governing Body
FORM 990, PART VI, Q. 7a
ACCORDING TO THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD.
Approval of Governing Body Decisions by Members/Stockholders
FORM 990, PART VI, Q. 7B
The organization's corporate member is SAINT CLARE'S HEALTH SERVICES, INC. D/B/A SAINT CLARE'S HEALTH SYSTEM. Pursuant to Section 2.1 of the organization's bylaws, both SAINT CLARE'S HEALTH SYSTEM and Catholic Health Initiatives ("CHI") (SAINT CLARE'S HEALTH SYSTEM's sole corporate member) have reserved powers as outlined in the CHI governance matrix. Pursuant to the governance matrix the following rights are held by the SAINT CLARE'S HEALTH SYSTEM Board: - Approve members of the ST. FRANCIS LIFE CARE CORPORATION board - Amendment of the corporate documents of ST. FRANCIS LIFE CARE CORPORATION - Approve removal of a member of the governing body of ST. FRANCIS LIFE CARE CORPORATION - Adoption of long range and strategic plans for ST. FRANCIS LIFE CARE CORPORATION The following rights are reserved to the CHI Board directly or through powers delegated to the CHI Chief Executive Officer: - Substantial change in the mission or philosophy of ST. FRANCIS LIFE CARE CORPORATION - Removal of a member of the governing body of ST. FRANCIS LIFE CARE CORPORATION - Approval of issuance of debt by ST. FRANCIS LIFE CARE CORPORATION - Approval of participation of ST. FRANCIS LIFE CARE CORPORATION in a joint venture - Approval of formation of a new corporation by ST. FRANCIS LIFE CARE CORPORATION - Approval of a merger involving ST. FRANCIS LIFE CARE CORPORATION - Approval of the sale of all or substantially all of the assets of ST. FRANCIS LIFE CARE CORPORATION - To require the transfer of assets by ST. FRANCIS LIFE CARE CORPORATION to CHI to accomplish CHI's goals and objectives, and to satisfy CHI debts. Pursuant to the organization's bylaws, SAINT CLARE'S HEALTH SYSTEM or CHI may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the Board and its President and the Chief Executive Officer of the organization, recommend such other or different actions as it deems appropriate.
Process the Organization uses to review form 990
Form 990, Part VI, Q. 11b
ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER of St. Clare's Hospital. THE CHIEF FINANCIAL OFFICER will provide a copy of the return to the BOARD by email. SUBSEQUENT TO providing a copy TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Procedures for Monitoring and Enforcing the COI Policy
Form 990, Part VI, Q. 12c
Annually, officers, trustees, and key employees are required to complete a conflict of interest statement acknowledging that they have no conflicts of interest. The completed Form is returned to the corporate compliance officer for review. In addition, any conflicts that may arise during the year must be disclosed to the compliance officer. In addition to the annual questionnaire, if there is an actual or potential conflict of interest, the individual with the conflict is prohibited from participating in discussions or voting on matters related to the conflict.
Process for Determining CEO's Compensation
Form 990, Part VI, Q. 15a
The organization's CEO's compensation is paid by CHI. CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 2011. In addition, in December 2009, Hay Group completed a comprehensive review of all positions at the level of vice president and above to determine and validate appropriate compensation levels.
Process for Determining Compensation - Officers/Key Employees
Form 990, Part VI, Q. 15b
THE NON-CEO OFFICER AND KEY EMPLOYEE COMPENSATION IS SET BY THE COMPENSATION COMMITTEE OF THE BOARD OF SAINT CLARE'S HEALTH SERVICES, INC. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS. ADDITIONALLY, THE CEO WILL MAKE RECOMMENDATIONS. THE COMPENSATION COMMITTEE USES MARKET STUDIES TO ASSIST IN DETERMINING THE APPROPRIATE COMPENSATION LEVELS.
Public Inspection of Documents
FORM 990, PART VI, q. 19
The organization's governing documents and conflict of interest policy are available upon request. In addition, the governing documents are available from the New Jersey Secretary of State. The organization's financial statements are included in Catholic Health Initiatives' consolidated audited financial statements that are available at www.CatholicHealthInit.org or at www.DACBOND.org.
Estimate of Hours for Related Organizations
Form 990, Part VII
COMPENSATION REPORTED ON FORM 990, PART VII WAS PAID TO THESE INDIVIDUALS BY RELATED ORGANIZATIONS IN EXCHANGE FOR THE FULFILLMENT OF THEIR DUTIES AS FULL-TIME, 60 HOUR-PER-WEEK EMPLOYEES.
Other Changes in Net Assets
Form 990, Part XI, Q. 5
Net Unrealized Gain/Loss $2,703,432 Prior Period Adjusment (237,453) ----------- Total 2,465,979
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.