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
2012
Open to Public Inspection
Name of the organization
ARC OF WABASH COUNTY INC
Employer identification number
35-1095971
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 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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2012.
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—2011.
If the organization did not check a 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—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
114,536
120,184
127,669
118,214
240,609
721,212
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......
1,463,136
1,355,188
1,469,221
1,699,115
1,763,829
7,750,489
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
5,288
4,762
4,955
5,726
6,530
27,261
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
0
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
6
Total. Add lines 1 through 5.
1,582,960
1,480,134
1,601,845
1,823,055
2,010,968
8,498,962
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..
8
Public support (Subtract line 7c from line 6.)
8,498,962
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
1,582,960
1,480,134
1,601,845
1,823,055
2,010,968
8,498,962
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
7,341
6,546
4,575
2,976
2,469
23,907
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
7,341
6,546
4,575
2,976
2,469
23,907
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
421
1,011
5,091
-1,772
4,149
8,900
13
Total support. (Add lines 9, 10c, 11, and 12.)..
1,590,722
1,487,691
1,611,511
1,824,259
2,017,586
8,531,769
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 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
99.620 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
99.420 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
0.280 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
0.480 %
19a
33 1/3% support tests—2012.
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—2011.
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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012
Additional Data
Software ID:
12000229
Software Version:
2012v2.0
-
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
2012
Open to Public Inspection
Name of the organization
ARC OF WABASH COUNTY INC
Employer identification number
35-1095971
Identifier
Return Reference
Explanation
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
FINANCIAL STATEMENTS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE(IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME BUT WOULD BE AVAILABLE 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 DECISIONS FOR ALL EMPLOYEES, INCLUDING THE CFO, ARE BASED ON MERIT AND ARE DETERMINED BY THE BOARD OF DIRECTORS ANNUALLY.WRITTEN ANNUAL JOB PERFORMANCE EVALUATIONS ARE CONDUCTED IN THE SPRING OF EACH FISCAL YEAR. THE EMPLOYEE AND HIS/HER SUPERVISOR SIT DOWN TOGETHER TO DO THE EVALUATION. ONCE COMPLETED, BOTH THE EMPLOYEE AND THE SUPERVISOR SIGN THE EVALUATION FORM. A COPY IS GIVEN TO THE EMPLOYEE AND THE ORIGINAL IS SUBMITTED TO THE EXECUTIVE DIRECTOR.AN OVERALL SCORE IS DERIVED FROM EACH OF THE EVALUATIONS, USING A SPECIFIC FORMULA. THEN, BASED ON THEIR SCORES, STAFF MEMBERS ARE PLACED ON A SPREADSHEET UNDER ONE OF FIVE PERFORMANCE CATEGORIES, SUBSTANDARD, SATISFACTORY, GOOD, EXCELLENT, AND OUTSTANDING. SUBSTANDARD PERFORMANCE RESULTS IN NO WAGE INCREASE. THE REMAINING FOUR CATEGORIES RESULT IN INCREASINGLY HIGHER INCREASES.NEXT, AT LEAST FOUR DIFFERENT PAY OPTIONS ARE DEVELOPED FOR THE BOARD'S CONSIDERATION. OPTION 1 MIGHT INCLUDE A RANGE FROM 1.5% TO 3.0% INCREASE. 1.5% FOR SATISFACTORY RATING, 2.0% FOR GOOD, 2.5% FOR EXCELLENT, AND 3.0% FOR OUTSTANDING RATING. OPTION 2 MIGHT INCLUDE A RANGE FROM 2.0% INCREASE TO 3.5%. OPTION 3 MIGHT INCLUDE A RANGE FROM 2.5% TO 4.0%, AND OPTION 4 MIGHT BE A RANGE FROM 3.0% TO 4.5%.FOR EACH OF THE DIFFERENT OPTIONS, A SPREADSHEET IS DEVELOPED LISTING EACH STAFF PERSON, THEIR PROJECTED ANNUAL WAGE BASED ON THE CURRENT YEAR, THE AMOUNT OF INCREASE BASED ON THEIR PERFORMANCE EVALUATION SCORE, CATEGORY FOR THAT OPTION, AND THE PROJECTED TOTAL COMPENSATION FOR THE NEXT YEAR. THEN ALL INCREASES ARE TOTALED SO THE BOARD CAN SEE WHAT THE FINANCIAL IMPACT OF EACH OPTION WILL HAVE ON ARC'S BUDGET.ANNUALLY, AT A REGULARLY SCHEDULED BOARD MEETING, BOARD MEMBERS ARE GIVEN THE SPREADSHEETS SHOWING THE FINANCIAL IMPACT OF EACH OF THE FOUR OPTIONS FOR INCREASED WAGES. BOARD MEMBERS CAN ALSO SEE WHERE EACH EMPLOYEE FALLS ACCORDING TO THEIR PERFORMANCE EVALUATION.BOARD MEMBERS ARE ALSO PROVIDED THE RESULTS OF THE INDIANA ASSOCIATION OF REHABILITATION FACILITIES(INARF)SALARY AND COMPENSATION SURVEY FOR STAFF POSITIONS WITHIN OUR INDUSTRY. COST OF LIVING ADJUSTMENT(COLA)FIGURES ARE ALSO RESEARCHED AND PROVIDED TO THE BOARD. PUBLISHED INFORMATION REGARDING THE PERCENTAGE OF WAGE INCREASES FOR LOCAL PUBLIC EMPLOYEES AND EMPLOYEES OF THE LOCAL PUBLIC SCHOOL SYSTEMS IS MADE AVAILABLE AS APPROPRIATE.THE BOARD OF DIRECTORS MAKES A DECISION AS TO WHICH OPTION TO GO WITH FOR WAGE INCREASES FOR THE COMING YEAR. WAGE INCREASES BECOME EFFECTIVE ON JULY 1, THE BEGINNING OF THE NEW FISCAL YEAR. INSTEAD OF THE OPTIONS PRESENTED, THE BOARD MAY ALSO CHOOSE TO DEVELOP AN ENTIRELY DIFFERENT OPTION. FOR INSTANCE ONE YEAR THE BOARD DECIDED TO GIVE A ONE-TIME BONUS TO ALL STAFF BASED ON ONE OF THE OPTIONS PROVIDED. INSTEAD OF GIVING A RAISE ANOTHER TIME, BOARD MEMBERS OPTED TO GIVE ADDITIONAL PAID-TIME-OFF HOURS TO ALL STAFF INSTEAD OF WAGE INCREASES. THE BOARD OF DIRECTORS ALWAYS MAKE THE FINAL DECISION.
Form 990, Part VI, Line 15a
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management
ARC HAS AN EXECUTIVE COMPENSATION POLICY WHICH WAS ORIGINALLY DEVELOPED IN 2007. THE PROCEDURES OUTLINED IN THIS POLICY HAVE BEEN USED ANNUALLY SINCE THEN. ARC'S BOARD OF DIRECTORS DETERMINES THE EXECUTIVE DIRECTOR'S COMPENSATION PACKAGE ON AN ANNUAL BASIS IN ORDER TO MAKE APPROPRIATE AND ONGOING COMPENSATION DECISIONS. BOARD MEMBERS ARE APPRISED OF THE FULL DETAILS OF THE EXECUTIVE DIRECTOR'S COMPENSATION PACKAGE, AND THEY ALSO HAVE THE OPPORTUNITY TO MEET AND DISCUSS THE DETAILS PRIOR TO APPROVING A COMPENSATION PACKAGE. THE EXECUTIVE DIRECTOR DOES NOT SUGGEST OR RECOMMEND HER OWN SALARY LEVELS AND IS NOT PRESENT DURING THE BOARD'S DISCUSSION ABOUT HER COMPENSATION LEVEL.PRIOR TO THE BOARD MEETING, INDIVIDUAL BOARD MEMBERS ARE PROVIDED A COMPLETED EXECUTIVE COMPENSATION FORM WHICH DETAILS THE EXECUTIVE DIRECTOR'S PRESENT(1)ANNUAL BASE SALARY.(2)AMOUNT OF HEALTH, LIFE AND DISABILITY INSURANCE PREMIUMS PAID BY ARC.(3)AMOUNT OF PENSION/RETIREMENT CONTRIBUTED BY ARC.(4)THE COST OF THE CELL PHONE PACKAGE PROVIDED BY ARC.(5)THE NUMBER OF VACATION AND SICK DAYS PAID BY ARC.(6)THE FACT THAT A VEHICLE IS PROVIDED FOR USE BY THE EXECUTIVE DIRECTOR, AND (7)ANY OTHER BENEFITS THAT MIGHT BE PROVIDED BY ARC.EACH BOARD MEMBER IS ALSO PROVIDED A COPY OF THE RESULTS OF THE INDIANA ASSOCIATION OF REHABILITATION FACILITIES(INARF)SALARY AND COMPENSATION SURVEY FOR CHIEF EXECUTIVE OFFICERS, WHICH IS CONDUCTED BY INARF EVERY OTHER YEAR. COST OF LIVING ALLOWANCE(COLA)FIGURES ARE ALSO RESEARCHED AND PROVIDED TO THE BOARD. FORMS 990 FILED BY PEER ORGANIZATIONS ARE AVAILABLE FOR REVIEW ON GUIDESTAR. LASTLY, PUBLISHED INFORMATION REGARDING THE PERCENTAGE OF WAGE INCREASES FOR LOCAL PUBLIC EMPLOYEES AND EMPLOYEES OF THE LOCAL PUBLIC SCHOOL SYSTEM IS MADE AVAILABLE AS APPROPRIATE.THE EXECUTIVE DIRECTOR'S COMPENSATION PACKAGE IS DETERMINED BY THE ENTIRE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED BOARD MEETING WHEN THIS ITEM COMES UP ON THE AGENDA. THE EXECUTIVE DIRECTOR IS EXCUSED FROM THE ROOM SO BOARD MEMBERS ARE FREE TO FULLY DISCUSS THE ISSUE WITHOUT INFLUENCE FROM THE EXECUTIVE DIRECTOR.FOLLOWING DISCUSSION, THE BOARD OF DIRECTORS COMPLETES THE EXECUTIVE COMPENSATION FORM INDICATING THE TERMS OF COMPENSATION FOR THE COMING YEAR.
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
ANNUAL DISCLOSURE IS PROVIDED TO EACH OFFICER AND BOARD MEMBER(THE ORGANIZATION DOES NOT HAVE ANY KEY EMPLOYEES OR HIGHLY COMPENSATED EMPLOYEES). EACH INDIVIDUAL COMPLETES AN ANNUAL CONFLICT OF INTEREST STATEMENT ONCE THE STATEMENTS ARE COMPLETED, THE EXECUTIVE DIRECTOR REVIEWS THEM TO DETERMINE IF THERE ARE ANY POTENTIAL CONFLICTS OF INTEREST. IF A POTENTIAL CONFLICT OF INTEREST ARISES, THE EXECUTIVE DIRECTOR REPORTS THE ISSUE TO THE BOARD PRESIDENT. THE PRESIDENT THEN REPORTS THE ISSUE TO THE ENTIRE BOARD OF DIRECTORS, WHICH THEN DETERMINES WHETHER OR NOT AN ACTUAL CONFLICT OF INTEREST EXISTS. IF AN ACTUAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD DETERMINES WHETHER THE MEMBER SHOULD EITHER 1)REMOVE HIMSELF OR HERSELF FROM VOTING ON THE ISSUE OR 2)NEEDS TO BE REMOVED FROM THE BOARD.
Form 990, Part VI, Line 11b
Form 990, Part VI, Line 11b: Form 990 Review Process
A BOARD MEETING IS HELD WITH OUR TAX ADVISORS TO PRESENT AND REVIEW A FINAL DRAFT OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES BEFORE IT IS FILED WITH THE IRS. EACH BOARD MEMBER IS PROVIDED A COPY OF THE RETURN AT THE BOARD MEETING AND IS ALLOWED TO ASK ANY QUESTIONS THEY MAY HAVE. UPON REVIEW AND APPROVAL BY THE BOARD, THE TAX RETURN WILL BE FILED WITH THE IRS.
Form 990, Part VI, Line 6
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder
MEMBERSHIP TO THE ORGANIZATION MAY BE OBTAINED ON APPLICATION TO THE CHAIRMAN OF THE MEMBERSHIP COMMITTEE. MEMBERSHIP MAY BE ON EITHER AN INDIVIDUAL OR A FAMILY BASIS. A FAMILY MEMBERSHIP SHALL ENTITLE BOTH THE HEAD OF THE FAMILY AND THE SPOUSE TO HOLD OFFICE AND TO VOTE. MEMBERS PAY ANNUAL DUES. THE AMOUNT OF WHICH IS DETERMINED BY THE BOARD OF DIRECTORS. A MEMBER IN GOOD STANDING IS ONE WHOSE DUES ARE NOT DELINQUENT OR HAVE BEEN WAIVED. MEMBERS IN GOOD STANDING SHALL BE ELIGIBLE TO HOLD OFFICE AND TO VOTE(ONLY IN PERSON)ON ALL QUESTIONS AT GENERAL MEMBERSHIP MEETINGS. OVERSIGHT OF THE ORGANIZATION RESTS WITH THE MEMBERSHIP. ANY ACTION OF THE BOARD OF DIRECTORS SHALL BE SUBJECT TO REVIEW BY THE MEMBERSHIP ON REQUEST OF ANY MEMBER. AN ACTION OF THE BOARD OF DIRECTORS MAY BE ALTERED OR RESCINDED BY A TWO-THIRDS VOTE OF THE MEMBERS, PROVIDED NO RIGHTS OF THIRD PARTIES ARE AFFECTED.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.