Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2011 and ending 06-30-2012
BCheck if applicable:
CName of organization
HOLY CROSS VILLAGE AT NOTRE DAME INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
54515 State Road 933 North
PO Box 303
Room/suite
City or town, state or country, and ZIP + 4
Notre Dame, IN465560303
D Employer identification number

35-2084623
E Telephone number

G Gross receipts $ 13,713,575
F Name and address of principal officer:
JOHN MAUCH
54515 State Road 933 North
Notre Dame,IN465560303
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HOLYCROSSVILLAGE.COM
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet0928
K Form of organization:
 
L Year of formation: 1999
M State of legal domicile: IN
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: HOLY CROSS VILLAGE AT NOTRE DAME IS AN INTERDEPENDENT COMMUNITY ENERGIZED BY HOLY CROSS SPIRITUALITY AND HOSPITALITY, AND DEDICATED TO PROVIDING A NURTURING ENVIRONMENT FOCUSED ON DIGNITY AND RESPECT.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 11
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 153
6 Total number of volunteers (estimate if necessary) .... 6 61
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 473,010
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,104,179 29,726
9 Program service revenue (Part VIII, line 2g) ......... 11,155,862 11,781,371
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 207,109 159,402
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 19,651,576 568,045
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 32,118,726 12,538,544
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 4,333 2,949
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 4,247,402 4,725,121
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 11,589,300 10,675,449
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 15,841,035 15,403,519
19 Revenue less expenses. Subtract line 18 from line 12....... 16,277,691 -2,864,975
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 61,176,332 58,772,751
21 Total liabilities (Part X, line 26)............. 56,151,035 56,384,804
22 Net assets or fund balances. Subtract line 21 from line 20..... 5,025,297 2,387,947
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: HOLY CROSS VILLAGE AT NOTRE DAME IS AN INTERDEPENDENT COMMUNITY ENERGIZED BY HOLY CROSS SPIRITUALITY AND HOSPITALITY, AND DEDICATED TO PROVIDING A NURTURING ENVIRONMENT FOCUSED ON DIGNITY AND RESPECT. (CONTINUED IN SCHEDULE O)
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 8,202,844 including grants of $ 1,880 ) (Revenue $ 7,426,025 )
INDEPENDENT AND ASSISTED LIVING: HOLY CROSS VILLAGE AT NOTRE DAME (HOLY CROSS VILLAGE) PROVIDES A COMPREHENSIVE SELECTION OF RESIDENTIAL LIVING OPTIONS SUPPORTED BY A FULL CONTINUUM OF ON-SITE HEALTH CARE. INDEPENDENT LIVING RESIDENTS ENJOY AN ACTIVE LIFESTYLE, COMPLEMENTED BY SUPERIOR SERVICES AND AMENITIES. PLUS, THEY HAVE THE ASSURANCE OF ON-SITE QUALITY HEALTH CARE, IF EVER NEEDED, AT AN AFFORDABLE, PREDICTABLE COST. (CONTINUED IN SCHEDULE O)
4b (Code:   ) (Expenses $ 4,665,917 including grants of $ 1,069 ) (Revenue $ 4,355,346 )
SKILLED NURSING AND MEMORY CARE: HOLY CROSS VILLAGE IS LICENSED BY THE STATE DEPARTMENT OF HEALTH AS A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) AND A SKILLED NURSING FACILITY. SERVICES ARE RESIDENT-CENTERED AND ARE FOCUSED ON LONG-TERM HEALTH CARE NEEDS AND/OR DIRECTED TO INDIVIDUALS THAT ARE RECOVERING FROM A BRIEF ILLNESS AND NEED TO REBUILD STRENGTH. (CONTINUED IN SCHEDULE O)
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 12,868,761
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part I....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part II...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III ....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements.
20b
 
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................
23
 
No
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2...........
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
165
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
153
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
12
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
IN
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JANET TODD
54515 STATE ROAD 933 NORTH
NOTRE DAME,IN465560303
(574) 287-1838
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) BR JOHN MAY CSC
SECRETARY
 1.00 X   X       0 0 0
(2) THOMAS CASSADY JR
CHAIRPERSON
 1.00 X   X       0 0 0
(3) BR CHESTER FREEL CSC
DIRECTOR
 1.00 X           0 0 0
(4) BR JAMES VAN DYKE CSC
DIRECTOR
 1.00 X           0 0 0
(5) BR MARK KNIGHTLEY CSC
DIRECTOR
 1.00 X           0 0 0
(6) CONNIE MCCAHILL
DIRECTOR
 1.00 X           0 0 0
(7) KATHLEEN BRICKLEY
DIRECTOR
 1.00 X           0 0 0
(8) PAT CRESSY
DIRECTOR
 1.00 X           0 0 0
(9) PERRY WATSON III
DIRECTOR
 1.00 X           0 0 0
(10) RICHARD HILMAN
DIRECTOR
 1.00 X           0 0 0
(11) SR RUTH MARIE NICKERSON CSC
DIRECTOR
 1.00 X           0 0 0
(12) TOM VELDMAN
DIRECTOR
 1.00 X           0 0 0
(13) JANET TODD
CONTROLLER
 65.00     X       63,277 0 8,607
(14) JOHN MAUCH
PRESIDENT/CEO
 50.00     X       0 0 0






Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 63,277 0 8,607
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
 
No
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SODEXO INC AND AFFILIATES
4880 PAYSPHERE CIRCLE
CHICAGO,IL60674 		DINING SERVICES 1,647,845
FRANCISCAN SISTERS OF CHICAGO SERVICE CORP
1055 W 175TH ST STE 202
HOMEWOOD,IL60430 		MANAGEMENT/OTHER SERVICES 680,730
ALLIANCE REHAB INC
1520 KENSINGTON RD SUITE 110
OAKBROOK,IL60523 		THERAPY SERVICES 305,069
NORTH AMERICA ADMINISTRATORS
1826 ELM HILL PIKE
NASHVILLE,IN37210 		ADMINISTRATION OF SELF-FUNDED EMPLOYEE HEALTH INSURANCE PLAN 211,050
TALBOOM LAWNCARE-LANDSCAPE INC
26981 KLINE TRAIL
SOUTH BEND,IN46614 		LAWNCARE/LANDSCAPING SERVICES 144,733
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet6
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 1,115
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		28,611
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 29,726
Program Service Revenue Business Code
2a INDEPENDENT AND ASSISTED LIVING 623,000 7,426,025 7,426,025    
b NURSING SERVICES 623,000 4,355,346 4,355,346    
c
d
e
f All other program service revenue . 0 0 0 0
g Total. Add lines 2a–2f........MediumBullet 11,781,371
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 162,645     162,645
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 12,317  
b Less: rental expenses    
c Rental income or (loss) 12,317 0
d Net rental income or (loss).......MediumBullet 12,317     12,317
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 1,171,788 0
b Less: cost or other basis and sales expenses 1,177,787 -2,756
c Gain or (loss) -5,999 2,756
d Net gain or (loss)..........MediumBullet -3,243     -3,243
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a HOUSEKEEPING/MAINTENANCE CONTRACTS 811,000 473,010   473,010  
b DINING/CAFETERIA/SNACK SHOP 900,099 66,142     66,142
c PURCHASE DISCOUNTS 900,099 10,497     10,497
d All other revenue .... 6,079 0 0 6,079
e Total. Add lines 11a–11d ......MediumBullet 555,728
12 Total revenue. See Instructions....MediumBullet 12,538,544 11,781,371 473,010 254,437
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 2,949 2,949
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 114,915   114,915  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 33,405 33,405    
7 Other salaries and wages 3,414,489 2,869,273 545,216  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 71,500 61,005 10,495  
9 Other employee benefits ....... 832,171 686,423 145,748  
10 Payroll taxes ........... 258,641 211,387 47,254  
11 Fees for services (non-employees):        
a Management ...... 480,400   480,400  
b Legal ......... 63,205   63,205  
c Accounting ........... 51,964   51,964  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 2,548,623 2,307,940 240,683  
12 Advertising and promotion .... 75,947   75,947  
13 Office expenses ....... 1,376,971 1,197,822 179,149  
14 Information technology ...... 8,078   8,078  
15 Royalties .. 0      
16 Occupancy ........... 716,978 656,281 60,697  
17 Travel ............ 22,518 6,441 16,077  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 12,145 5,311 6,834  
20 Interest ........... 1,631,160 1,631,160    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 3,358,534 2,994,589 363,945  
23 Insurance .............. 156,490 114,731 41,759  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a BAD DEBT EXPENSE 45,833 45,833    
b DUES AND SUBSCRIPTIONS 20,313 3,366 16,947  
c RECRUITMENT, TRAINING AND DEVELOPMENT 33,842 7,275 26,567  
d UNIFORMS 8,120 7,977 143  
e
f All other expenses 64,328 25,593 38,735 0
25 Total functional expenses. Add lines 1 through 24f 15,403,519 12,868,761 2,534,758 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720). 0      
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 2,310,324 1 1,584,054
2 Savings and temporary cash investments ....... 2,686,435 2 4,677,439
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 1,197,095 4 648,108
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 34,913 8 42,079
9 Prepaid expenses and deferred charges ............ 58,015 9 29,781
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 56,226,956
b Less: accumulated depreciation. ..... 10b 15,835,720 43,100,053 10c 40,391,236
11 Investments—publicly traded securities .......... 7,297,901 11 6,661,791
12 Investments—other securities. See Part IV, line 11 ...... 1,137,443 12 1,201,944
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 3,354,153 15 3,536,319
16 Total assets. Add lines 1 through 15 (must equal line 34)... 61,176,332 16 58,772,751
Liabilities 17 Accounts payable and accrued expenses . 1,210,517 17 1,186,013
18 Grants payable ..........   18  
19 Deferred revenue .......... 112,003 19 81,414
20 Tax-exempt bond liabilities .......... 27,989,724 20 27,578,476
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 26,838,791 25 27,538,901
26 Total liabilities. Add lines 17 through 25..... 56,151,035 26 56,384,804
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 3,837,854 27 1,136,003
28 Temporarily restricted net assets ..... 1,187,443 28 1,251,944
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 5,025,297 33 2,387,947
34 Total liabilities and net assets/fund balances ..... 61,176,332 34 58,772,751
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
12,538,544
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
15,403,519
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
-2,864,975
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
5,025,297
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
227,625
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
2,387,947
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2011)
Additional Data


Software ID: 11000230
Software Version: v2011.1.0
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
HOLY CROSS VILLAGE AT NOTRE DAME INC
 
Employer identification number

35-2084623
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
f
g
(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
(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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . 867,294 651,534 678,610 1,104,179 29,726 3,331,343
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...... 7,804,818 10,903,589 11,660,683 11,155,862 11,781,371 53,306,323
3 Gross receipts from activities that are not an unrelated trade or business under section 513.. 116,255 163,861 730,690 19,003,064 82,718 20,096,588
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. 8,788,367 11,718,984 13,069,983 31,263,105 11,893,815 76,734,254
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.. 0 0 0 0 0 0
8 Public Support (Subtract line 7c from line 6.)           76,734,254
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6... 8,788,367 11,718,984 13,069,983 31,263,105 11,893,815 76,734,254
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 470,444 169,782 126,177 198,379 174,962 1,139,744
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.           0
c Add lines 10a and 10b. 470,444 169,782 126,177 198,379 174,962 1,139,744
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. 0 0 0 0 0 0
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) 0 0 0 102,029 0 102,029
13 Total support (Add lines 9, 10c, 11 and 12.). 9,258,811 11,888,766 13,196,160 31,563,513 12,068,777 77,976,027
14
Section C. Computation of Public Support Percentage
15
15
98.410 %
16
16
98.420 %
Section D. Computation of Investment Income Percentage
17
17
1.460 %
18
18
1.430 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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
OTHER INCOME, SCHEDULE A, PART III, LINE 12, DESCRIPTION - MANAGEMENT CONTRACTS, COLUMN A - 0, COLUMN B - 0, COLUMN C - 0, COLUMN D - 102029, COLUMN E - 0, COLUMN F - 102029;,
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID: 11000230
Software Version: v2011.1.0
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
HOLY CROSS VILLAGE AT NOTRE DAME INC
 
Employer identification number

35-2084623
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 75,835 65,229 57,995 0
b Contributions ........     0 60,000
c Net investment earnings, gains, and losses ... 1,441 12,328 8,715 -2,005
d Grants or scholarships ..... 3,511 1,722 1,481 0
e Other expenditures for facilities
and programs ........ 		    0 0
f Administrative expenses ....     0 0
g End of year balance ...... 73,765 75,835 65,229 57,995
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet0 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
Yes
 
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................     0
b Buildings ................   36,692,654 8,140,855 28,551,799
c Leasehold improvements ............   3,865,632 1,870,472 1,995,160
d Equipment ................   15,397,858 5,824,393 9,573,465
e Other .................   270,812   270,812
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 40,391,236
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DEFERRED MARKETING COSTS 2,016,397
(2) DEFERRED BOND ISSUANCE COSTS 970,635
(3) DUE FROM AFFILIATE - BROTHERS OF HOLY CROSS 465,404
(4) DUE FROM AFFILIATE - HOLY CROSS COLLEGE 83,883





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 3,536,319
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
REFUNDABLE AND UNEARNED ENTRANCE FEES 25,883,560
DUE TO AFFILIATE - HOLY CROSS VILLAGE FOUNDATION 915,400
RESIDENT DEPOSITS 519,500
ACCRUED INTEREST PAYABLE 203,507
CAPITAL LEASE OBLIGATION 16,934




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 27,538,901
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 12,538,544
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 15,403,519
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 -2,864,975
4 Net unrealized gains (losses) on investments .......................... 4 123,208
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8 104,417
9 Total adjustments (net). Add lines 4 through 8 ......................... 9 227,625
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -2,637,350
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 13,163,768
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 123,208
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d 502,016
e Add lines 2a through 2d ..................... 2e 625,224
3 Subtract line 2e from line 1..................... 3 12,538,544
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b 0
c Add lines 4a and 4b....................... 4c 0
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 12,538,544
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 15,403,519
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d 0
e Add lines 2a through 2d...................... 2e 0
3 Subtract line 2e from line 1..................... 3 15,403,519
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b 0
c Add lines 4a and 4b....................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 15,403,519
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Intended uses of endowment funds Schedule D, Part V, Line 4 ENDOWMENT FUNDS ARE HELD BY THE COMMUNITY FOUNDATION OF ST. JOSEPH COUNTY FOR THE BENEFIT OF HOLY CROSS VILLAGE AT NOTRE DAME. THE ENDOWMENT FUNDS ARE INTENDED TO PROVIDE FUNDING TO SUPPORT HOLY CROSS VILLAGE AT NOTRE DAME'S MISSION AND TAX-EXEMPT PURPOSE.
FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE ORGANIZATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. U.S. GAAP REQUIRES THAT A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. DUE TO ITS TAX-EXEMPT STATUS, THE ORGANIZATION IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE ORGANIZATION'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF INDIANA FOR THE LAST THREE YEARS. THE ORGANIZATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE ORGANIZATION RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT JUNE 30, 2012 OR 2011.
Schedule D (Form 990) 2011

Additional Data


Software ID: 11000230
Software Version: v2011.1.0




Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
HOLY CROSS VILLAGE AT NOTRE DAME INC
 
Employer identification number
35-2084623
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A ST JOSEPH COUNTY INDIANA
  		35-6000194 790608CR2 03-30-2006 36,701,276 CONSTRUCT AND EQUIP NEW FACILITY   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 8,990,000      
2 Amount of bonds legally defeased . . . . . . . . . . 0      
3 Total proceeds of issue . . . . . . . . . . . . . 38,722,533      
4 Gross proceeds in reserve funds . . . . . . . . 1,997,932      
5 Capitalized interest from proceeds . . . . . . . . . . 3,917,764      
6 Proceeds in refunding escrows . . . . . . . . . . . 0      
7 Issuance costs from proceeds . . . . . . . . . . . 722,500      
8 Credit enhancement from proceeds . . . . . . . . . . 204,125      
9 Working capital expenditures from proceeds . . . . . . . 0      
10 Capital expenditures from proceeds . . . . . . . . . . 32,039,432      
11 Other spent proceeds . . . . . . . . . . . 0      
12 Other unspent proceeds . . . . . . . . . . . 0      
13 Year of substantial completion . . . . . . . . . . . 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . .   X            
15 Were the bonds issued as part of an advance refunding issue? . . . .   X            
16 Has the final allocation of proceeds been made? . . . . . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X            
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . X              
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X              
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   X            
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.0000%   %   %   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.0000%   %   %   %
6 Total of lines 4 and 5 . . .. . . . . . . . . 0.0000%   %   %   %
7 Does the bond issue meet the private security or payment test? . . . X              
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X            
2 Is the bond issue a variable rate issue? X              
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X              
b Name of provider . . . . . . . . ALLIED IRISH BANKS PLC NEW YORK BRANCH
  		 
  		 
  		 
 
c Term of hedge . . . . . . . . 2.5      
d Was the hedge superintegrated? . . . .   X            
e Was a hedge terminated? . . . . .   X            
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . X              
b Name of provider . . . . . . AIG MATCHED FUNDING CORPORATION
  		 
  		 
  		 
 
c Term of GIC . . . . . . . 4.3      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . . X              
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X            
6 Did the bond issue qualify for an exception to rebate? .   X            
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X            
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
TOTAL PROCEEDS OF ISSUE PART II, LINE 3 PROCEEDS OF ISSUE - $36,701,276 INVESTMENT EARNINGS ON PROCEEDS - $2,021,257
TERM OF HEDGE PART IV, LINE 3C TERM OF 2006E HEDGE - 2.5 YEARS TERM OF 2006D HEDGE - 3.5 YEARS
Schedule K (Form 990) 2011

Additional Data


Software ID: 11000230
Software Version: v2011.1.0

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
HOLY CROSS VILLAGE AT NOTRE DAME INC
 
Employer identification number

35-2084623
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) BARBARA CASSADY
  		SPOUSE (THOMAS CASSADY, JR.) IS A BOARD MEMBER 35,242 EMPLOYEE COMPENSATION   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID: 11000230
Software Version: v2011.1.0




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.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
HOLY CROSS VILLAGE AT NOTRE DAME INC
 
Employer identification number

35-2084623
Identifier Return Reference Explanation
ORGANIZATION'S MISSION (CONTINUED FROM PART III) FORM 990, PART III, LINE 1 HOLY CROSS VILLAGE AT NOTRE DAME WAS ESTABLISHED AS A FAITH-BASED, NON-PROFIT ORGANIZATION AND HAS SINCE DEDICATED ITSELF TO PROVIDING HOUSING, HEALTH CARE AND SUPPORT SERVICES EXCLUSIVELY TO OLDER ADULTS IN WAYS THAT PROMOTE INDEPENDENCE AND A HEALTHY, ACTIVE LIFESTYLE THROUGH A CONTINUING CARE RETIREMENT COMMUNITY. HOLY CROSS VILLAGE IS NORTHERN INDIANA'S PREMIER CONTINUING CARE RETIREMENT COMMUNITY. OFFERING RESIDENTIAL LIVING, LIFELONG LEARNING AND SECURITY FOR THE FUTURE, HOLY CROSS VILLAGE IS THE PERFECT RETIREMENT OPTION FOR THOSE SEEKING AN ACTIVE, INDEPENDENT LIFESTYLE WITH SERVICES AND AMENITIES TO KEEP THE MIND, BODY AND SPIRIT YOUNG. THE ORGANIZATION STRIVES TO: - ENHANCE THE QUALITY OF SENIORS' LIVES THROUGH WELLNESS PROGRAMS AND ENGAGING LIFELONG LEARNING ACTIVITIES; - PROVIDE THE HIGHEST QUALITY OF LIVING AND PERSONAL CARE WHILE RESPECTING THE RESIDENTS' INDIVIDUAL DIGNITY AND RIGHT TO PERSONAL CHOICE; - PROVIDE A HOME-LIKE ATMOSPHERE THAT ALLOWS RESIDENTS TO ENJOY THE ADVANTAGES OF COMMUNITY LIVING WITHOUT COMPROMISING THEIR INDIVIDUALITY, DIGNITY OR PRIVACY; AND - WORK TO CREATE A MODEL OF SUCCESSFUL AGING THAT ENHANCES EVERY PERSON'S POTENTIAL AND LESSENS THE EFFECTS OF GETTING OLDER.
INDEPENDENT AND ASSISTED LIVING (CONTINUED FROM PART III) FORM 990, PART III, LINE 4A HOLY CROSS VILLAGE IS AN INTERDEPENDENT COMMUNITY ENERGIZED BY HOLY CROSS SPIRITUALITY AND HOSPITALITY, AND DEDICATED TO PROVIDING A NURTURING ENVIRONMENT FOCUSED ON DIGNITY AND RESPECT. HOLY CROSS VILLAGE GOES BEYOND WHAT'S EXPECTED TO OFFER A LIFESTYLE THAT ALLOWS RESIDENTS TO LIVE AS INDEPENDENTLY AS POSSIBLE, WHILE STAYING CLOSE TO FAMILY, FRIENDS, AND THE BEST CARE AVAILABLE. RESIDENTS HAVE PEACE OF MIND KNOWING THEIR FUTURES ARE SECURE, WHICH IS SOMETHING THEY WILL VALUE AS MUCH TODAY AS THEY WILL TOMORROW. HOLY CROSS VILLAGE IS ALSO A LICENSED ASSISTED LIVING COMMUNITY, AND OUR ASSISTED LIVING APARTMENTS ALLOW FOR PRIVACY AND INDEPENDENCE. IF RESIDENTS REQUIRE ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, OUR COMPREHENSIVE RANGE OF SUPPORTIVE SERVICES IS DESIGNED TO FIT THEIR NEEDS, AND OUR CARING STAFF IS AVAILABLE 24 HOURS A DAY TO ASSIST THEM. DURING THE YEAR ENDED JUNE 30, 2012, THE ORGANIZATION PROVIDED SERVICES TO 179 RESIDENTS IN AN INDEPENDENT LIVING SETTING WITH 152 APARTMENTS AND VILLAS, AS WELL AS 52 RESIDENTS IN AN ASSISTED LIVING SETTING WITH 46 APARTMENTS.
SKILLED NURSING AND MEMORY CARE (CONTINUED FROM PART III) FORM 990, PART III, LINE 4B REHABILITATION SERVICES ARE DELIVERED IN A RESIDENT-CENTERED PROGRAM THAT IS FOCUSED ON ACHIEVING POSITIVE OUTCOMES. RESIDENTS RECEIVE 24-HOUR NURSING SUPERVISION AND RESTORATIVE THERAPIES THAT ARE PHYSICIAN DIRECTED. THE ONSITE REHABILITATION CENTER DELIVERS PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES AS WELL AS OTHER SPECIALIZED SERVICES TO MEET REHABILITATION NEEDS. MEMORY CARE ACCOMMODATIONS ARE OFFERED IN A SECURED ENVIRONMENT DESIGNED TO MEET THE NEEDS OF SENIORS WITH ALZHEIMER'S, DEMENTIA AND OTHER MEMORY LOSS. INDIVIDUALS WHO NEED HELP WITH DAY-TO-DAY LIVING RECEIVE SPECIAL ENCOURAGEMENT TO ADD MEANING AND FULFILLMENT TO THEIR LIVES. SERVICES ARE TAILORED SPECIFICALLY TO EACH RESIDENT WHILE SUPPORTING A HEALTHY LIFESTYLE IN A SECURED AREA THAT HAS ACCESS TO A COURTYARD AND VIEWS OF A WOODED AREA. CERTIFIED NURSING ASSISTANTS PROVIDE STANDBY AND HANDS ON ASSISTANCE WITH BATHING, GROOMING AND ESCORTS. RESIDENTS ARE ENCOURAGED TO CONTINUE ACTIVITIES THEY LOVE AND ENJOY. A WIDE RANGE OF LIFE ENRICHING ACTIVITIES ARE PLANNED FOR RESIDENTS EACH DAY THAT ARE TARGETED TO RAISE SPIRITS, STIMULATE MINDS AND PROMOTE HAPPINESS. DURING THE YEAR ENDED JUNE 30, 2012, THE ORGANIZATION PROVIDED SERVICES TO 105 RESIDENTS IN A NURSING SETTING WITH 36 BEDS AND A NURSING DEMENTIA CENTER WITH 12 ROOMS.
Delegate broad authority to a committee Form 990, Part VI, Section A, Line 1a THE BOARD, BY RESOLUTION OF A MAJORITY OF THE DIRECTORS THEN IN OFFICE, MAY APPOINT ONE OR MORE STANDING OR SPECIAL COMMITTEES AS NEEDED. THE BOARD SHALL APPOINT THE EXECUTIVE COMMITTEE, WHICH SHALL BE A STANDING COMMITTEE. MEMBERS OF THE BOARD COMMITTEES SHALL BE APPOINTED BY THE BOARD OR BY THE CHAIRPERSON, SUBJECT TO THE APPROVAL OF THE BOARD. EACH COMMITTEE AUTHORIZED TO EXERCISE ANY POWER OF THE BOARD (AS OPPOSED TO MERELY ADVISORY COMMITTEES) SHALL HAVE AT LEAST TWO (2) DIRECTORS AND MAY CONSIST OF PERSONS OTHER THAN DIRECTORS, PROVIDED THAT AT LEAST A MAJORITY OF SUCH COMMITTEE MEMBERS ARE DIRECTORS. THE EXECUTIVE COMMITTEE SHALL BE A STANDING COMMITTEE, AND SHALL HAVE AND MAY EXERCISE ALL POWERS OF THE BOARD (SUBJECT TO THE LIMITATIONS SET FORTH IN THE ORGANIZATION'S BYLAWS) BETWEEN MEETINGS OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON, PRESIDENT AND TWO OTHER DIRECTORS SELECTED BY THE CHAIRMAN, SUBJECT TO THE APPROVAL OF THE BOARD. ACTIONS DULY TAKEN BY THE EXECUTIVE COMMITTEE WITHIN THE SCOPE OF ITS AUTHORITY SHALL BE CONSIDERED THE ACTIONS OF THE BOARD.
Delegation of management duties Form 990, Part VI, Section A, Line 3 THE ORGANIZATION HAD A MANAGEMENT AGREEMENT WITH THE FRANCISCAN SISTERS OF CHICAGO SERVICE CORPORATION (FSCSC), AN UNRELATED TAX-EXEMPT ORGANIZATION THAT IS A FULL-SERVICE MANAGEMENT ORGANIZATION OF THE FRANCISCAN SISTERS OF CHICAGO. FSCSC ASSUMED MANAGERIAL DUTIES OF THE HOLY CROSS VILLAGE ON OCTOBER 1, 2004. FSCSC OVERSAW ALL OPERATIONS AND PROVIDED THE ORGANIZATION'S PRESIDENT/CEO. THE AGREEMENT WAS EFFECTIVE THROUGH FEBRUARY 2011 AND WAS RENEWED ON MARCH 1, 2011 FOR A TERM OF ONE YEAR. THE AGREEMENT WAS NOT REVEWED AFTER EXPIRATION IN FEBRUARY 2012. HOWEVER, AFTER THE EXPIRATION OF THE MANAGEMENT AGREEMENT, THE ORGANIZATION EXTENDED THE CONTRACT FOR ASSISTANCE WITH SYSTEMS CONVERSIONS.
Significant changes to organizational documents Form 990, Part VI, Section A, Line 4 THE ORGANIZATION'S BYLAWS WERE AMENDED TO: - ADD AND EXPAND THE RESERVED POWERS OF THE MEMBER; - DESIGNATE ADDITIONAL EX-OFFICIO MEMBERS OF THE BOARD; - DESIGNATE THAT AT LEAST 25% OF THE BOARD SHALL BE MEMBERS OF THE CONGREGATION OF HOLY CROSS; - ADD AND CLARIFY RESPONSIBILITIES OF THE BOARD FOR WHICH THE MEMBER MUST BE CONSULTED; - CLARIFY APPOINTMENT OF THE PRESIDENT AND OTHER OFFICERS; - CHANGE THE CHAIRPERSON'S TERM OF OFFICE FROM THREE YEARS TO TWO YEARS; AND - INCREASE THE SIZE OF THE EXECUTIVE COMMITTEE FROM TWO VOTING MEMBERS TO THREE VOTING MEMBERS.
Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE BROTHERS OF HOLY CROSS, A RELATED TAX-EXEMPT ORGANIZATION, IS THE SOLE CORPORATE MEMBER OF HOLY CROSS VILLAGE AT NOTRE DAME, INC .
Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a THE BROTHERS OF HOLY CROSS, THE ORGANIZATION'S SOLE MEMBER, HAS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS, INCLUDING THE CHAIRPERSON.
Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b THE BROTHERS OF HOLY CROSS, THE ORGANIZATION'S SOLE MEMBER, HAS THE FOLLOWING ADDITIONAL RESERVED POWERS: 1. TO REVIEW AND CONSULT WITH THE HCV BOARD ON ANY CHANGES TO OR DEVIATIONS FROM THE MISSION AND VALUES OF HCV AND TO APPROVE ANY SUCH CHANGES OR DEVIATIONS. 2. TO APPROVE THE CORPORATION'S ANNUAL AND CAPITAL BUDGETS AND SIMILAR DOCUMENTS DEVELOPED BY THE BOARD. 3. TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION, BYLAWS AND SIMILAR GOVERNING DOCUMENTS OF THE CORPORATION. 4. TO APPOINT AND REMOVE DIRECTORS TO THE BOARD. 5. TO APPOINT AND REMOVE THE CHAIRPERSON AND THE PRESIDENT BASED UPON RECOMMENDATIONS OF THE HCV BOARD. 6. TO APPROVE ANY MERGER, CONSOLIDATION, DISSOLUTION OR LIQUIDATION OF THE CORPORATION. 7. TO APPROVE THE PURCHASE, SALE, DONATION, LEASE, MORTGAGE, OR ANY OTHER ACQUISITION, DISPOSITION OR ENCUMBRANCE OF ANY ASSETS OF THE CORPORATION, EXCEPT WITH RESPECT TO TRANSACTIONS WITHIN LIMITS DELEGATED TO THE CORPORATION, OR SPECIFICALLY APPROVE AS PART OF A STRATEGIC AND FINANCIAL PLAN OF THE CORPORATION. 8. TO APPROVE THE ESTABLISHMENT, TERMINATION, TRANSFER OR OTHER ACQUISITION OR DISPOSITION OF ANY MAJOR MINISTRY, WORK OR SIMILAR PROGRAM BY HCV. 9. TO APPROVE THE CREATION OF ANY NEW AFFILIATE OR ANY AFFILIATION OF THE CORPORATION WITH ANOTHER ENTITY. 10. TO APPROVE THE INCURRENCE OF INDEBTEDNESS, THE MAKING OF LOANS TO OTHER ENTITIES OR THE GUARANTY OF ANY INDEBTEDNESS OF OTHERS, BY THE CORPORATION, FOR AMOUNTS IN EXCESS OF THE MEMBER-SPECIFIED LIMITS, EXCEPT WITH RESPECT TO TRANSACTIONS SPECIFICALLY APPROVED AS PART OF A STRATEGIC AND FINANCIAL PLAN OF THE CORPORATION. 11. TO ESTABLISH DOLLAR LIMITS BELOW WHICH THE CORPORATION MAY AUTHORIZE FINANCIAL EXPENDITURES, INCLUDING CONTRACTS INVOLVING SUCH EXPENDITURES. 12. TO ESTABLISH DOLLAR LIMITS BELOW WHICH THE CORPORATION MAY AUTHORIZE LITIGATION SETTLEMENTS OR ANY RELEASE OR CANCELLATION BY THE CORPORATION OF A CLAIM OR RIGHT OF ACTION AGAINST ANOTHER PARTY.
Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THE ORGANIZATION'S MANAGEMENT REVIEWED A DRAFT OF THE FORM 990 IN DETAIL. A FINAL DRAFT OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, ALONG WITH A MANAGEMENT SUMMARY WAS THEN PRESENTED TO THE ORGANIZATION'S FINANCE COMMITTEE IN JANUARY 2013. A COPY OF THE FULL FORM 990 AND MANAGEMENT SUMMARY WAS THEN PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS IN FEBRUARY 2013 FOR REVIEW PRIOR TO ITS FILING WITH THE IRS.
Conflict of interest policy Form 990, Part VI, Section B, Line 12c THE SECRETARY OF THE BOARD OF DIRECTORS DISTRIBUTES THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, WHICH INCLUDES A CONFLICT OF INTEREST QUESTIONNAIRE, TO THE BOARD MEMBERS ANNUALLY. THE SECRETARY COLLECTS AND REVIEWS THE COMPLIANCE QUESTIONNAIRE FORMS FOR ANY POTENTIAL CONFLICTS OF INTEREST. IF ANY ACTUAL CONFLICTS OF INTEREST ARE DETERMINED TO EXIST, THE BOARD MEMBER IS RECUSED FROM VOTING ON THE CONFLICTING ISSUE. IN ADDITION, A REVIEW OF THE CONFLICT OF INTEREST POLICY AND COMPLETION OF A COMPLIANCE QUESTIONNAIRE IS PART OF EVERY EMPLOYEES' ANNUAL REVIEW. THIS ANNUAL REVIEW IS DONE BY THE INDIVIDUAL'S DIRECT SUPERVISOR AND THE HUMAN RESOURCE DIRECTOR.
PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS FORM 990, PART VI, LINE 15 DURING THE TIME THE ORGANIZATION'S MANAGEMENT AGREEMENT WAS IN AFFECT, COMPENSATION FOR THE ORGANIZATION'S PRESIDENT/CEO WAS PAID BY THE ORGANIZATION'S MANAGEMENT COMPANY, FRANCISCAN SISTERS OF CHICAGO SERVICE CORPORATION (FSCSC), WHICH IS AN UNRELATED ORGANIZATION. SUBSEQUENT TO EXPIRATION OF THE MANAGEMENT AGREEMENT WITH FSCSC, THE ORGANIZATION'S PRESIDENT/CEO WAS PAID DIRECTLY BY THE ORGANIZATION. IN APRIL 2010, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF HOLY CROSS VILLAGE ENGAGED MERCER, A NATIONAL HR CONSULTING FIRM, TO CONDUCT AN ANALYSIS OF THE CURRENT COMPENSATION OF THE POSITIONS OF PRESIDENT/CEO, TREASURER/CONTROLLER, AND DIRECTOR OF CAMPUS OPERATIONS. MERCER ANALYZED DATA FROM FIVE MAJOR NATIONAL COMPENSATION SURVEYS AS WELL AS REGIONAL DATA. IN JULY 2010, MERCER PRESENTED ITS FINDINGS TO THE EXECUTIVE COMMITTEE. THOSE FINDINGS CONCLUDED THAT THE CURRENT BASE COMPENSATION OF THE THREE POSITIONS SUBJECT TO THIS STUDY WERE WITHIN THE RESPECTIVE PAY RANGES DEVELOPED BY MERCER BASED UPON THE SURVEY DATA WHICH IT HAD UTILIZED AND, THUS, SATISFIED THE CONDITION OF REBUTTABLE PRESEUMPTION OF REASONABLENESS. THE EXECUTIVE COMMITTEE ACCEPTED THE REPORT BY MERCER. IN ADDITION, THE ORGANIZATION'S HUMAN RESOURCES (HR) DEPARTMENT ESTABLISHES A MERIT-BASED COMPENSATION MATRIX THAT PROVIDES FOR ANY INCREASES TO BASE COMPENSATION FOR ALL EMPLOYEES, INCLUDING THE ORGANIZATION'S OFFICERS. THE MATRIX IS NOT REVIEWED OR APPROVED BY THE BOARD OF DIRECTORS. HOWEVER, THE BOARD'S APPROVAL OF THE ORGANIZATION'S OVERALL ANNUAL BUDGET, WHICH INCLUDES THE BUDGET FOR SALARIES AND BENEFITS, IS TAKEN INTO CONSIDERATION WHEN THE HR DEPARTMENT DEVELOPS THE MATRIX.
Governing documents, conflict of interest policy and financial statements available to the public 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, EITHER IN PRINTED OR PDF COPY, UPON REQUEST
Average number of hours devoted per week to related organization Form 990, Part VII, Section A, Column B JANET TODD - DEVOTES APPROXIMATELY ONE HOUR PER WEEK TO HOLY CROSS VILLAGE FOUNDATION, INC., A RELATED TAX-EXEMPT ORGANIZATION. BR. JOHN MAY, CSC - DEVOTES APPROXIMATELY ONE HOUR PER WEEK TO HOLY CROSS VILLAGE FOUNDATION, INC., A RELATED TAX-EXEMPT ORGANIZATION. JOHN MAUCH - DEVOTES APPROXIMATELY ONE HOUR PER WEEK TO HOLY CROSS VILLAGE FOUNDATION, INC., A RELATED TAX-EXEMPT ORGANIZATION.
COMPENSATION PAID BY UNRELATED MANAGEMENT COMPANY FORM 990, PART VII, SECTION A, LINE 1A CALENDAR YEAR 2011 COMPENSATION FOR THE ORGANIZATION'S PRESIDENT/CEO WAS PAID BY THE ORGANIZATION'S MANAGEMENT COMPANY, FRANCISCAN SISTERS OF CHICAGO SERVICE CORPORATION (FSCSC), WHICH IS AN UNRELATED ORGANIZATION. ACCORDING TO THE IRS INSTRUCTIONS FOR PART VII, ONLY COMPENSATION FROM A MANAGEMENT COMPANY THAT PROVIDES SERVICES TO THE ORGANIZATION AND IS A RELATED ORGANIZATION MUST BE REPORTED IN PART VII. THUS, SINCE THE ORGANIZATION'S MANAGEMENT COMPANY IS AN UNRELATED ORGANIZATION, NO COMPENSATION HAS BEEN REPORTED FOR THE PRESIDENT/CEO IN PART VII.
Other changes in net assets or fund balances Form 990, Part XI, Line 5 NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 123208; CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION - 502016; TRANSFER TO BROTHERS OF HOLY CROSS - -397599;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID: 11000230
Software Version: v2011.1.0
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
HOLY CROSS VILLAGE AT NOTRE DAME INC
 
Employer identification number

35-2084623
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) BROTHERS OF HOLY CROSS INC

54515 SR 933 N PO BOX 460

NOTRE DAME,IN46556
35-0868938 		ROMAN CATHOLIC CHURCH RELIGIOUS ORDER IN 501(C)(3) 11 NA
 
 
No
(2) HOLY CROSS VILLAGE FOUNDATION

54515 SR 933 N PO BOX 303

NOTRE DAME,IN46556
26-3861889 		SUPPORT HOLY CROSS VILLAGE AT NOTRE DAME IN 501(C)(3) 11 - Type II BROTHERS OF HOLY CROSS
 
 
No










For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership












Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
Yes
 
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID: 11000230
Software Version: v2011.1.0