TY 2012 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) STEPHEN CHINN........................................................................ DIRECTOR/CHAIRMAN	1.0 .......................0.0	X	X		0	0	0
(2) ROBERT PIEPHO PHD........................................................................ DIRECTOR/VICE-CHAIRMAN	1.0 .......................1.0	X	X		0	0	0
(3) WANDA CHINNERY........................................................................ DIRECTOR/SECRETARY	1.0 .......................1.0	X	X		0	0	0
(4) CAROL EVANS........................................................................ DIRECTOR	1.0 .......................0.0	X			0	0	0
(5) LARRY CROZIER........................................................................ DIRECTOR	1.0 .......................1.0	X			0	0	0
(6) DENISE MCNERNEY........................................................................ DIRECTOR	1.0 .......................0.0	X			0	0	0
(7) CHUCK ROBB........................................................................ DIRECTOR	1.0 .......................0.0	X			0	0	0
(8) GEORGE RUSSELL........................................................................ DIRECTOR	1.0 .......................0.0	X			0	0	0
(9) DANIEL REXROTH........................................................................ PRESIDENT	40.0 .......................2.0		X		379,163	0	23,908
(10) RICHARD KIM KLOCKENGA........................................................................ VP OF FINANCE & TREASURER	40.0 .......................2.0		X		142,364	0	8,660
(11) RODNEY MCBRIDE........................................................................ VP-HEALTH & COMMUNITY SERVICES	40.0 .......................0.0		X		194,958	0	12,641
(12) BETTY FREEMAN-BOOTS........................................................................ VP OF HUMAN RESOURCES	40.0 .......................0.0		X		138,377	0	26,994
(13) MARIA TIMBERLAKE........................................................................ VP OF SENIOR LIVING	40.0 .......................0.0		X		145,018	0	19,915
(14) JAMES FRANKLIN-RETIRED 6212........................................................................ VP OF FINANCE & TREASURER	40.0 .......................1.0		X		139,935		4,607
(15) DONNA BARRON........................................................................ ASSISTANT SECRETARY	40.0 .......................		X		43,407	0	9,698
(16) JULIA MAHONY........................................................................ COMMUNITY HEALTH SVCS ADMIN	40.0 .......................0.0			X	119,359	0	2,525
(17) DAVID MERCIER........................................................................ VCC ADMINISTRATOR	40.0 .......................0.0			X	117,296	0	20,494

(A) Name and business address	(B) Description of services	(C) Compensation
AEGIS THERAPIES,	CONTRACT THERAPY	2,810,593
GLYNNDEVINS INC,	ADVERTISING	760,267
HARMON FLOOR COVERING INC,	CONSTRUCTION	488,547
WELLNESS INNOVATIONS NURSING,	STAFFING	461,497
LARRY HARKRADER,	CONSTRUCTION	257,178
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 18

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	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	69,578	69,578
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 ....	1,537,172	1,403,691	133,481
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	28,573,643	26,092,438	2,481,205
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	259,836	237,273	22,563
9	Other employee benefits .......	3,531,853	3,225,163	306,690
10	Payroll taxes ...........	2,406,471	2,236,173	170,298
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	218,364		218,364
c	Accounting ...........	69,991		69,991
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	1,015,322		1,015,322
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	3,402,250	3,390,951	11,299
12	Advertising and promotion ....	1,139,838	1,139,838
13	Office expenses .......	3,958,214	3,598,168	360,046
14	Information technology ......	492,065	26,955	465,110
15	Royalties ..	0
16	Occupancy ...........	4,119,968	3,194,525	925,443
17	Travel ............	1,447,591	1,321,103	126,488
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	54,651	54,651
20	Interest ...........	2,744,732	2,590,632	154,100
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	8,115,925	7,640,446	475,479
23	Insurance ..............	1,286,694	1,214,454	72,240
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	1,837,007	1,837,007
b	MEDICAID TAX	1,513,154	1,513,154
c	BAD DEBT EXPENSE	995,544	995,544
d	DUES & SUBSCRIPTIONS	152,737	148,002	4,735
e	All other expenses	385,280	5,158	380,122
25	Total functional expenses. Add lines 1 through 24e	69,327,880	61,934,904	7,392,976	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 if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	0	1	0
2	Savings and temporary cash investments .........	3,208,638	2	3,516,720
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	5,654,672	4	5,593,744
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	474,987	8	496,488
9	Prepaid expenses and deferred charges ..........	670,537	9	913,228
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	194,306,554
b	Less: accumulated depreciation .....	10b	115,642,082	82,080,835	10c	78,664,472
11	Investments—publicly traded securities ..........	31,644,484	11	28,650,904
12	Investments—other securities. See Part IV, line 11 .....	8,692,119	12	10,716,064
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	4,505,871	15	4,296,286
16	Total assets. Add lines 1 through 15 (must equal line 34)......	136,932,143	16	132,847,906
	17	Accounts payable and accrued expenses .........	7,629,197	17	7,479,202
18	Grants payable .................	0	18	0
19	Deferred revenue ................	49,752,551	19	49,323,710
20	Tax-exempt bond liabilities .............	54,625,925	20	52,878,733
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	6,373,386	23	6,976,461
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
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....................	3,881,909	25	4,043,883
26	Total liabilities. Add lines 17 through 25.........	122,262,968	26	120,701,989
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	14,669,175	27	12,145,917
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	14,669,175	33	12,145,917
34	Total liabilities and net assets/fund balances ........	136,932,143	34	132,847,906

- TIN:

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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

JOHN KNOX VILLAGE

Employer identification number

23-7365138

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	503,516	363,362	160,708	240,855	186,210	1,454,651
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......	59,755,323	58,000,684	59,531,966	59,760,998	60,078,740	297,127,711
3	Gross receipts from activities that are not an unrelated trade or business under section 513..						0
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.	60,258,839	58,364,046	59,692,674	60,001,853	60,264,950	298,582,362
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...	0	0	0	0		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	0	0	0		0
c	Add lines 7a and 7b..	0	0	0	0		0
8	Public support (Subtract line 7c from line 6.)						298,582,362

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
9	Amounts from line 6...	60,258,839	58,364,046	59,692,674	60,001,853	60,264,950	298,582,362
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	1,505,287	732,569	1,536,203	1,610,341	1,420,720	6,805,120
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.						0
c	Add lines 10a and 10b.	1,505,287	732,569	1,536,203	1,610,341	1,420,720	6,805,120
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.			17,163	1,040	53,919	72,122
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..	2,720,389	2,948,604	3,541,667	3,318,612	3,491,692	16,020,964
13	Total support. (Add lines 9, 10c, 11, and 12.)..	64,484,515	62,045,219	64,787,707	64,931,846	65,231,281	321,480,568

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

92.877 %

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

92.775 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

2.117 %

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

2.410 %

19a

33 1/3% support tests—2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2012

Name of the organization

JOHN KNOX VILLAGE

Employer identification number

23-7365138

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 2

Name of organization JOHN KNOX VILLAGE

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 3

Name of organization JOHN KNOX VILLAGE

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Page 4

Name of organization
JOHN KNOX VILLAGE

Employer identification number

23-7365138

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

JOHN KNOX VILLAGE

Employer identification number

23-7365138

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2012

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2012

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

2,560

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Total. Add lines 1c through 1i ...............................

2,560

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule C (Form 990 or 990EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

2012

Open to Public Inspection

Name of the organization

JOHN KNOX VILLAGE

Employer identification number

23-7365138

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, 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.

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 XIII, the text of the footnote to its financial statements that describes these items.

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

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:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	1,594,795	1,612,013	1,460,712	2,194,249	2,574,110
b	Contributions ........	84,454	5,364	150,887	30,428	363,356
c	Net investment earnings, gains, and losses	91,224	67,936	102,705	3,608	-352,272
d	Grants or scholarships .....		0	0	0	0
e	Other expenditures for facilities and programs ........	53,014	90,518	102,291	767,573	327,580
f	Administrative expenses ....		0	0	0	63,365
g	End of year balance ......	1,717,459	1,594,795	1,612,013	1,460,712	2,194,249

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

12.840 %

Permanent endowment SchDMd Bullet

85.700 %

Temporarily restricted endowment SchDMd Bullet

1.460 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII 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		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	5,623,592		5,623,592
b	Buildings ................	146,512,717	87,761,357	58,751,360
c	Leasehold improvements ............
d	Equipment ................	29,540,432	22,227,835	7,312,597
e	Other .................	12,629,813	5,652,890	6,976,923
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				78,664,472

Schedule D (Form 990) 2012

Page 3

Part VII

InvestmentsOther 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
(3)Other (A) JKV REDEVELOPMENT	1,000	C
(B) ALTERNATIVE INVESTMENTS	10,715,064	F







Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	10,716,064

Part VIII

InvestmentsProgram 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.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
ASSET RETIREMENT OBLIGATION		4,043,883








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		4,043,883
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	67,550,659
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	785,626
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	1,390,445
e	Add lines 2a through 2d .....................			2e	2,176,071
3	Subtract line 2e from line 1.....................			3	65,374,588
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 XIII.) ...........	4b	192,521
c	Add lines 4a and 4b.......................			4c	192,521
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	65,567,109

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........			1	69,912,329
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 XIII.) ............	2d	654,027
e	Add lines 2a through 2d......................			2e	654,027
3	Subtract line 2e from line 1.....................			3	69,258,302
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 XIII.) ............	4b	69,578
c	Add lines 4a and 4b.......................			4c	69,578
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	69,327,880

Part XIII

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
ENDOWMENT FUNDS	SCHEDULE D, PART V, LINE 4	THE ENDOWMENT FUNDS ARE HELD AT THE JOHN KNOX VILLAGE FOUNDATION FOR THE BENEFIT OF JOHN KNOX VILLAGE. RESIDENT FINANCIAL ASSISTANCE ENDOWMENT FUND (PERMANENT ENDOWMENT): INVESTMENT INCOME IS USED TO PROVIDE SLIDING SCALE ASSISTANCE TO HELP RESIDENTS WITH THEIR MONTHLY SERVICE FEES. JOHN KNOX VILLAGE ENDOWMENT FUND (PERMANENT ENDOWMENT): INVESTMENT INCOME IS USED BY TRUSTEES FOR PROJECTS OR PROGRAMS WHERE THERE ARE INSUFFICIENT DONOR RESTRICTED FUNDS OR NO DONOR RESTRICTED FUNDS AT ALL FOR THE PROJECT OR PROGRAM. TRUSTEE DESIGNATED ENDOWMENT FUNDS (BOARD DESIGNATED QUASI-ENDOWMENT): BY POLICY, ONE HALF OF UNRESTRICTED ESTATE GIFTS ARE DESIGNATED BY THE TRUSTEES, FOR LONG-RANGE, LARGER PROJECTS OR INITIATIVES. INVESTMENT INCOME FROM THOSE FUNDS ARE USED FOR CURRENT PROJECTS OR PROGRAMS. DONOR RESTRICTED FUNDS (TERM ENDOWMENT): USED TO FUND THE PROJECT OR PROGRAM STIPULATED BY THE DONOR AT THE TIME THEY MAKE THE GIFT.
UNCERTAIN TAX POSITIONS DISCLOSURE	SCHEDULE D, PART X, LINE 2	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
RECONCILIATION OF REVENUES	SCHEDULE D, PART XI, LINE 2D	RELATED PARTY REVENUE $ 808,536 ELIMINATIONS (188,568) CHANGE IN VALUE OF FDA 451,887 LOSS ON SALE OF FIXED ASSET 318,590 ---------- TOTAL $ 1,390,445
RECONCILIATION OF REVENUES	SCHEDULE D, PART XI, LINE 4B	RELATED ORGANIZATION TRANFER FOR FIXED ASSET $ 122,943 RESIDENTIAL FINANCIAL ASSISTANCE 69,578 ---------- TOTAL $ 192,521
RECONCILIATION OF EXPENSES	SCHEDULE D, PART XII, LINE 2D	EXPENSES FROM RELATED ORGANIZATION $ 542,327 ELIMINATIONS (206,890) LOSS ON SALE OF FIXED ASSET 318,590 --------- TOTAL $ 654,027
RECONCILIATION OF EXPENSES	SCHEDULE D, PART XII, LINE 4B	RESIDENTIAL FINANCIAL ASSISTANCE $ 69,578

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization
JOHN KNOX VILLAGE

Employer identification number

23-7365138

Part I

General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of the grants or

assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used to award

the grants or assistance? ...................................

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in region
	Central America and the Caribbean	Investments	10,129,703
















3a	Sub-total .....		10,129,703
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)		10,129,703

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012

Schedule F (Form 990) 2012

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .... MediumBullet

Enter total number of other organizations or entities ....................... MediumBullet

Schedule F (Form 990) 2012

Schedule F (Form 990) 2012Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2012

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2012

Page 5

Part V

Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	ReturnReference	Explanation

Schedule F (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization
JOHN KNOX VILLAGE

Employer identification number
23-7365138

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2012

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant
(1) RESIDENTIAL FINANCIAL ASSISTANCE	23	69,578

Part IV

Supplemental Information.

Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Identifier	Return Reference	Explanation
PROCESS FOR MONITORING THE USE OF GRANTS IN THE U.S.	SCHEDULE I, PART I, LINE 2	JOHN KNOX VILLAGE HAS A BOARD APPROVED RESIDENT ASSISTANCE POLICY WHICH OUTLINES THE APPLICATION AND PROCESS FOR THE ASSISTANCE. THE POLICY IS REVIEWED AND UPDATED ANNUALLY AS NEEDED. RESIDENTS REQUESTING FINANCIAL ASSISTANCE COMPLETE A QUESTIONNAIRE THAT IS REVIEWED BY THE VP OF FINANCE OF JOHN KNOX VILLAGE. THE VILLAGE POSSESSES DOCUMENTATION THAT SHOWS THE FUNDS WERE EXPENDED FOR THE INTENDED PURPOSE.

Schedule I (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

JOHN KNOX VILLAGE

Employer identification number

23-7365138

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)DANIEL REXROTHPRESIDENT	(i) (ii)	293,201 0	25,051 0	60,911 0	6,363 0	17,545 0	403,071 0
(2)RICHARD KIM KLOCKENGAVP OF FINANCE & TREASURER	(i) (ii)	109,527 0	19,200 0	13,637 0	0 0	8,660 0	151,024 0
(3)RODNEY MCBRIDEVP-HEALTH & COMMUNITY SERVICES	(i) (ii)	163,579 0	10,763 0	20,616 0	4,444 0	8,197 0	207,599 0
(4)BETTY FREEMAN-BOOTSVP OF HUMAN RESOURCES	(i) (ii)	111,197 0	8,392 0	18,788 0	3,286 0	23,708 0	165,371 0
(5)MARIA TIMBERLAKEVP OF SENIOR LIVING	(i) (ii)	120,988 0	7,569 0	16,461 0	3,570 0	16,345 0	164,933 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Identifier	Return Reference	Explanation

Schedule J (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

2012

Open to Public
Inspection

Name of the organization
JOHN KNOX VILLAGE

Employer identification number
23-7365138

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	THE INDUSTRIAL DEVEL AUTHORITY OF THE CITY OF LS	43-1255189	524292AL3	05-24-2007	58,019,157	SEE SUPPLEMENTAL INFORMATION		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	2,940,000
2 Amount of bonds legally defeased . . . . . . . . . . .	0
3 Total proceeds of issue . . . . . . . . . . . . . .	58,927,328
4 Gross proceeds in reserve funds . . . . . . . . . . . .	4,937,945
5 Capitalized interest from proceeds . . . . . . . . . . .	373,621
6 Proceeds in refunding escrows . . . . . . . . . . . .	0
7 Issuance costs from proceeds . . . . . . . . . . . .	880,930
8 Credit enhancement from proceeds . . . . . . . . . . .	0
9 Working capital expenditures from proceeds . . . . . . . . .	0
10 Capital expenditures from proceeds . . . . . . . . . . .	27,615,041
11 Other spent proceeds . . . . . . . . . . . . . .	26,324,598
12 Other unspent proceeds . . . . . . . . . . . . . .	0
13 Year of substantial completion . . . . . . . . . . . .	2010
	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 Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2012

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? . . . . . . . . . . . . . . . .
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 . .	0.00000%		%		%		%
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 . . . . . . .	0.00000%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0.00000%		%		%		%
7 Does the bond issue meet the private security or payment test? . . . . .	X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.	0.00000%		%		%		%
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X
9 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 the issuer filed Form 8038-T? . . . . .		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X
b Exception to rebate? . . . . . . . .
c No rebate due? . . . . . . . . . .
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . . .	0
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . . . .
e Was a hedge terminated? . . . . . . .

Schedule K (Form 990) 2012

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .	X
b Name of provider . . . . . . . . .	SEE SCH K PART VI
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .	X
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 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?	X

Part VI

Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation
DESCRIPTION OF PURPOSE	SCHEDULE K, PART I, LINE A, COLUMN F	- IMPROVEMENTS TO SENIOR LIVING FACILITIES $26,526,489 - NEW SENIOR LIVING FACILITY $1,351,493 - REFUND 1995 BONDS (ORIGINALLY ISSUED ON 9/1/1995) - REFUND 1999 BONDS (ORIGINALLY ISSUED ON 10/15/1999) - REFUND 2002 BONDS (ORIGINALLY ISSUED ON 5/22/2002)
TOTAL PROCEEDS OF ISSUE	SCHEDULE K, PART II, LINE 3	ADDITIONAL PROCEEDS ARE DUE TO INVESTMENT EARNINGS DURING THE PROJECT PERIOD.
CAPITALIZED INTEREST FROM PROCEEDS	SCHEDULE K, PART II, LINE 5	INVESTMENT EARNINGS ON THE DSR AND COI FUND DURING THE PROJECT PERIOD WERE ALLOCATED TO PAY INTEREST ON THE BONDS.
OTHER SPENT PROCEEDS	0	OTHER PROCEEDS WERE SPENT TO REFUND THE FOLLOWING BONDS: - REFUND 1995 BONDS (ORIGINALLY ISSUED ON 9/1/1995) - REFUND 1999 BONDS (ORIGINALLY ISSUED ON 10/15/1999) - REFUND 2002 BONDS (ORIGINALLY ISSUED ON 5/22/2002)
GROSS PROCEEDS INVESTED IN GIC	SCHEDULE K, PART, IV, LINES 4B & C	GROSS PROCEEDS IN THE DEBT SERVICE RESERVE FUND WERE INVESTED IN TWO GUARANTEED INVESTMENT CONTRACTS. NAME OF PROVIDERS & TERM OF GUARANTEED INVESTMENT CONTRACTS: - WACHOVIA BANK, NATIONAL ASSOCIATION (TERM: 17.7 YEARS) - THIS FORWARD DELIVERY AGREEMENT WAS TRANSFERRED TO THE DEBT SERVICE RESERVE FUND FROM THE 1995 BONDS. - BEAR STERNS CAPITAL MARKETS, INC. (TERM: 25.2 YEARS)

Schedule K (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

JOHN KNOX VILLAGE

Employer identification number

23-7365138

Identifier	Return Reference	Explanation
ORGANIZATION'S MISSION	FORM 990, PART III, LINE 1	JOHN KNOX VILLAGE IS ORGANIZED FOR THE PURPOSE OF PROVIDING RESIDENCES, HEALTH CARE, AND RELATED SERVICES TO SENIOR CITIZENS WITHIN A COMMUNITY SETTING. THE VILLAGE OFFERS VARIOUS SERVICES THROUGHOUT THE RESIDENT'S LIFE TO PROMOTE THE WELL BEING OF THE RESIDENT AS WELL AS A SENSE OF COMMUNITY AMONG ALL RESIDENTS.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	FORM 990, PART III, LINES 4A, B & C	Successful businesses thrive in healthy communities. That's why many organizations, like John Knox Village, are challenging themselves to make an even greater impact in the areas where they conduct business through their community involvement efforts. Although monetary donations are significant, it's the power of the people - our skills and talents - that really make a difference. Village associates and residents who share their time and expertise make a positive impact within the communities where they live, work, worship, volunteer, etc. It's not only the right thing to do - it's a business strategy that means success for our organization. John Knox Village is dedicated to helping to build stronger and more vibrant communities. It is a commitment we live out each day as part of our mission of "enriching lives, building community." But this tenet involves more than just the people who live and work at John Knox Village; it includes the people and organizations we serve throughout the entire Kansas City Metropolitan through our various lines of business. What's more, this commitment enables the Village to remain a leading provider of services and care to older adults, as well as a source of support for their families. In addition to providing quality care and services to seniors, the Village provides a diverse array of dependable services, such as catering, banquet facilities and more, to members of the outside community - offerings that enable a diverse array of people to benefit from the Village's offerings. Because of the Village's size, diverse array of services, amenities and offerings, we are able to allocate multiple resources toward our community involvement commitments. We share facilities, facilitate the giving of resident and associate time and talents, offer leadership and/or modest financial support to community-based organizations, share entertainment and promote education and intergenerational activities. In turn, the Village benefits greatly. - We are making strides in achieving the Village's mission, vision and values by enriching the lives of residents, associates and members of the surrounding community. - We are strengthening the Village's position as a valuable community resource and leader. - We are heightening awareness of and understanding about John Knox Village. - We are enhancing the image of John Knox Village and breaking down stereotypes about aging and older adults. - We are generating interest in residency at or use of John Knox Village services. - We are promoting John Knox Village as a good place to live, work and conduct business with. - We are reinforcing the appropriateness of our not-for-profit status. The Village's community involvement initiative extends beyond volunteering and/or donating goods and services. We are taking steps to become a more sustainable, earth-friendly organization. What better way to make a positive impression on the communities we touch than by minimizing our carbon footprint for future generations? This report is more than a just a showcase of the Village's generosity and our long-standing commitment to community involvement. It's the story of our efforts to make a greater impression in the communities we are involved in. The Village's community involvement efforts enrich the lives of thousands of individuals - all of who are potential supporters, customers, residents or associates of our organization. We are proud of our accomplishments and excited about future community involvement prospects. ABOUT JOHN KNOX VILLAGE - ONE OF THE LARGEST CONTINUING CARE RETIREMENT COMMUNITIES IN THE NATION - NOT-FOR-PROFIT ORGANIZATION 501(C)(3), RUN BY A NINE-MEMBER VOLUNTEER BOARD OF DIRECTORS - MISSION: TO ENRICH THE LIVES OF OLDER ADULTS THROUGH COMMUNITY LIVING - FOUNDED IN 1970 - LOCATED ON MORE THAN 400 ACRES IN LEE'S SUMMIT, MO., WITH HOME HEALTH OFFICES IN OVERLAND PARK, KS. - SERVES ABOUT 1,800 RESIDENTS ON ITS CAMPUS AND ABOUT 3,000 COMMUNITY MEMBERS ANNUALLY WHO LIVE THROUGHOUT THE GREATER KANSAS CITY AREA - ACCREDITED BY CARF-CCAC, THE INTERNATIONAL ACCREDITATION BODY FOR CONTINUING CARE RETIREMENT COMMUNITIES - WITH ABOUT 1,000 ASSOCIATES ON STAFF, THE VILLAGE IS ONE OF THE LARGEST EMPLOYERS IN LEE'S SUMMIT AND THE GREATER KANSAS CITY AREA, ACCORDING TO SURVEYS PUBLISHED BY THE KANSAS CITY BUSINESS JOURNAL, KANSAS CITY'S INGRAM'S MAGAZINE AND LEADINGAGE. INDEPENDENT LIVING: RESIDENTS CAN ENJOY MAINTENANCE-FREE LIVING WHILE LIVING IN FREESTANDING HOMES, VILLAS AND APARTMENTS. ON-SITE AMENITIES INCLUDE: ART STUDIO; LIBRARY; BEAUTY SALONS; MEETING AND BANQUET ROOMS; BOWLING ALLEY; NATURE TRAILS AND PARK; CHAPEL AND PRAYER ROOM; 9-HOLE EXECUTIVE GOLF COURSE; COMPUTER CENTER; FITNESS CENTER; CONVENIENCE STORES; RESTAURANTS; ICE CREAM SHOP; 2,000-SEAT PAVILION; GUEST ROOMS; INDOOR AND OUTDOOR SWIMMING POOLS AND WHIRLPOOL; AND MORE. Village Helpers (formerly LifeStyle Services): Village Helpers offers in-home, private-duty care, including household assistance, personal care, companion visits, respite care and more. Village Home Health: With offices in both Lees Summit, Mo., and Overland Park, Kan., this Medicare certified home health agency provides intermittent skilled care as ordered by a physician. Our licensed health care professionals provide services to patients who live throughout the Greater Kansas City Area. Valley View Residential Care: Licensed by the state of Missouri, Valley View is a 119-unit residential care facility II. It offers 24-hour nursing, regular housekeeping, three meals a day, planned activities and more. Valley View Memory Care: Licensed by the state of Missouri, this assisted living facility provides a full range of services and a supportive and secure environment for residents with memory-related diseases. Available in two wings of the facility, it provides 24-hour nursing care and support staff; private and semiprivate rooms; secured entrances and monitoring systems in resident rooms; and more. Village Care Center: The Village Care Center is a 430-bed, freestanding skilled-nursing facility. It provides 24-hour licensed nursing services, an Alzheimers unit, a Medicare-certified rehabilitation unit and short-term, in-patient hospice care. Village Hospice of John Knox Village: Village Hospice provides comfort-oriented services to individuals with life-limiting illnesses and their loved ones in their homes. The agency is licensed and certified by the state of Missouri and Medicare. Home For Life Solutions: Home for Life Solutions provides an innovative personal response system that is ideal for people who face physical or memory challenges. The simple technology tools allow individuals continue to live in the comfort of their own homes.
CIVIC ENGAGEMENT		Civic engagement is an umbrella term used to describe how community service, political activity, activism and advocacy can enhance the lives of individuals who give of their time to the communities in which they live and work. Chamber of Commerce/Economic Development John Knox Village's ongoing involvement in the Lee's Summit Chamber of Commerce has included both leadership and financial support. Management representatives have consistently served on various chamber committees and in officer positions. Currently, Vice President of Health and Community Services Rodney McBride is serving on the board of directors. The Village also offers financial and organizational support to chamber events. Finally, 27 JKV associates have participated in Leadership Lee's Summit, a nine-month program designed to educate and build community leaders. JKV President/CEO Dan Rexroth serves as an advisor to the Lee's Summit Economic Development Council. Civic/Community Organizations Many John Knox Village community members are involved in a variety of worthwhile athletic, charitable, civic, church, school and organizations that are located throughout Lee's Summit and the rest of the Greater Kansas City Area. Although not sponsored or facilitated by John Knox Village, such involvement indirectly - yet positively - reflects on the Village. In addition, these organizations also benefit from the leadership, intellectual capital and other contributions by Village associates, residents and board members. The following list includes examples of the diversity of organizations in which JKV community members have been involved. Boy Scouts of America, Center for Practical Bioethics, Citizen's Advisory Committee, Girl Scouts of the USA, Heartland Men's Chorus, Humane Society, Indian Association of Kansas City, Junior Achievement of Middle America Inc., Kannada Sangha of Kansas City, Kansas City Chamber of Commerce, Lee's Summit Optimists, Lee's Summit Chamber of Commerce, Lee's Summit Economic Development Council, Lee's Summit Character Council, Lee's Summit Sunrise Rotary Club, Lee's Summit R-7 School District, Mayor's Health Education Advisory Board, Raymore Historical Society, Sunset Garden Club, United Way Review Board and Workforce Investment Board, Water Utilities Community Action Group, and Lee's Summit Sustainability Committee. John Knox Village President/CEO Dan Rexroth strongly believes in giving back to the community. He is an active member of multiple professional and community-based organizations, including the Board of Directors of the Greater Lee's Summit Healthcare Foundation (member); Board of Directors of the Palestine Economic Development Corporation (member); Board of Directors of Caring Communities Insurance Company (chair); Lee's Summit Civic Roundtable (member); Board of Directors of Overland Park Regional Medical Center (member); Board of Directors of Olivet Nazarene University Foundation (member); Board of Directors for the Mid-American Nazarene University (member); and Advisory Board for the Lee's Summit Economic Development Council (member). Political Participation John Knox Village residents actively participate in political activities, issues, campaigns and voting. They frequently invite and host elected officials and candidates to speak to resident groups and occasionally organize letter-writing campaigns on issues important to them. From time to time, the Village provides support to these efforts. The Village also leases space to the Jackson County Board of Election Commissioners for two voting precincts. Residents readily volunteer to man those polling places as well as voting sites located outside the Village campus. During fiscal year 2013, several elected officials held events on the campus of John Knox Village, including Lt. Gov. Peter Kinder, Sen. Will Kraus and Rep. Gary Dusenburg. Furthermore, several John Knox Village associates have been active in advocating for older adults and services for seniors, as well as acting as industry advocates in both state and national arenas. Public Safety Emergency Management John Knox Village's Public Safety Department (which includes Dispatch, Transportation, Security, Emergency Medical Services and Emergency Management Services) provides services to Village residents and associates, as well as to members of the outside community. The Village's ability and willingness to provide assistance helps take financial and staffing strains off stressed city and state programs. During emergency situations that occur outside the Village campus, John Knox Village Public Safety can allocate resources and man-power to assist city and state response efforts without adversely affecting the safety or well being of people on the Village campus. A series of partnerships with a variety of local, state, regional and national public service organizations has enabled the JKV Public Safety department to assist with security, emergency service administration and more. Public Safety's partnerships include: Lee's Summit Emergency Services (police, fire department), local hospitals, local care facilities, Jackson County Emergency Management, Jackson County Health Department, Missouri Department of Health and Senior Services, (Missouri) State Emergency Management Agency, Federal Emergency Management Agency and Homeland Security - to name a few. JKV Public Safety provides many services to Lee's Summit and surrounding communities. Examples include: -Safety: Security patrols at community events such as Lee's Summit Downtown Days. -Education: Partnered with the Lee's Summit Police Department to host a "Prescription Take Back" event for Village residents and members of the surrounding community. -Transport: Non-emergency transport of patients between hospitals as well as local care facilities. -Mutual Aid: In addition to assisting the residents of John Knox Village, Public Safety has mutual aid agreements with the cities of Lee's Summit, Mo., and Raytown, Mo. With the agreement, when the need arises to respond to an emergency within city limits, John Knox Village Public Safety services can help out. What's more, the Village is a member of a Kansas City metropolitan-wide emergency preparedness group, so if a city or region-wide emergency were to occur, the Village would be able to assist after first assisting its own community members - residents and associates. - Emergency Preparedness Activities: Activities include developing plans and analysis; fostering relationships with city, state and national organizations, such as the fire department, the Jackson County Health Department and the American Red Cross; continuing education and training for associates; communication; and conducting exercises, such as fire drills, to test our response time and planning. Being prepared enables the Village to better respond to and assist with emergencies both on campus and within the community. Members of the public safety staff participate in a variety of industry associations, including the Missouri Ambulance Association, Missouri Emergency Medical Services Association, Mid America Regional Council Emergency Response, American Ambulance Association and International Police Mountain Bike Association. Finally, staff members also are active in political groups, such as Missouri State Region A EMS Committee and the Lee's Summit Livable Streets Advisory Committee.
Corporate and Community Philanthropy		John Knox Village offers modest financial support to organizations that host events or provide services that have measurable social impact within the community and/or support older adults. The Village has three categories of giving. -Corporate giving helps build awareness of the Village and integrates the organization into the local community. Examples of corporate giving in fiscal year 2013 include financial support of the Lee's Summit Parks and Recreation baseball league; the Lee's Summit Chamber of Commerce golf tournament; Downtown Lee's Summit's Piccadilly Gala; Lee's Summit Chamber of Commerce Oktoberfest; Lee's Summit Educational Foundation events; and others. -Community giving helps make Lee's Summit and surrounding communities stronger. Examples include donations to support the Lee's Summit city-wide Martin Luther King Celebration, Lee's Summit CARES, Hope House, Lee's Summit Social Services, Alzheimer's Association and others. -Workplace giving enables generous people to give back. What's more, John Knox Village has been a long-time United Way supporter. In addition to raising funds that make a critical difference in the Greater Kansas City Area, members of the JKV community have the opportunity to contribute to national organizations, such as the Alzheimer's Association and Alex's Lemonade Stand. Cultural Offerings/Special Events John Knox Village hosts and sponsors a number of special events each year that are open to members of the Village community and surrounding areas. These activities are a way to share resources and allow people to have a positive experience on the Village campus. -JKV music concerts by choral and instrumental groups. -Free concerts included performances by the American Legion Band, United States Air Force Jazz Band: Shades of Blue, Kansas City Metro Area Men's Chorus Festival, Kansas City Wind Symphony, and New Horizons Concert Band. -The John Knox Village Community Theatre, which is a group of Village resident volunteers, produces free, twice-a-year productions. -A Mission Fair was held, which enabled missionaries and outreach organizations to teach and information members of the communication about their ministries. -Valley View Residential Care/Memory Care hosted a Memory Screening and Education session that was open to members of the surrounding community. In addition to learning more about memory and exercises individuals can do to help retain it, nurses gave memory screening tests. Donation of John Knox Village Facilities and Equipment Classrooms/Meeting Spaces/Tours Because of its centralized location and the availability of meeting room space, several organizations offer classes/seminars/meetings on the Village campus. Classroom/meeting space was donated to the Missouri League of Nursing; Jackson County Legislature; Lee's Summit Chamber of Commerce; National Association of Health Care Assistants; and more. During fiscal year 2013, the value of the donated classroom/meeting space was nearly $16,000. Notable events that were held on campus during FY13 include the following: -Working with the partnership formed between Jackson County, MARC, KCATA and the City of Kansas City, the Village hosted two open house/educational sessions about a proposal to use the old Rock Island Rail Line through Lee's Summit as part of an upgraded metro area transit system. -Lee's Summit Police Department is using the Calvin Community West apartment building, which is no longer used as a residence and has been shut down to the general public, to train K-9 units. Residents often are involved in civic/church/retiree groups not affiliated with the Village and at times have invited these groups to hold meetings on the Village campus. The Village also regularly hosts tours of the campus for area schools, churches, Scout troops, business groups, etc. The aforementioned efforts help position John Knox Village as a good community resource and enable the organization to break down stereotypes about aging, retirement communities and John Knox Village in particular. The Pavilion at John Knox Village John Knox Village donates its special event venue, The Pavilion at John Knox Village, multiple times a year. Many of these events offer entertainment that might not otherwise be available if the appropriate space wasn't available. In other cases, important community meetings and programs are enhanced because of the amenities and services provided by The Pavilion's staff. In fiscal year 2013 The Village donated the venue multiple times at a value of nearly $50,000 (figure based on current rental rates). -Lee's Summit R-7 School District's Partners In Education Banquet -Lee's Summit R-7 Partners in Education Student Showcase -Lee's Summit Journal's Senior Ball -Lee's Summit Mayor's Outreach Breakfast for Community of Character -Lee's Summit Chamber of Commerce annual banquet -Lee's Summit Martin Luther King Tribute -Downtown Lee's Summit Piccadilly Gala -Hospice Volunteer Coordinator's Symposium -CLAIM Medicare Enrollment event -Prescription Drug Take Back Event -Multiple events in partnership with the Mid-Continent Library -Concern Cares of Lee's Summit
Surplus Equipment		John Knox Village donates obsolete equipment or supplies to other not-for-profit organizations. The Village has donated maintenance/construction/HVAC items to Habitat for Humanity and repurposed cell phones to Lee's Summit Hope House. Local schools and children's camps also have benefited from surplus supplies that can be used for classroom projects and/or activities. In addition, the Village has also donated items to nursing homes, churches and child care facilities. (It should be noted that donations to the Thrift Shop are the most-frequent outlets for these materials, allowing nominal funds to stay within the John Knox Village organization.) Education John Knox Village offers a variety of educational opportunities for people of all ages and skill levels that enhance the lives and careers of Village community members as well as members of the outside community. Auxiliary Scholarship Program The John Knox Village Auxiliary Health Care Career Scholarship Committee annually awards more than $10,000 worth of health care scholarships to John Knox Village associates, family members of Village associates and family members of Village residents. Recipients are students pursuing studies in a health care related vocational/technical program at a college or university. Emergency Training Institute The John Knox Village Emergency Training Institute is a training entity established within the John Knox Village Emergency Medical Services Department. It has been providing continuing education units of credit (CEUs) for paramedics and emergency medical technicians since it was established and accredited in June 2006. The institute's initial emergency medical training and our training facility accredits continuing units of education provided by physicians and other EMS specialists from the Missouri State EMS Region A committee. The institute has provided several favorable outcomes for both the Village and the community. In addition to training much-needed emergency medical providers for the community, the Village was able to hire multiple individuals who have successfully completed the classes. Lee's Summit R-7 School District Involvement John Knox Village supports the Lee's Summit R-7 School District in a variety of ways. -Partners in Education: John Knox Village has been involved with the Lee's Summit School District's Partners in Education (PIE) program for more than 20 years. In addition to the educational opportunities for both the students and residents, PIE activities have provided positive media coverage. Village associates are actively involved in the program administration, and The Pavilion is donated to the school district for the Partners in Education Banquet, an event that is held to recognize and thank R-7 School District business partners. -Voting: It is important to note that residents actively support the Lee's Summit schools by voting in favor of bond and levy issues. Intergenerational: John Knox Village residents helped students multiple times through the year with their coursework and extracurricular activities. A group of former educators, engineers and other professionals met regularly with a group of 5th and 6th graders from Trailridge Elementary. The students participate in an afterschool robotics club called FIRST Lego League. FIRST (For Inspiration and Recognition of Science and Technology) enables students to use science, technology, engineering and math to complete a series of challenges. Each year the students are assigned a challenge and compete in meets. The challenge they worked on: Senior Solutions. Mentoring Program In 2001, John Knox Village began a mentoring program in conjunction with the University of Missouri-Kansas City School of Medicine to provide an experiential setting for first- and second-year medical students to interact with "well elderly" JKV residents. Through conversations and social events, future doctors more fully understand the normal processes of aging and are able to eliminate negative stereotypes. The mentoring program also teaches the students how to relate to people as a whole person, not just a patient. By emphasizing communication and listening skills, the program has helped to shape an entire generation of physicians by making them more sensitive to issues affecting older adults and helping them become listeners and more effective communicators. In 2003, the mentoring program won the Distinguished Service Award through LeadingAge Missouri. The program received national attention in 2004 by being chosen for the Community Service Award through the LeadingAge. Health Care Education John Knox Village is involved in beneficial clinical education partnerships with multiple schools. These relationships have enabled hundreds of students who are studying health care to benefit from the hands-on, real-world experiences. -Students from the Metropolitan Community Colleges (which includes Longview Community College; Penn Valley Community College; Maple Woods Community College; Business and Technology; and Blue River), Brown Mackey College, the Metropolitan School of Nursing, Colorado Technical University, Cass Career Center and National American University have been seen around campus, especially at the Village Care Center. Student Internships Student internship programs are a win-win for everyone involved. Students can start using the skills they've acquired at school while gaining valuable work experience (both practical and for rsum enhancement). The Village benefits from the students' insights and enthusiasm. An added bonus: The Village is able to gauge the talents of a new generation of workers first-hand. Teaching A number of John Knox Village management team members have participated in periodic or ongoing teaching positions and/or serve on advisory committees at area colleges and universities including the University of Missouri-Kansas City School of Business, Central Missouri State University, Rockhurst University, Longview Community College and the University of Kansas.
Environment/Sustainability Efforts	Because it is important to our residents, associates and members of the	surrounding community, John Knox Village is making strides to become a more sustainable, earth-friendly organization. We are working to reduce our environmental impact through operational initiatives, energy conservation, recycling and waste management, and more. What's more, becoming better environmental stewards has forced us to become more conscious of how all our activities impact the environment. Recycling at the Village - 15 co-mingle bins throughout the campus - 1 glass recycling bin - 4 collection points for corrugated cardboard. All corrugated cardboard ends up at the warehouse where it is baled, stored and picked up when six bales are ready Other notable "green" efforts include: - Greater use of technology to cut down on printing and paper usage. - Investment in new equipment and lighting to reduce energy use. - Continued participation in the KCP&L Energy Optimizer program. Energy-reducing optimizer thermostats were installed in more than 400 independent living homes. - Incorporating native plants in landscaping, which require less water throughout the summer. - Increased promotion of the John Knox Village Auxiliary Thrift Shop as a way for members of the Lee's Summit community to recycle, reuse and repurpose items they no longer need. The Thrift Shop has been in the "recycling" business for more than 25 years. - Reduced the number of miles driven by the transportation vehicle fleet and business vehicles. - Installed 618 solar panels on the roofs of the Courtyard apartment buildings, Valley View and the Village Care Center. Together, the panels, which make up one of the largest fields of solar panels in the state of Missouri, produce about 180,000 kilowatt hours per year.
Industry Involvement		Membership and involvement in industry and professional organizations aid in building the knowledge and skills of John Knox Village associates, introducing new ideas to the organization and enabling Village associates to share expertise. John Knox Village is actively involved in LeadingAge Missouri and LeadingAge. Membership in both organizations enables Village leadership to remain informed of industry trends and innovations. Members of the management staff attend the state and national conferences, make presentations at these conferences, serve on state and national committees and hold positions of leadership. The Village's general and professional liability insurance company, Caring Communities Insurance Company (CCIC), shoulders the advanced risk management and quality healthcare responsibilities for many other not-for-profit continuing care retirement communities around the nation. John Knox Village was a pioneer in the establishment of this innovative risk-financing program. The Village has experienced significant savings because of the group, which enables it to better meet community involvement goals and commitments. Professional Involvement Most members of the JKV management team are involved in the local chapters of professional associations, and a number hold leadership roles at the local, state and national level. From time to time, association meetings are held on the Village campus or feature a John Knox Village associate as a speaker. Village associates are members or serve on the boards of a variety of industry associations, such as the Missouri Hospice and Palliative Care Association, National Hospice and Palliative Care Association, Missouri Alliance for Home Care, Professionals in Aging, Metropolitan Discharge Coordinators, Assisted Living Association of Kansas, the National Association of Home Care, Missouri Association of Nursing Home Administrators, Missouri League for Nursing, Institute to Transform Senior Life, and Full Employment Council/ Eastern Jackson County Workforce Investment Board, University of Missouri Human Resource Advisory Board, Certified Aging Services Professionals, Kansas City Compensation and Benefits Association, Activity Directors Association of Missouri, American Health Information Management Association, American Society of Safety Engineers, Association of Medical Staff Services, American Association of Nurse Assessment Coordinators, American Congress of Governmental Industrial Hygienists, Board of Certified Safety Professionals, Association of Energy Engineers, Dietary Managers Association, Funeral Consumer Alliance of Kansas City, Human Resources Management Association of Greater Kansas City, Healthcare Compliance Association, Healthcare Financial Management Association, American Society of Healthcare Risk Managers, Kansas City Regional Healthcare Materials Management Association, Activity Director Association of Missouri, American Society of Heating and Refrigeration, Missouri Association of Directors of Volunteer Service in Healthcare, Association of Professionals in Infection Control and Epidemiology, Inc., Association of Fundraising Professionals, Society for Human Resource Management, Group Leaders of America, Missouri Restaurant Association, Health Care Food Service Management, the Kansas City Chapter of International Society of Certified Employee Benefits Specialists, Missouri Area Hospitals and Auxiliaries, Culinary Advisors Board for the Olathe School District, the Kansas State Advisory Board for Hospitality Management, Missouri Area Volunteer Professional, Missouri Association Natural Gas Operators, American Association of Nurse Assessment Coordination; Hotel/Restaurant Advisory Board for University of Missouri; and and literally dozens more. Support Groups John Knox Village offers a variety of support groups that are open to members of both the Village and surrounding communities. During fiscal year 2013, the Village offered an Alzheimer's and Dementia Support Group, Low Vision Support Group, Parkinson's Support Group and Dealing with Loss Support Group. The organization also offers spiritual support groups for reading, prayer and discussion that are open to the public, some of which are led by community volunteers. JOHN KNOX VILLAGE AUXILIARY More than 139 Auxiliary volunteers help out in various capacities, such as running four convenience stores and a Thrift Shop that provide residents and members of the surrounding community convenient and easy ways to purchase an assortment of merchandise, from knick-knacks to clothing to food staples and everything in between. The five shops operated by the Auxiliary, which was named the Volunteer Program of the Year by LeadingAge Missouri, serve residents, associates and non-residents. Nearly 75 percent of the 150 average daily customers at the Thrift Shop live outside the Village. Some of the items donated to the Thrift Shop are passed on to multiple organizations around the area. The Auxiliary funded several notable projects throughout the fiscal year, including funds to purchase a new state-of-the-art ambulance for use in the Village and surrounding communities, and to help clean up the fishing lake, a notable and well-known feature in the Village campus. Since 1989, the John Knox Village Auxiliary has donated funds to Lee's Summit Social Services to purchase medical supplies for an area child through a program called "Our Child." Last year about $1,800 was contributed, with a portion of that amount being collected from simple cans placed on the counters of the various Auxiliary shops, beauty salons, and the Village's on-campus ice cream parlor. Additionally Thrift Shop volunteers hosted hot dog sales during the summer. See the "Education" section for information on the Auxiliary's Health Career Scholarships.
John Knox Village Board of Directors		Because good governance is vital in business, one of the most valuable assets the business community can offer is intellectual capital. Members of the John Knox Village Board of Directors are volunteers who offer insight and help make decisions about strategy, direction and mission. The board is made up of three resident and six non-resident members. Most board members are involved in a number of professional and civic organizations and are (or were - prior to retirement) prominent in their professions. The board members' involvement reflects well on John Knox Village, and their connections help spread the word about the Village. Examples of board members' community involvement including the following: Stinson, Morrison, Hecker, LLP board chair; Lee's Summit Economic Development Council, board member; Lee's Summit Chamber of Commerce, past board chair; Lee's Summit Municipal Building Authority, board member/treasurer; American Heart Association, board member; Parkinson's Foundation of the Heartland, board member; Truman Medical Center, board member; American College of Clinical Pharmacology, board member; the UMKC Pharmacy Foundation, board member; and many, many more.
BUSINESS RELATIONSHIPS	FORM 990, PART VI, SECTION A, LINE 2	DANIEL REXROTH, RICHARD KIM KLOCKENGA AND JAMES FRANKLIN HAVE A BUSINESS RELATIONSHIP. THEY SERVE AS AN OFFICER OR DIRECTOR FOR THE JOHN KNOX VILLAGE REDEVELOPMENT CORPORATION, WHICH IS A RELATED FOR PROFIT COMPANY. THE OFFICERS AND DIRECTORS DO NOT RECEIVE ANY COMPENSATION FROM OR HAVE ANY STOCK OWNERSHIP IN THE RELATED FOR PROFIT COMPANY.
MEMBERS	FORM 990, PART VI, SECTION A, LINE 6	PREMIERLIFE, A MISSOURI NONPROFIT CORPORATION, IS THE SOLE MEMBER OF JOHN KNOX VILLAGE. PREMIERLIFE IS DESIGNATED AS THE SOLE MEMBER SO LONG AS PREMIERLIFE SHALL CONTINUE TO QUALIFY AS A TAX EXEMPT, NONPROFIT ENTITY RECOGNIZED UNDER SECTION 501(C)(3) OF THE IRC. PREMIERLIFE HAS THE RIGHT TO ELECT THE MEMBERS OF JOHN KNOX VILLAGE'S GOVERNING BODY. PREMIERLIFE HAS THE RESERVED POWER TO APPROVE SIGNIFICANT DECISIONS OF JOHN KNOX VILLAGE'S GOVERNING BODY. PREMIERLIFE IS NOT ENTITLED TO RECEIVE A SHARE OF JOHN KNOX VILLAGE'S PROFITS, EXCESS DUES OR A SHARE OF JOHN KNOX VILLAGE'S NET ASSETS UPON DISSOLUTION.
MEMBERS MAY ELECT GOVERNING BODY	FORM 990, PART VI, SECTION A, LINE 7A	PREMIERLIFE BEING THE SOLE MEMBER OF JOHN KNOX VILLAGE HAS THE RIGHT TO ELECT ALL THE BOARD OF DIRECTORS.
GOVERNING BODY DECISIONS SUBJECT TO APPROVAL OF MEMBERS	FORM 990, PART VI, SECTION A, LINE 7B	THE CORPORATE BYLAWS OF JOHN KNOX VILLAGE IDENTIFY CERTAIN RIGHTS AND POWERS WHICH ARE RESERVED TO PREMIERLIFE, THE SOLE MEMBER. IN EACH INSTANCE, THE RIGHTS AND POWERS RESERVED TO THE SOLE MEMBER MAY BE SUMMARIZED AS FOLLOWS: 1. ELECTION OF DIRECTORS THE SOLE MEMBER ELECTS ALL DIRECTORS OF JOHN KNOX VILLAGE BASED UPON NOMINATIONS SUBMITTED BY JOHN KNOX VILLAGE'S BOARD Of DIRECTORS. TERMS OF OFFICE ARE STAGGERED ON JOHN KNOX VILLAGE'S BOARD SUCH THAT APPROXIMATELY 1/3 OF THE DIRECTORS' TERMS EXPIRE EACH YEAR. 2. ARTICLES OF INCORPORATION AND BYLAWS JOHN KNOX VILLAGE'S ARTICLES OF INCORPORATION AND BYLAWS MAY NOT BE AMENDED, RESTATED, ALTERED OR REPEALED BY THE CORPORATION UNLESS AND UNTIL SUCH ACTION IS RATIFIED AND APPROVED BY THE SOLE MEMBER. 3. ANNUAL BUDGETS/FINANCIAL POLICIES/INVESTMENT JOHN KNOX VILLAGE'S ANNUAL OPERATING AND CAPITAL BUDGETS PREPARED AND RECOMMENDED BY THE CORPORATE BOARD ARE SUBJECT TO REVIEW AND APPROVAL OF THE SOLE MEMBER. CORPORATE FINANCIAL POLICIES AND INVESTMENT STRATEGIES RECOMMENDED BY JOHN KNOX VILLAGE'S BOARD ALSO ARE SUBJECT TO PRIOR REVIEW AND APPROVAL OF THE SOLE MEMBER. 4. SALE OF ASSETS/MERGER, CONSOLIDATION/DISSOLUTION ANY SALE, LEASE OR OTHER DISPOSITION OF SUBSTANTIALLY ALL OF THE ASSETS OF JOHN KNOX VILLAGE, AND ANY MERGER, CONSOLIDATION, REORGANIZATION OR OTHER NOT-IN-THE-ORDINARY-COURSE TRANSACTION IS SUBJECT TO THE PRIOR REVIEW, RATIFICATION AND APPROVAL OF THE SOLE MEMBER. JOHN KNOX VILLAGE SHALL NOT BE DISSOLVED OR LIQUIDATED NOR ANY PLAN OF DISSOLUTION ADOPTED BY THE CORPORATION'S BOARD OF DIRECTORS WITHOUT THE RATIFICATION AND APPROVAL OF THE SOLE MEMBER. 5. LONG-TERM DEBT/LEASES ALL LONG-TERM DEBT OBLIGATIONS AND LONG-TERM LEASE OBLIGATIONS IN EXCESS OF ONE YEAR ARE SUBJECT TO PRIOR REVIEW/APPROVAL OF THE SOLE MEMBER. 6. CHIEF EXECUTIVE OFFICER ACTIONS OF THE BOARD OF DIRECTORS OF JOHN KNOX VILLAGE TO EMPLOY OR TERMINATE THE EMPLOYMENT OF THE CEO OF THE CORPORATION ARE SUBJECT TO REVIEW AND APPROVAL BY THE SOLE MEMBER.
FORM 990 REVIEW PROCESS	FORM 990, PART VI, SECTION B, LINE 11B	AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS OR CONCERNS THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE 990 IS THEN PROVIDED TO THE FINANCE COMMITTEE OF THE BOARD FOR THEIR REVIEW PRIOR TO FILING THE 990. ANY QUESTIONS OR CONCERNS THE FINANCE COMMITTEE HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990.
CONFLICT OF INTEREST POLICY	FORM 990, PART VI, SECTION B, LINE 12C	AT THE TIME OF HIRE (OR ELECTION IN THE CASE OF CORPORATE DIRECTORS AND TRUSTEES) AND ANNUALLY THEREAFTER, THE CEO OR HIS/HER DESIGNEE SHALL PROVIDE TO THE BOARD AND TO ALL EXECUTIVE OFFICERS, ADMINISTRATIVESTAFF, ASSOCIATES AND VOLUNTEERS A COPY OF THE CONFLICT OF INTEREST POLICY AND THE APPLICABLE CONFLICT OF INTEREST DISCLOSURE FORM AND QUESTIONNAIRE, WHICH SHALL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES WITH RESPECT TO WHICH IT IS BELIEVED A CONFLICT MAY ARISE. SUCH ANNUAL MONITORING AND REVIEW PROCEDURES SHALL BE PART OF THE CORPORATE COMPLIANCE PLAN. AN APPROPRIATE REPORT SHALL BE SUBMITTED TO THE AUDIT COMMITTEE CONCERNING ANY INTEREST SO DISCLOSED. EACH MEMBER OF THE BOARD OF DIRECTORS AND ALL MANAGEMENT ASSOCIATES SHALL DISCLOSE FULLY AND FRANKLY ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS OR DUALITY OF INTEREST OR RESPONSIBILITY, WHETHER INDIVIDUAL, PERSONAL OR BUSINESS, WHICH MAY EXIST OR APPEAR AS TO PREMIERLIFE OR ANY SYSTEM ENTITY OR ANY MATTER OR BUSINESS WHICH MAY COME BEFORE THE BOARD (INCLUDING ITS COMMITTEES). THREE OF NINE BOARD OF DIRECTORS ARE RESIDENTS AND APPROVE THE VILLAGE'S ANNUAL BUDGET, WHICH INCLUDES APPROVAL OF THE INCREASES IN RESIDENTS' MONTHLY SERVICE FEES. SINCE THOSE RESIDENT DIRECTORS ONLY REPRESENT ONE THIRD OF THE VOTING BOARD OF DIRECTORS, THIS PARTICIPATORY ACTION BY THE RESIDENT DIRECTORS IS BELIEVED TO BE IN COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ALSO, MISSOURI LAW REQUIRES CERTAIN SYSTEM ENTITIES TO HAVE AT LEAST ONE MEMBER OF ITS BOARD OF DIRECTORS WHO IS A RESIDENT. THE DISCLOSING INDIVIDUAL SHALL NEITHER VOTE NOR ENDEAVOR TO INFLUENCE CORPORATE ACTION IN ANY SUCH MATTER. UPON REQUEST OF THE SUBJECT BOARD, THE AFFECTED INDIVIDUAL SHALL LEAVE THE BOARDROOM WHILE THE MATTER IS DISCUSSED AND A VOTE, IF ANY, SHALL BE RECORDED IN THE MINUTES OF THE BOARD OR ITS COMMITTEE.
COMPENSATION REVIEW	FORM 990, PART VI, SECTION B, LINES 15A & B	JOHN KNOX VILLAGE USES THE FOLLOWING: 1. PEER GROUP: THE PEER GROUP WILL INCLUDE CONTINUING-CARE COMMUNITIES, NURSING HOMES AND CLOSELY RELATED ORGANIZATIONS, NATIONALLY. 2. BASE SALARIES: WILL BE POSITIONED SO THAT MIDPOINTS TARGET THE 60TH PERCENTILE. EXECUTIVE SALARIES WILL BE ADMINISTERED WITHIN RANGES BUILT AROUND THE 60TH PERCENTILE AND BASED ON PERFORMANCE, EXPERIENCE, TENURE AND OTHER RELEVANT FACTORS. 3. INCENTIVES: WILL BE POSITIONED TO PROVIDE TOTAL CASH COMPENSATION AT THE 60TH PERCENTILE OF THE PEER GROUP FOR ON-PLAN PERFORMANCE. ACHIEVING MAXIMUM INCENTIVES MAY RAISE TOTAL COMPENSATION TO APPROXIMATELY THE 65TH TO 75TH PERCENTILE. 4. BENEFITS: WILL BE POSITIONED AT MARKET COMPETITIVE LEVELS, APPROXIMATING THE 60TH TO 75TH PERCENTILE OF THE PEER GROUP. 5. TOTAL COMPENSATION: WILL BE POSITIONED AT APPROXIMATELY THE 60TH PERCENTILE FOR ON-PLAN PERFORMANCE WITH TARGET INCENTIVE AWARDS, AND APPROXIMATELY THE 65TH TO 75TH PERCENTILE FOR OUTSTANDING PERFORMANCE WITH MAXIMUM INCENTIVE AWARDS. JOHN KNOX VILLAGE EXECUTIVE COMMITTEE WILL DETERMINE THE TOTAL COMPENSATION PACKAGE FOR THE CEO. THE CEO SHALL MAKE RECOMMENDATIONS FOR THE SALARIES AND INCENTIVE PAYMENTS FOR OTHER EXECUTIVES. THESE AMOUNTS WILL BE PROVIDED ANNUALLY TO THE EXECUTIVE COMMITTEE FOR THEIR REVIEW AND APPROVAL. THE EXECUTIVE COMMITTEE WILL REPORT THE AGGREGATE INCREASES AND PERCENTAGE COMPARISON TO THE PHILOSOPHY TO THE BOARD OF DIRECTORS FOR APPROVAL. THE LAST REVIEW WAS CONDUCTED BY INTEGRATED HEALTHCARE STRATEGIES (FORMERLY CLARK CONSULTING OUT OF MINNESOTA) IN 2009. A WRITTEN OPINION FROM THE CONSULTANT WAS RECEIVED STATING THAT THE EXECUTIVE COMPENSATION PACKAGES ARE REASONABLE AND DO NOT CONSTITUTE EXCESS BENEFIT TRANSACTIONS. THE LETTER ALSO OUTLINES THE STEPS THE COMMITTEE TOOK TOWARD ESTABLISHING A REBUTTABLE PRESUMPTION THAT TOTAL PAY LEVELS ARE REASONABLE. THE CONSULTANT REVIEWED THE MINUTES TO ENSURE THE STEPS TAKEN SATISFIED THE IRS REQUIREMENTS. THE LETTER IS ON FILE AT THE FACILITY. JKV'S PHILOSOPHY REGARDING EXECUTIVE COMPENSATION IS TO PAY AT APPROXIMATELY THE 60TH PERCENTILE OF THE MARKET. WHILE JKV DID NOT HAVE AN EXTERNAL REVIEW OF EXECUTIVE COMPENSATION FOR THE FISCAL YEAR, IT IS OUR PRACTICE TO ENSURE THE SALARIES ARE CONSISTENT WITH THE VILLAGE'S GOAL.
AVAILABILITY OF DOCUMENTS	FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS (BYLAWS) ARE AVAILABLE FOR PUBLIC INSPECTION IN THE ADMINSTRATIVE CENTER BUILDING; THE CONFLICT OF INTEREST POLICY IS AVAILABLE FOR PUBLIC INSPECTION IN THE ADMINISTRATIVE CENTER BUILDING; A COPY OF THE MOST RECENTLY FILED IRS FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION AT THE ADMINISTRATIVE CENTER BUILDING SECOND FLOOR. AUDITED FINANCIALS ARE ALSO AVAILABLE AT THE MARKETING OFFICE.
RECONCILIATION OF NET ASSETS	FORM 990, PART XI, LINE 9	CHANGE IN VALUE OF FDA $ 451,887

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

JOHN KNOX VILLAGE

Employer identification number

23-7365138

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)

(a) Name, address, and EIN (if applicable) 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" to 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 entity?
(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	Yes	No
(1) PREMIERLIFE 400 NW MURRAY ROAD LEES SUMMIT,MO64081 20-3587205	SUPPORT ORG	MO	501(C)(3)	11B	NA		No
(2) THE JOHN KNOX VILLAGE FOUNDATION 400 NW MURRAY ROAD LEES SUMMIT,MO64081 43-1304714	SUPPORT JKV	MO	501(C)(3)	7	PREMIERLIFE	Yes
(3) PREMIERLIFE REAL ESTATE HOLDING 400 NW MURRAY ROAD LEES SUMMIT,MO64081 20-3587252	REAL ESTATE	MO	501(C)(2)	N/A	PREMIERLIFE	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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	(i) Section 512(b)(13) controlled entity?
(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		Yes	No
(1) THE JKV REDEVELOPMENT CORPORATION 400 NW MURRAY ROAD LEES SUMMIT,MO64081 20-0528072	REAL ESTATE	MO	JKV	C CORPORATION		1,000	100.000 %	Yes

Schedule R (Form 990) 2012

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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-s)	(c) Amount involved	(d) Method of determining amount involved
(1) PREMIERLIFE REAL ESTATE HOLDINGS	A(I)	58,573	FMV
(2) PREMIERLIFE REAL ESTATE HOLDINGS	D	3,640,226	FMV
(3) THE JOHN KNOX VILLAGE FOUNDATION	C	141,210	FMV
(4) THE JOHN KNOX VILLAGE FOUNDATION	D	112,244	FMV

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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)	(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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2012

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:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: "ENRICHING LIVES, BUILDING COMMUNITY"
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	1,415
6	Total number of volunteers (estimate if necessary) .............	6	429
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	589,547
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	22,756

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	273,271	186,210
9	Program service revenue (Part VIII, line 2g) .........	59,760,998	60,078,740
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,200,678	1,102,130
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,174,708	4,200,029
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	65,409,655	65,567,109
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	118,692	69,578
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)	37,296,110	36,308,975
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	32,035,689	32,949,327
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	69,450,491	69,327,880
19	Revenue less expenses. Subtract line 18 from line 12.......	-4,040,836	-3,760,771
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	136,932,143	132,847,906
21	Total liabilities (Part X, line 26).............	122,262,968	120,701,989
22	Net assets or fund balances. Subtract line 21 from line 20.....	14,669,175	12,145,917

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 61,934,904 including grants of $ 69,578 ) (Revenue $ 63,980,506 )
	HEALTH SERVICES - SEE SCHEDULE O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	RESIDENT SERVICES - SEE SCHEDULE O

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	RESIDENTIAL CARE FACILITY AND ALZHEIMER'S ASSISTED LIVING FACILITY - SEE SCHEDULE O

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses61,934,904

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,729,735	0	150,535

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(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
(A) Name and Title
(18) SALLY ARREY........................................................................ REGISTERED NURSE	40.0 .......................0.0	X	107,217	0	10,691
(19) TAMI HOVERSTEN........................................................................ DIRECTOR OF NURSING SERVICES	40.0 .......................0.0	X	102,276	0	2,237
(20) BRIAN PETERSEN........................................................................ DIRECTOR OF OPERATIONS	40.0 .......................0.0	X	100,365	0	8,165

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		141,210
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		45,000

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			186,210
			Business Code
2a	NET PATIENT REVENUE		623000	60,078,740	60,078,740
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			60,078,740
3	Investment income (including dividends, interest, and other similar amounts).......			1,325,300			1,325,300
4	Income from investment of tax-exempt bond proceeds..			95,420			95,420
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	298,263
b	Less: rental expenses
c	Rental income or (loss)	298,263	0
d	Net rental income or (loss).......			298,263			298,263
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		1,100
b	Less: cost or other basis and sales expenses		319,690
c	Gain or (loss)		-318,590
d	Net gain or (loss)..........			-318,590			-318,590
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..			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...			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..			0
Miscellaneous Revenue			Business Code
11a	Cafeteria		722210	2,218,794	2,218,794
b	Beauty Shops		812900	446,136	446,136
c	All Other Misc Revenue		900099	1,236,836	647,289	589,547
d	All other revenue ....			1,236,836	647,289	589,547
e	Total. Add lines 11a–11d ......			3,901,766
12	Total revenue. See Instructions......			65,567,109	63,390,959	589,547	1,400,393


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			0	1	0
2	Savings and temporary cash investments .........			3,208,638	2	3,516,720
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			5,654,672	4	5,593,744
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			474,987	8	496,488
9	Prepaid expenses and deferred charges ..........			670,537	9	913,228
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	194,306,554
b	Less: accumulated depreciation .....	10b	115,642,082	82,080,835	10c	78,664,472
11	Investments—publicly traded securities ..........			31,644,484	11	28,650,904
12	Investments—other securities. See Part IV, line 11 .....			8,692,119	12	10,716,064
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			4,505,871	15	4,296,286
16	Total assets. Add lines 1 through 15 (must equal line 34)......			136,932,143	16	132,847,906
17	Accounts payable and accrued expenses .........			7,629,197	17	7,479,202
18	Grants payable .................			0	18	0
19	Deferred revenue ................			49,752,551	19	49,323,710
20	Tax-exempt bond liabilities .............			54,625,925	20	52,878,733
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			6,373,386	23	6,976,461
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
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....................			3,881,909	25	4,043,883
26	Total liabilities. Add lines 17 through 25.........			122,262,968	26	120,701,989
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			14,669,175	27	12,145,917
28	Temporarily restricted net assets ...........			0	28	0
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			14,669,175	33	12,145,917
34	Total liabilities and net assets/fund balances ........			136,932,143	34	132,847,906

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................	Yes	No