Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
RYDER ASSISTED CARE INC
Employer identification number
66-0537553
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
179,406
215,739
255,622
258,220
286,926
1,195,913
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..
179,406
215,739
255,622
258,220
286,926
1,195,913
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.
1,195,913
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
7
Amounts from line 4..
179,406
215,739
255,622
258,220
286,926
1,195,913
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
952
736
647
588
324
3,247
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
2,300
2,871
3,395
3,332
3,611
15,509
11
Total support (Add lines 7 through 10).
1,214,669
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
55,867
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
98.460 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
98.340 %
16a
33 1/3% support test—2011.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2010.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2010.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
RYDER ASSISTED CARE INC
Employer identification number
66-0537553
Identifier
Return Reference
Explanation
ELECTION OF MEMBERS AND THEIR RIGHTS
FORM 990, PAGE 6, PART VI, LINE 7A
MEMBERSHIP IN THE BOARD OF DIRECTORS SHALL BE LIMITED TO INDIVIDUALS WHO ARE EITHER MEMBERS OF THE BOARD OF DIRECTORS OF RYDER MEMORIAL HOSPITAL, INC. OR NON-MEMBERS WHO HAVE THE APPROVAL OF SAID SPONSORING ORGANIZATION. THE BOARD OF DIRECTORS SHALL CONSIST OF FIFTEEN (15) PEOPLE WHO QUALIFY AS PREVIOUSLY MENTIONED AND WHO SHALL BE ELECTED AS SUCH BY THE INCORPORATORS WHO EXECUTED AND FILED THE CHARTER. AT THE FIRST ANNUAL MEETING OF THE MEMEBERS AND AT EACH ANNUAL MEETING THEREAFTER, MEMBERS SHALL ELECT DIRECTORS TO HOLD OFFICE UNTIL THEIR TERM EXPIRES OR UNTIL THEIR SUCCESSORS ARE ELECTED AND QUALIFIED. IN ORDER TO AVOID THAT ALL MEMBERS OF THE BOARD CONCLUDE THEIR TERMS AT THE SAME TIME, THEY ARE SEGREGATED IN 3 GROUPS, WHOSE TERMS WILL BE OF 3 YEARS AS DIRECTORS, EXCEPT FOR FILING A VACANCY, IN WHICH SUCH TERM WILL COVER THE REMAINING TIME OF REPLACED MEMBER.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS
FORM 990, PAGE 6, PART VI, LINE 7B
1) INCREASE THE NUMBER OF MEMBERS OF THE BOD. 2) AMEND BY-LAWS OF THE CORPORATION. 3) APPROVE ANY PLAN FOR DISSOLUTION, MERGER OR DISPOTION OF THE ASSETS OF THE CORPORATION. 4) APPROVE THE SELECTION OF THE INDEPENDENT AUDITORS OF THE CORPORATION
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE REVIEW PROCESS OF THE FORM 990 IS UNDER THE RESPONSIBILITY OF THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE OF RYDER ASSISTED CARE, INC. SUCH COMMITTEE AT THE SAME TIME, DELEGATES THIS TASK TO THE EXECUTIVE DIRECTOR, WHO PERFORMS THE REVIEW OF THE 990 FORM AND IS AUTHORIZED TO PROVIDE THE RELEASE FOR THE FINAL ISSUANCE OF THE FORM.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE PROPER GOVERNANCE OF RYDER ASSISTED CARE, INC. IS EXERCISED BY MEMBERS WHO GIVE THEIR TIME FOR THE BENEFIT OF THE COMMUNITY SERVED BY THIS CORPORATION. BECAUSE THE VARIED INTEREST AND BACKGROUND OF THE GOVERNING BOARD MEMBERS, MAY RESULT IN SITUATIONS INVOLVING A DUAL INTEREST THAT MIGHT APPEAR AS CONFLICT OF INTEREST; AND SERVICES SHOULD NOT BE RENDERED IMPOSSIBLE SOLELY BY REASON OF DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST; AND SERVICE CARRIES A REQUIREMENT OF LOYALTY AND FIDELITY TO THE CORPORATION KNOWN AS RYDER ASSISTED CARE, INC, IT IS THE RESPONSIBILITY OF THE BOARD MEMBERS TO GOVERN THE INSTITUTION'S AND THE COMMUNITY'S INTEREST WITH HONESTY, EXCERCISING THEIR BEST CARE, SKILL AND JUDGEMENT FOR THE BENEFIT OF THE INSTITUTION AND ITS MEMBERS; AND THE MATTER OF ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST CAN BEST BE HANDLED THROUGH FULL DISCLOSURE OF ANY SUCH INTEREST, TOGETHER WITH ABSTENTION IN ANY VOTE WHERE IN THE INTEREST IS INVOLVED. THE FOLLOWING POLICY OF DUALITY AND CONFLICT OF INTEREST IS HEREBY ADOPTED: 1. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST OF THE PART OF ANY GOVERNING BOARD MEMBER SHOULD BE DISCLOSED TO THE OTHER BOARD MEMBERS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. 2. ANY BOARD MEMBER HAVING A DUALITY OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD NOT VOTE OR USE HIS PERSONAL INFLUENCES ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING AND THE QUORUM SITUATION. 3. THE ABOVE MENTIONED REQUIREMENTS SHOULD NOT BE CONSTRUED AS PREVENTING THE BOARD MEMBERS FROM STATING HIS POSITION IN THE MATTER, NOR FROM ANSWERING PERTINENT QUESTIONS IN SUCH MATTER. THAT THIS POLICY BE REVISED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF THE BOARD MEMBERS, AND THAT ANY NEW MEMBER BE ADVISED OF THE POLICY UPON ENTERING ON THE DUTIES OF HIS OFFICE.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
THE PROCESS TO DETERMINE THE COMPENSATION TO OFFICERS IS BASED ON: 1) JOB DESCRIPTIONS 2) MINIMUM QUALIFICATIONS FOR THE POSITION 3) EXPERIENCE 4) EDUCATION THE ORGANIZATION ALSO PERFORMS BENCHMARKING OF THE INDUSTRY AND THE MARKET IN THE GENERAL TO SEE AND OFFER COMPETITIVE SALARIES. THE ORGANIZATION REVIEWS ANNUALLY THE SALARIES GRANTED TO EMPLOYEES AND INCREASES ARE APPROVED DEPENDING ON THE FINANCIAL POSITION OF THE ORGANIZATION. RAISES MUST BE APPROVED BY THE BOD. THE ORGANIZATION ALSO COMPLIES WITH MANDATORY DECREES BY THE GOVERNMENT.
COMPENSATION PROCESS FOR OFFICERS
FORM 990, PAGE 6, PART VI, LINE 15B
THE PROCESS TO DETERMINE THE COMPENSATION TO OFFICERS IS BASED ON: 1) JOB DESCRIPTIONS 2) MINIMUM QUALIFICATIONS FOR THE POSITION 3) EXPERIENCE 4) EDUCATION THE ORGANIZATION ALSO PERFORMS BENCHMARKING OF THE INDUSTRY AND THE MARKET IN THE GENERAL TO SEE AND OFFER COMPETITIVE SALARIES. THE ORGANIZATION REVIEWS ANNUALLY THE SALARIES GRANTED TO EMPLOYEES AND INCREASES ARE APPROVED DEPENDING ON THE FINANCIAL POSITION OF THE ORGANIZATION. RAISES MUST BE APPROVED BY THE BOD. THE ORGANIZATION ALSO COMPLIES WITH MANDATORY DECREES BY THE GOVERNMENT.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS OR BYLAWS AVAILABLE TO THE MEMBERS OF THE BOARD OF DIRECTORS AND TOP MANAGEMENT. THE POLICY OF CONFLICTS OF INTEREST IS AVAILABLE TO THE ORGANIZATION'S BOARD OF DIRECTORS, TOP MANAGEMENT AND EMPLOYEES IN ORDER THAT ALL BE AWARE OF SUCH IN THE PERFORMANCE OF THEIR FUNCTIONS. IN CASE OF THE FINANCIAL STATEMENTS THESE ARE MADE AVAILABLE TO CERTAIN PARTIES IN ADDITION TO THE ORGANIZATION'S MANAGEMENT, SUCH AS THE FEDERAL GOVERNMENT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.