TY 2012 Form 990

- TIN:

Form990

Department of the Treasury
Internal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-0047

2012

Open to Public Inspection

A For the 2012 calendar year, or tax year beginning 07-01-2012 , 2012, and ending 06-30-2013

BCheck if applicable: Address change Name change Initial return Terminated Amended return Application pending

CName of organization
HOLY CROSS VILLAGE AT NOTRE DAME INC

Doing Business As

Number and street (or P.O. box if mail is not delivered to street address)
54515 State Road 933 North
PO Box 303

Room/suite

City or town, state or country, and ZIP + 4
Notre Dame, IN465560303

D Employer identification number

35-2084623

E Telephone number

G Gross receipts $ 12,781,077

F Name and address of principal officer:
JOHN MAUCH
54515 State Road 933 North
Notre Dame,IN465560303

Tax-exempt status: 501(c)(3) 501(c) ( ) LeftBullet

(insert no.) 4947(a)(1) or 527

Website:

WWW.HOLYCROSSVILLAGE.COM

H(a)

Is this a group return for
affiliates? Yes No

H(b)

Are all affiliates included?

Yes No

If "No," attach a list. (see instructions)

H(c)

Group exemption number MediumBullet

0928

K Form of organization: Corporation Trust Association Other MediumBullet

L Year of formation: 1999

M State of legal domicile: IN

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: HOLY CROSS VILLAGE AT NOTRE DAME IS AN INTERDEPENDENT COMMUNITY ENERGIZED BY HOLY CROSS SPIRITUALITY AND HOSPITALITY, AND DEDICATED TO PROVIDING A NURTURING ENVIRONMENT FOCUSED ON DIGNITY AND RESPECT.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	156
6	Total number of volunteers (estimate if necessary) .............	6	33
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	573,484
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	29,726	28,991
9	Program service revenue (Part VIII, line 2g) .........	11,781,371	11,692,731
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	159,402	166,217
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	568,045	660,388
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	12,538,544	12,548,327
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,949	3,462
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	4,725,121	4,940,042
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)....	10,675,449	10,125,737
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	15,403,519	15,069,241
19	Revenue less expenses. Subtract line 18 from line 12.......	-2,864,975	-2,520,914
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	58,772,751	55,586,615
21	Total liabilities (Part X, line 26).............	56,384,804	59,582,131
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,387,947	-3,995,516

Part II

Signature Block

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title

Paid Preparer Use Only

Print/Type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name MediumBullet

Firm's EIN MediumBullet

Firm's address MediumBullet

Phone no.

May the IRS discuss this return with the preparer shown above? (see instructions) ............YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y

Form 990 (2012)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response to any question in this Part III ...............

Briefly describe the organization’s mission: HOLY CROSS VILLAGE AT NOTRE DAME IS AN INTERDEPENDENT COMMUNITY ENERGIZED BY HOLY CROSS SPIRITUALITY AND HOSPITALITY, AND DEDICATED TO PROVIDING A NURTURING ENVIRONMENT FOCUSED ON DIGNITY AND RESPECT. (CONTINUED IN SCHEDULE O)

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ...................... Yes No

If “Yes,” describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................ Yes No

If “Yes,” describe these changes on Schedule O.

Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.


4a	(Code: ) (Expenses $ 8,235,346 including grants of $ 2,210 ) (Revenue $ 7,029,491 )
	INDEPENDENT AND ASSISTED LIVING: HOLY CROSS VILLAGE AT NOTRE DAME (HOLY CROSS VILLAGE) PROVIDES A COMPREHENSIVE SELECTION OF RESIDENTIAL LIVING OPTIONS SUPPORTED BY A FULL CONTINUUM OF ON-SITE HEALTH CARE. INDEPENDENT LIVING RESIDENTS ENJOY AN ACTIVE LIFESTYLE, COMPLEMENTED BY SUPERIOR SERVICES AND AMENITIES. PLUS, THEY HAVE THE ASSURANCE OF ON-SITE QUALITY HEALTH CARE, IF EVER NEEDED, AT AN AFFORDABLE, PREDICTABLE COST. (CONTINUED IN SCHEDULE O)

4b	(Code: ) (Expenses $ 4,662,730 including grants of $ 1,252 ) (Revenue $ 4,663,240 )
	SKILLED NURSING AND MEMORY CARE: HOLY CROSS VILLAGE IS LICENSED BY THE STATE DEPARTMENT OF HEALTH AS A CONTINUING CARE RETIREMENT COMMUNITY (CCRC) AND A SKILLED NURSING FACILITY. SERVICES ARE RESIDENT-CENTERED AND ARE FOCUSED ON LONG-TERM HEALTH CARE NEEDS AND/OR DIRECTED TO INDIVIDUALS THAT ARE RECOVERING FROM A BRIEF ILLNESS AND NEED TO REBUILD STRENGTH. (CONTINUED IN SCHEDULE O)

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses12,898,076

Form 990 (2012)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule A Click to see attachment

........................

Yes

Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment

...

Yes

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........

Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part II........

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part III............................

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part I........................

Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part II...

Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III ....................

Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IV..............

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part V Click to see attachment

......

Yes

If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.

Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI. Click to see attachment

...................

11a

Yes

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.......

11b

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.......

11c

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX Click to see attachment

............

11d

Yes

Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X Click to see attachment

11e

Yes

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X Click to see attachment

.........................

11f

Yes

12a

Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment

.................

12a

Yes

Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional

12b

Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....

14a

Did the organization maintain an office, employees, or agents outside of the United States?.....

14a

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........

14b

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV...

Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................

20a

Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H....

20a

If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return?

20b

Form 990 (2012)

Page 4

Part IV

Checklist of Required Schedules (continued)

Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...

Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........

Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J.......................

24a

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment

24a

Yes

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................

24c

Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I...................

25b

Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II..........................

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........

Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ..........................

28a

A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment

28b

Yes

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV...

28c

Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............

Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........

Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...

35b

Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2.............

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI

Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Form 990 (2012)

Page 5

Part V

Statements Regarding Other IRS Filings and Tax Compliance

Check if Schedule O contains a response to any question in this Part V ...............

Yes

Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Yes

Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................

156

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)

Yes

Did the organization have unrelated business gross income of $1,000 or more during the year?...

Yes

If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....

Yes

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................

If "Yes," enter the name of the foreign country: MediumBullet

See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...

If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................

If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................

If “Yes,” indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................

Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............

Sponsoring organizations maintaining donor advised funds.

Did the organization make any taxable distributions under section 4966?..........

Did the organization make a distribution to a donor, donor advisor, or related person?.......

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........

11b

12a

Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?

12a

If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.

13a

Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....

13b

Enter the amount of reserves on hand ............

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..

14b

Form 990 (2012)

Page 6

Part VI

Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule O contains a response to any question in this Part VI ...............

Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year .....................

If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independent ...................

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................

Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Yes

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................

Yes

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................

Yes

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .........................

Yes

Each committee with authority to act on behalf of the governing body? ............

Yes

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?

10b

11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................

11a

Yes

Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....

12a

Did the organization have a written conflict of interest policy? If “No,” go to line 13.......

12a

Yes

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................

12b

Yes

Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................

12c

Yes

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization’s CEO, Executive Director, or top management official ...........

15a

Yes

Other officers or key employees of the organization ................

15b

Yes

If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).

16a

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................

16a

If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Section C. Disclosure

List the States with which a copy of this Form 990 is required to be filed MediumBullet

Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request Other (explain in Schedule O)

Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.

State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBullet

JANET TODD54515 STATE ROAD 933 NORTHNOTRE DAMEIN465560303 (574) 287-1838

Form 990 (2012)

Page 7

Part VII

Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Check if Schedule O contains a response to any question in this Part VII ...............

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet

List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

List all of the organization’s current key employees, if any. See instructions for definition of "key employee."

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.

Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

(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)		(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
(1) BR JOHN MAY CSC........................................................................ SECRETARY	1.00 .......................1.00	X	X	0	0	0
(2) KATHLEEN BRICKLEY........................................................................ TREASURER	1.00 .......................0.00	X	X	0	0	0
(3) THOMAS CASSADY JR........................................................................ CHAIRPERSON	1.00 .......................0.00	X	X	0	0	0
(4) BR CHESTER FREEL CSC........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(5) BR JAMES VAN DYKE CSC........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(6) BR MARK KNIGHTLEY........................................................................ DIRECTOR - PARTIAL YEAR	1.00 .......................0.00	X		0	0	0
(7) BR WILLIAM NICK........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(8) LINDA PASKIEWICZ........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(9) PAT CRESSY........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(10) PERRY WATSON III........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(11) RICHARD GILMAN........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(12) SR RUTH MARIE NICKERSON CSC........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(13) TOM VELDMAN........................................................................ DIRECTOR	1.00 .......................0.00	X		0	0	0
(14) JANET TODD........................................................................ CONTROLLER	65.00 .......................1.00		X	65,549	0	11,362
(15) JOHN MAUCH........................................................................ PRESIDENT/CEO	50.00 .......................1.00		X	96,382	0	11,159
(16) WILLIAM QUIG........................................................................ CFO	30.00 .......................0.00		X	11,728	0	2,458

Form 990 (2012)

Page 8

Part VII

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) Name and Title	(B) Average hours per week (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)						(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

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	173,659	0	24,979

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet

Yes

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........

Section B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.

(A) Name and business address	(B) Description of services	(C) Compensation
SODEXO INC AND AFFILIATES4880 PAYSPHERE CIRCLECHICAGOIL60674	DINING SERVICES	1,846,756
ALLIANCE REHAB INC1520 KENSINGTON RD SUITE 110OAKBROOKIL60523	THERAPY SERVICES	314,633
FRANCISCAN SISTERS OF CHICAGO SERVICE CORP1055 WEST 175TH STREET SUITE 202HOMEWOODIL60430	IT/SYSTEM CONVERSION SERVICES	228,389
TALBOOM LAWNCARE-LANDSCAPE INC26981 KLINE TRAILSOUTH BENDIN46614	LAWNCARE/LANDSCAPING SERVICES	142,686
RMC'S FINISHES INC21240 JOHNSON ROADSOUTH BENDIN46614	PAINTING	133,435
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 6

Form 990 (2012)

Page 9

Part VIII

Statement of Revenue

Check if Schedule O contains a response to any question in this Part VIII ..............

				(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		7,645
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		21,346

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			28,991
			Business Code
2a	INDEPENDENT AND ASSISTED LIVING		623000	7,029,491	7,029,491
b	NURSING SERVICES		623000	4,663,240	4,663,240
c				0
d				0
e				0
f	All other program service revenue .			0	0	0	0
g	Total. Add lines 2a–2f........			11,692,731
3	Investment income (including dividends, interest, and other similar amounts).......			135,841			135,841
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	13,253
b	Less: rental expenses
c	Rental income or (loss)	13,253	0
d	Net rental income or (loss).......			13,253			13,253
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	259,526	3,600
b	Less: cost or other basis and sales expenses	220,015	12,735
c	Gain or (loss)	39,511	-9,135
d	Net gain or (loss)..........			30,376			30,376
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	HOUSEKEEPING, MAINTENANCE & SECURITY SERVICES		811000	573,484		573,484
b	DINING, CAFETERIA & SNACK SHOP		900099	49,447			49,447
c	PURCHASE DISCOUNTS, REBATES & REFUNDS		900099	13,928			13,928
d	All other revenue ....			10,276	0	0	10,276
e	Total. Add lines 11a–11d ......			647,135
12	Total revenue. See Instructions......			12,548,327	11,692,731	573,484	253,121

Form 990 (2012)

Page 10

Part IX

Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	3,462	3,462
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	289,752		289,752
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	37,196	37,196
7	Other salaries and wages	3,608,067	3,024,435	583,632
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	79,533	66,269	13,264
9	Other employee benefits .......	644,398	534,446	109,952
10	Payroll taxes ...........	281,096	220,966	60,130
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	55,783		55,783
c	Accounting ...........	61,425		61,425
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	2,723,315	2,521,314	202,001	0
12	Advertising and promotion ....	63,767		63,767
13	Office expenses .......	1,315,904	1,167,740	148,164
14	Information technology ......	12,119		12,119
15	Royalties ..	0
16	Occupancy ...........	600,698	569,640	31,058
17	Travel ............	20,448	4,462	15,986
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	10,970	3,919	7,051
20	Interest ...........	1,605,623	1,605,623
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	3,236,425	2,873,172	363,253
23	Insurance ..............	160,522	116,800	43,722
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	BAD DEBT EXPENSE	95,061	95,061
b	DUES AND SUBSCRIPTIONS	21,446	3,815	17,631
c	RECRUITMENT, TRAINING AND DEVELOPMENT	24,031	9,602	14,429
d	UNIFORMS	13,902	13,276	626
e	All other expenses	104,298	26,878	77,420	0
25	Total functional expenses. Add lines 1 through 24e	15,069,241	12,898,076	2,171,165	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).	0

Form 990 (2012)

Page 11


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............			1,584,054	1	1,753,729
2	Savings and temporary cash investments .........			4,677,439	2	3,963,240
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			648,108	4	847,964
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					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
					6	0
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			42,079	8	44,394
9	Prepaid expenses and deferred charges ..........			29,781	9	75,593
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	56,763,061
b	Less: accumulated depreciation .....	10b	18,768,670	40,391,236	10c	37,994,391
11	Investments—publicly traded securities ..........			6,661,791	11	6,806,909
12	Investments—other securities. See Part IV, line 11 .....			1,201,944	12	1,182,884
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			3,536,319	15	2,917,511
16	Total assets. Add lines 1 through 15 (must equal line 34)......			58,772,751	16	55,586,615
17	Accounts payable and accrued expenses .........			1,186,013	17	935,212
18	Grants payable .................				18
19	Deferred revenue ................			81,414	19	53,649
20	Tax-exempt bond liabilities .............			27,578,476	20	27,147,228
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
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..........				22	0
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			27,538,901	25	31,446,042
26	Total liabilities. Add lines 17 through 25.........			56,384,804	26	59,582,131
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			1,136,003	27	-5,288,400
28	Temporarily restricted net assets ...........			1,251,944	28	1,292,884
29	Permanently restricted net assets ...........				29
	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 ...........			2,387,947	33	-3,995,516
34	Total liabilities and net assets/fund balances ........			58,772,751	34	55,586,615

Form 990 (2012)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response to any question in this Part XI ...............

Total revenue (must equal Part VIII, column (A), line 12) ............

12,548,327

Total expenses (must equal Part IX, column (A), line 25) ............

15,069,241

Revenue less expenses. Subtract line 2 from line 1 ..............

-2,520,914

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..

2,387,947

Net unrealized gains (losses) on investments ...............

170,482

Donated services and use of facilities .................

Investment expenses .....................

Prior period adjustments .....................

Other changes in net assets or fund balances (explain in Schedule O) ........

-4,033,031

Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))

-3,995,516

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response to any question in this Part XII ..............

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

Were the organization’s financial statements audited by an independent accountant?

Yes

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?

Yes

If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?

If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits

Form 990 (2012)

Form 990, Special Condition Description:

Special Condition Description

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

HOLY CROSS VILLAGE AT NOTRE DAME INC

Employer identification number

35-2084623

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

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.") .	651,534	678,610	1,104,179	29,726	28,991	2,493,040
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......	10,903,589	11,660,683	11,155,862	11,781,371	11,692,731	57,194,236
3	Gross receipts from activities that are not an unrelated trade or business under section 513..	163,861	730,690	19,003,064	82,718	73,651	20,053,984
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.	11,718,984	13,069,983	31,263,105	11,893,815	11,795,373	79,741,260
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...	0	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	0
c	Add lines 7a and 7b..	0	0	0	0	0	0
8	Public support (Subtract line 7c from line 6.)						79,741,260

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...	11,718,984	13,069,983	31,263,105	11,893,815	11,795,373	79,741,260
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	169,782	126,177	198,379	174,962	149,094	818,394
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.						0
c	Add lines 10a and 10b.	169,782	126,177	198,379	174,962	149,094	818,394
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.	0	0	0	0	0	0
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..	0	0	102,029	0		102,029
13	Total support. (Add lines 9, 10c, 11, and 12.)..	11,888,766	13,196,160	31,563,513	12,068,777	11,944,467	80,661,683

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)) .........

98.860 %

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

98.410 %

Section D. Computation of Investment Income Percentage

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

1.010 %

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

1.460 %

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
OTHER INCOME, SCHEDULE A, PART III, LINE 12, DESCRIPTION - MANAGEMENT CONTRACTS, COLUMN A - 0, COLUMN B - 0, COLUMN C - 102029, COLUMN D - 0, COLUMN E - , COLUMN F - 102029;,

Schedule A (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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

HOLY CROSS VILLAGE AT NOTRE DAME INC

Employer identification number

35-2084623

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 HOLY CROSS VILLAGE AT NOTRE DAME INC

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 HOLY CROSS VILLAGE AT NOTRE DAME INC

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
HOLY CROSS VILLAGE AT NOTRE DAME INC

Employer identification number

35-2084623

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:	12000266
Software Version:	v2012.1.0

- 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

HOLY CROSS VILLAGE AT NOTRE DAME INC

Employer identification number

35-2084623

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

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 ....	73,765	75,835	65,229	57,995	0
b	Contributions ........				0	60,000
c	Net investment earnings, gains, and losses	8,202	1,441	12,328	8,715	-2,005
d	Grants or scholarships .....	3,723	3,511	1,722	1,481	0
e	Other expenditures for facilities and programs ........				0	0
f	Administrative expenses ....				0	0
g	End of year balance ......	78,244	73,765	75,835	65,229	57,995

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

0 %

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)

Yes

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

3a(ii)

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

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 .................			0
b	Buildings ................	36,706,794	9,648,021	27,058,773
c	Leasehold improvements ............	3,876,484	2,172,116	1,704,368
d	Equipment ................	16,179,783	6,948,533	9,231,250
e	Other .................			0
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				37,994,391

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
Other








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

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
(1) DEFERRED MARKETING COSTS				1,778,713
(2) DEFERRED BOND ISSUANCE COSTS				916,604
(3) DUE FROM AFFILIATE - BROTHERS OF HOLY CROSS				68,665
(4) DUE FROM AFFILIATE - HOLY CROSS COLLEGE				153,529





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,917,511

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes		0
REFUNDABLE AND UNEARNED ENTRANCE FEES		29,756,742
DUE TO AFFILIATE - HOLY CROSS VILLAGE FOUNDATION		868,685
RESIDENT DEPOSITS		607,660
ACCRUED INTEREST PAYABLE		200,561
CAPITAL LEASE OBLIGATION		12,394




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		31,446,042
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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
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
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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

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
Intended uses of endowment funds	Schedule D, Part V, Line 4	ENDOWMENT FUNDS ARE HELD BY THE COMMUNITY FOUNDATION OF ST. JOSEPH COUNTY FOR THE BENEFIT OF HOLY CROSS VILLAGE AT NOTRE DAME. THE ENDOWMENT FUNDS ARE INTENDED TO PROVIDE FUNDING TO SUPPORT HOLY CROSS VILLAGE AT NOTRE DAME'S MISSION AND TAX-EXEMPT PURPOSE.
FIN 48 (ASC 740) footnote	Schedule D, Part X, Line 2	THE ORGANIZATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. U.S. GAAP REQUIRES THAT A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. DUE TO ITS TAX-EXEMPT STATUS, THE ORGANIZATION IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE ORGANIZATION'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF INDIANA FOR THE LAST THREE YEARS. THE ORGANIZATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE ORGANIZATION RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT JUNE 30, 2013 OR 2012.

Schedule D (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- 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
HOLY CROSS VILLAGE AT NOTRE DAME INC

Employer identification number
35-2084623

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(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	ST JOSEPH COUNTY INDIANA	35-6000194	790608CR2	03-30-2006	36,701,276	CONSTRUCT AND EQUIP NEW FACILITY		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	9,400,000
2 Amount of bonds legally defeased . . . . . . . . . . .	0
3 Total proceeds of issue . . . . . . . . . . . . . .	38,736,372
4 Gross proceeds in reserve funds . . . . . . . . . . . .	2,002,619
5 Capitalized interest from proceeds . . . . . . . . . . .	3,917,764
6 Proceeds in refunding escrows . . . . . . . . . . . .	0
7 Issuance costs from proceeds . . . . . . . . . . . .	722,500
8 Credit enhancement from proceeds . . . . . . . . . . .	88,673
9 Working capital expenditures from proceeds . . . . . . . . .	0
10 Capital expenditures from proceeds . . . . . . . . . . .	31,988,900
11 Other spent proceeds . . . . . . . . . . . . . .	0
12 Other unspent proceeds . . . . . . . . . . . . . .	0
13 Year of substantial completion . . . . . . . . . . . .	2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

For 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? . . . . . . . . . . . . . . . .	X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .		X
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 . .	0.0000%		%		%		%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0.0000%		%		%		%
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .	0.0000%		%		%		%
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.	0.0000%		%		%		%
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? . . . . . . . .		X
c No rebate due? . . . . . . . . . .	X
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 . . . . . . . . .	ALLIED IRISH BANKS PLC NEW YORK BRANCH
c Term of hedge . . . . . . . . . .	2.5
d Was the hedge superintegrated? . . . . . .		X
e Was a hedge terminated? . . . . . . .		X

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 . . . . . . . . .	AIG MATCHED FUNDING CORPORATION
c Term of GIC . . . . . . . . . .	4.3
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .	X
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
TOTAL PROCEEDS OF ISSUE	SCHEDULE K, PART II	$36,701,276 ISSUE PRICE + 2,035,096 INVESTMENT EARNINGS ON PROCEEDS THROUGH JUNE 30, 2013 = 38,736,372 TOTAL PROCEEDS OF ISSUE (PART II, LINE 3) NOTE THAT THE SUM OF PART II, LINES 4-12 DOES NOT EQUAL THE AMOUNT REPORTED ON PART II, LINE 3. THE DIFFERENCE IS THE RESULT OF THE DESCREASED VALUE OF GROSS PROCEEDS IN RESERVE FUNDS FROM THE DATE OF ISSUANCE THROUGH JUNE 30, 2013. $2,018,535 GROSS PROCEEDS IN RESERVE FUNDS ON DATE OF ISSUE - 15,916 DECREASED VALUE THROUGH JUNE 30, 2013 = 2,002,619 GROSS PROCEEDS IN RESERVE FUNDS AT JUNE 30, 2013 (PART II, LINE 4)
TERM OF HEDGE	SCHEDULE K, PART IV, LINE 4C	TERM OF 2006E HEDGE - 2.5 YEARS TERM OF 2006D HEDGE - 3.5 YEARS
WRITTEN PROCEDURES TO ENSURE ALL NONQUALIFIED BONDS ARE REMEDIATED IN ACCORDANCE WITH REGULATIONS	SCHEDULE K, PART III, LINE 9	THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES TO ENSURE ALL NONQUALIFIED BONDS (IF ANY) OF THE ISSUE ARE REMEDIATED IN ACCORDANCE WITH THE ASSOCIATED REGULATIONS. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS.
WRITTEN PROCEDURES TO MONITOR REQUIREMENTS OF SECTION 148	SCHEDULE K, PART IV, LINE 7	THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES TO MONITOR THE ORGANIZATION'S ABILITY TO REMAIN IN COMPLIANCE WITH THE ARBITRAGE REQUIREMENTS UNDER SECTION 148 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS.
WRITTEN PROCEDURES TO ENSURE VIOLATIONS ARE IDENTIFIED AND CORRECTED THROUGH VCAP	SCHEDULE K, PART V	THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES WHICH DICTATE HOW MANAGEMENT TIMELY IDENTIFIES AND CORRECTS VIOLATIONS OF FEDERAL TAX REQUIREMENTS USING THE VOLUNTARY CLOSING AGREEMENT PROGRAM (VCAP) PROVIDED BY THE IRS WHEN SELF-REMEDIATION IS NOT AVAILABLE TO THE ORGANIZATION. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS. IN THE EVENT A VIOLATION IS IDENTIFIED THE ORGANIZATION'S POLICY IS TO CORRECT THE VIOLATION AS SOON AS POSSIBLE, WHILE WORKING WITH THE FEDERAL AUTHORITIES AS NECESSARY TO ENSURE THAT SUFFICIENT CONTROLS ARE PRESENT WHICH WILL GUARD AGAINST FUTURE VIOLATIONS.
ISSUER NAME: St. Joseph County, Indiana: No Rebate Due.	Schedule K, Part IV, Line 2c	THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 3/29/2011.

Schedule K (Form 990) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

HOLY CROSS VILLAGE AT NOTRE DAME INC

Employer identification number

35-2084623

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2012

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) BARBARA CASSADY	SPOUSE (THOMAS CASSADY, JR.) IS A BOARD MEMBER	37,196	EMPLOYEE COMPENSATION		No

Part V

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

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2012

Additional Data

Software ID:	12000266
Software Version:	v2012.1.0

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

HOLY CROSS VILLAGE AT NOTRE DAME INC

Employer identification number

35-2084623

Identifier	Return Reference	Explanation
ORGANIZATION'S MISSION (CONTINUED FROM PART III)	FORM 990, PART III, LINE 1	HOLY CROSS VILLAGE AT NOTRE DAME WAS ESTABLISHED AS A FAITH-BASED, NON-PROFIT ORGANIZATION AND HAS SINCE DEDICATED ITSELF TO PROVIDING HOUSING, HEALTH CARE AND SUPPORT SERVICES EXCLUSIVELY TO OLDER ADULTS IN WAYS THAT PROMOTE INDEPENDENCE AND A HEALTHY, ACTIVE LIFESTYLE THROUGH A CONTINUING CARE RETIREMENT COMMUNITY. HOLY CROSS VILLAGE IS NORTHERN INDIANA'S PREMIER CONTINUING CARE RETIREMENT COMMUNITY. OFFERING RESIDENTIAL LIVING, LIFELONG LEARNING AND SECURITY FOR THE FUTURE, HOLY CROSS VILLAGE IS THE PERFECT RETIREMENT OPTION FOR THOSE SEEKING AN ACTIVE, INDEPENDENT LIFESTYLE WITH SERVICES AND AMENITIES TO KEEP THE MIND, BODY AND SPIRIT YOUNG. THE ORGANIZATION STRIVES TO: - ENHANCE THE QUALITY OF SENIORS' LIVES THROUGH WELLNESS PROGRAMS AND ENGAGING LIFELONG LEARNING ACTIVITIES; - PROVIDE THE HIGHEST QUALITY OF LIVING AND PERSONAL CARE WHILE RESPECTING THE RESIDENTS' INDIVIDUAL DIGNITY AND RIGHT TO PERSONAL CHOICE; - PROVIDE A HOME-LIKE ATMOSPHERE THAT ALLOWS RESIDENTS TO ENJOY THE ADVANTAGES OF COMMUNITY LIVING WITHOUT COMPROMISING THEIR INDIVIDUALITY, DIGNITY OR PRIVACY; AND - WORK TO CREATE A MODEL OF SUCCESSFUL AGING THAT ENHANCES EVERY PERSON'S POTENTIAL AND LESSENS THE EFFECTS OF GETTING OLDER.
INDEPENDENT AND ASSISTED LIVING (CONTINUED FROM PART III)	FORM 990, PART III, LINE 4A	HOLY CROSS VILLAGE IS AN INTERDEPENDENT COMMUNITY ENERGIZED BY HOLY CROSS SPIRITUALITY AND HOSPITALITY, AND DEDICATED TO PROVIDING A NURTURING ENVIRONMENT FOCUSED ON DIGNITY AND RESPECT. HOLY CROSS VILLAGE GOES BEYOND WHAT'S EXPECTED TO OFFER A LIFESTYLE THAT ALLOWS RESIDENTS TO LIVE AS INDEPENDENTLY AS POSSIBLE, WHILE STAYING CLOSE TO FAMILY, FRIENDS, AND THE BEST CARE AVAILABLE. RESIDENTS HAVE PEACE OF MIND KNOWING THEIR FUTURES ARE SECURE, WHICH IS SOMETHING THEY WILL VALUE AS MUCH TODAY AS THEY WILL TOMORROW. HOLY CROSS VILLAGE IS ALSO A LICENSED ASSISTED LIVING COMMUNITY, AND OUR ASSISTED LIVING APARTMENTS ALLOW FOR PRIVACY AND INDEPENDENCE. IF RESIDENTS REQUIRE ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, OUR COMPREHENSIVE RANGE OF SUPPORTIVE SERVICES IS DESIGNED TO FIT THEIR NEEDS, AND OUR CARING STAFF IS AVAILABLE 24 HOURS A DAY TO ASSIST THEM. DURING THE YEAR ENDED JUNE 30, 2013 THE ORGANIZATION PROVIDED SERVICES TO 189 RESIDENTS IN AN INDEPENDENT LIVING SETTING WITH 152 APARTMENTS AND VILLAS, AS WELL AS 59 RESIDENTS IN AN ASSISTED LIVING SETTING WITH 46 APARTMENTS.
SKILLED NURSING AND MEMORY CARE (CONTINUED FROM PART III)	FORM 990, PART III, LINE 4B	REHABILITATION SERVICES ARE DELIVERED IN A RESIDENT-CENTERED PROGRAM THAT IS FOCUSED ON ACHIEVING POSITIVE OUTCOMES. RESIDENTS RECEIVE 24-HOUR NURSING SUPERVISION AND RESTORATIVE THERAPIES THAT ARE PHYSICIAN DIRECTED. THE ONSITE REHABILITATION CENTER DELIVERS PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES AS WELL AS OTHER SPECIALIZED SERVICES TO MEET REHABILITATION NEEDS. MEMORY CARE ACCOMMODATIONS ARE OFFERED IN A SECURED ENVIRONMENT DESIGNED TO MEET THE NEEDS OF SENIORS WITH ALZHEIMER'S, DEMENTIA AND OTHER MEMORY LOSS. INDIVIDUALS WHO NEED HELP WITH DAY-TO-DAY LIVING RECEIVE SPECIAL ENCOURAGEMENT TO ADD MEANING AND FULFILLMENT TO THEIR LIVES. SERVICES ARE TAILORED SPECIFICALLY TO EACH RESIDENT WHILE SUPPORTING A HEALTHY LIFESTYLE IN A SECURED AREA THAT HAS ACCESS TO A COURTYARD AND VIEWS OF A WOODED AREA. CERTIFIED NURSING ASSISTANTS PROVIDE STANDBY AND HANDS ON ASSISTANCE WITH BATHING, GROOMING AND ESCORTS. RESIDENTS ARE ENCOURAGED TO CONTINUE ACTIVITIES THEY LOVE AND ENJOY. A WIDE RANGE OF LIFE ENRICHING ACTIVITIES ARE PLANNED FOR RESIDENTS EACH DAY THAT ARE TARGETED TO RAISE SPIRITS, STIMULATE MINDS AND PROMOTE HAPPINESS. DURING THE YEAR ENDED JUNE 30, 2013, THE ORGANIZATION PROVIDED SERVICES TO 135 RESIDENTS IN A NURSING SETTING WITH 36 BEDS AND A NURSING DEMENTIA CENTER WITH 12 ROOMS.
Delegate broad authority to a committee	Form 990, Part VI, Section A, Line 1a	THE BOARD, BY RESOLUTION OF A MAJORITY OF THE DIRECTORS THEN IN OFFICE, MAY APPOINT ONE OR MORE STANDING OR SPECIAL COMMITTEES AS NEEDED. THE BOARD SHALL APPOINT THE EXECUTIVE COMMITTEE, WHICH SHALL BE A STANDING COMMITTEE. MEMBERS OF THE BOARD COMMITTEES SHALL BE APPOINTED BY THE BOARD OR BY THE CHAIRPERSON, SUBJECT TO THE APPROVAL OF THE BOARD. EACH COMMITTEE AUTHORIZED TO EXERCISE ANY POWER OF THE BOARD (AS OPPOSED TO MERELY ADVISORY COMMITTEES) SHALL HAVE AT LEAST TWO (2) DIRECTORS AND MAY CONSIST OF PERSONS OTHER THAN DIRECTORS, PROVIDED THAT AT LEAST A MAJORITY OF SUCH COMMITTEE MEMBERS ARE DIRECTORS. THE EXECUTIVE COMMITTEE SHALL BE A STANDING COMMITTEE, AND SHALL HAVE AND MAY EXERCISE ALL POWERS OF THE BOARD (SUBJECT TO THE LIMITATIONS SET FORTH IN THE ORGANIZATION'S BYLAWS) BETWEEN MEETINGS OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON, PRESIDENT AND TWO OTHER DIRECTORS SELECTED BY THE CHAIRMAN, SUBJECT TO THE APPROVAL OF THE BOARD. ACTIONS DULY TAKEN BY THE EXECUTIVE COMMITTEE WITHIN THE SCOPE OF ITS AUTHORITY SHALL BE CONSIDERED THE ACTIONS OF THE BOARD.
Classes of members or stockholders	Form 990, Part VI, Section A, Line 6	THE BROTHERS OF HOLY CROSS, A RELATED TAX-EXEMPT ORGANIZATION, IS THE SOLE CORPORATE MEMBER OF HOLY CROSS VILLAGE AT NOTRE DAME, INC .
Members or stockholders electing members of governing body	Form 990, Part VI, Section A, Line 7a	THE BROTHERS OF HOLY CROSS, THE ORGANIZATION'S SOLE MEMBER, HAS THE POWER TO APPOINT AND REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS, INCLUDING THE CHAIRPERSON.
Decisions requiring approval by members or stockholders	Form 990, Part VI, Section A, Line 7b	THE BROTHERS OF HOLY CROSS, THE ORGANIZATION'S SOLE MEMBER, HAS THE FOLLOWING ADDITIONAL RESERVED POWERS: 1. TO REVIEW AND CONSULT WITH THE HCV BOARD ON ANY CHANGES TO OR DEVIATIONS FROM THE MISSION AND VALUES OF HCV AND TO APPROVE ANY SUCH CHANGES OR DEVIATIONS. 2. TO APPROVE THE CORPORATION'S ANNUAL AND CAPITAL BUDGETS AND SIMILAR DOCUMENTS DEVELOPED BY THE BOARD. 3. TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION, BYLAWS AND SIMILAR GOVERNING DOCUMENTS OF THE CORPORATION. 4. TO APPOINT AND REMOVE DIRECTORS TO THE BOARD. 5. TO APPOINT AND REMOVE THE CHAIRPERSON AND THE PRESIDENT BASED UPON RECOMMENDATIONS OF THE HCV BOARD. 6. TO APPROVE ANY MERGER, CONSOLIDATION, DISSOLUTION OR LIQUIDATION OF THE CORPORATION. 7. TO APPROVE THE PURCHASE, SALE, DONATION, LEASE, MORTGAGE, OR ANY OTHER ACQUISITION, DISPOSITION OR ENCUMBRANCE OF ANY ASSETS OF THE CORPORATION, EXCEPT WITH RESPECT TO TRANSACTIONS WITHIN LIMITS DELEGATED TO THE CORPORATION, OR SPECIFICALLY APPROVE AS PART OF A STRATEGIC AND FINANCIAL PLAN OF THE CORPORATION. 8. TO APPROVE THE ESTABLISHMENT, TERMINATION, TRANSFER OR OTHER ACQUISITION OR DISPOSITION OF ANY MAJOR MINISTRY, WORK OR SIMILAR PROGRAM BY HCV. 9. TO APPROVE THE CREATION OF ANY NEW AFFILIATE OR ANY AFFILIATION OF THE CORPORATION WITH ANOTHER ENTITY. 10. TO APPROVE THE INCURRENCE OF INDEBTEDNESS, THE MAKING OF LOANS TO OTHER ENTITIES OR THE GUARANTY OF ANY INDEBTEDNESS OF OTHERS, BY THE CORPORATION, FOR AMOUNTS IN EXCESS OF THE MEMBER-SPECIFIED LIMITS, EXCEPT WITH RESPECT TO TRANSACTIONS SPECIFICALLY APPROVED AS PART OF A STRATEGIC AND FINANCIAL PLAN OF THE CORPORATION. 11. TO ESTABLISH DOLLAR LIMITS BELOW WHICH THE CORPORATION MAY AUTHORIZE FINANCIAL EXPENDITURES, INCLUDING CONTRACTS INVOLVING SUCH EXPENDITURES. 12. TO ESTABLISH DOLLAR LIMITS BELOW WHICH THE CORPORATION MAY AUTHORIZE LITIGATION SETTLEMENTS OR ANY RELEASE OR CANCELLATION BY THE CORPORATION OF A CLAIM OR RIGHT OF ACTION AGAINST ANOTHER PARTY.
Review of form 990 by governing body	Form 990, Part VI, Section B, Line 11b	THE ORGANIZATION'S MANAGEMENT REVIEWED A DRAFT OF THE FORM 990 IN DETAIL. A FINAL DRAFT OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, ALONG WITH A MANAGEMENT SUMMARY WAS THEN PRESENTED TO THE ORGANIZATION'S FINANCE COMMITTEE IN JANUARY 2014. A COPY OF THE FULL FORM 990 AND MANAGEMENT SUMMARY WAS THEN PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS IN FEBRUARY 2014 FOR REVIEW PRIOR TO ITS FILING WITH THE IRS.
Conflict of interest policy	Form 990, Part VI, Section B, Line 12c	THE SECRETARY OF THE BOARD OF DIRECTORS DISTRIBUTES THE ORGANIZATION'S CONFLICT OF INTEREST POLICY, WHICH INCLUDES A CONFLICT OF INTEREST QUESTIONNAIRE, TO THE BOARD MEMBERS ANNUALLY. THE SECRETARY COLLECTS AND REVIEWS THE COMPLIANCE QUESTIONNAIRE FORMS FOR ANY POTENTIAL CONFLICTS OF INTEREST. IF ANY ACTUAL CONFLICTS OF INTEREST ARE DETERMINED TO EXIST, THE BOARD MEMBER IS RECUSED FROM VOTING ON THE CONFLICTING ISSUE. IN ADDITION, A REVIEW OF THE CONFLICT OF INTEREST POLICY AND COMPLETION OF A COMPLIANCE QUESTIONNAIRE IS PART OF EVERY EMPLOYEES' ANNUAL REVIEW. THIS ANNUAL REVIEW IS DONE BY THE INDIVIDUAL'S DIRECT SUPERVISOR AND THE HUMAN RESOURCE DIRECTOR.
PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS	FORM 990, PART VI, LINE 15	IN APRIL 2010, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF HOLY CROSS VILLAGE ENGAGED MERCER, A NATIONAL HR CONSULTING FIRM, TO CONDUCT AN ANALYSIS OF THE CURRENT COMPENSATION OF THE POSITIONS OF PRESIDENT/CEO, TREASURER/CONTROLLER, AND DIRECTOR OF CAMPUS OPERATIONS. MERCER ANALYZED DATA FROM FIVE MAJOR NATIONAL COMPENSATION SURVEYS AS WELL AS REGIONAL DATA. IN JULY 2010, MERCER PRESENTED ITS FINDINGS TO THE EXECUTIVE COMMITTEE. THOSE FINDINGS CONCLUDED THAT THE CURRENT BASE COMPENSATION OF THE THREE POSITIONS SUBJECT TO THIS STUDY WERE WITHIN THE RESPECTIVE PAY RANGES DEVELOPED BY MERCER BASED UPON THE SURVEY DATA WHICH IT HAD UTILIZED AND, THUS, SATISFIED THE CONDITION OF REBUTTABLE PRESEUMPTION OF REASONABLENESS. THE EXECUTIVE COMMITTEE ACCEPTED THE REPORT BY MERCER. IN ADDITION, THE ORGANIZATION'S HUMAN RESOURCES (HR) DEPARTMENT ESTABLISHES A MERIT-BASED COMPENSATION MATRIX THAT PROVIDES FOR ANY INCREASES TO BASE COMPENSATION FOR ALL EMPLOYEES, INCLUDING THE ORGANIZATION'S OFFICERS. THE MATRIX IS NOT REVIEWED OR APPROVED BY THE BOARD OF DIRECTORS. HOWEVER, THE BOARD'S APPROVAL OF THE ORGANIZATION'S OVERALL ANNUAL BUDGET, WHICH INCLUDES THE BUDGET FOR SALARIES AND BENEFITS, IS TAKEN INTO CONSIDERATION WHEN THE HR DEPARTMENT DEVELOPS THE MATRIX.
Process used to establish compensation of top management official	Form 990, Part VI, Section B, Line 15a	IN APRIL 2013, THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF HOLY CROSS VILLAGE ENGAGED MERCER, A NATIONAL HR CONSULTING FIRM, TO CONDUCT AN ANALYSIS OF THE ORGANIZATION'S CURRENT COMPENSATION LEVELS. MERCER ANALYZED DATA FROM FIVE MAJOR NATIONAL COMPENSATION SURVEYS AS WELL AS REGIONAL DATA. THE COMPENSATION COMMITTEE MET ON JUNE 7, 2013, TO REVIEW THE FINDINGS OF MERCER'S STUDY AND PROVIDE RECOMMENDATIONS FOR ANY ADJUSTMENTS TO COMPENSATION LEVELS FOR SEVERAL KEY POSITIONS, INCLUDING THE PRESIDENT/CEO, CFO, AND TREASURER/CONTROLLER. THE COMPENSATION COMMITTEE'S REVIEW, RECOMMENDATIONS, AND APPROVAL WERE DOCUMENTED IN THE MEETING MINUTES.
Process used to establish compensation of other officers/key employees	Form 990, Part VI, Section B, Line 15b	SEE NARRATIVE FOR FORM 990, PART VI, LINE 15A.
Governing documents, conflict of interest policy and financial statements available to the public	Form 990, Part VI, Section C, Line 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC, EITHER IN PRINTED OR PDF COPY, UPON REQUEST
Other Expenses	Form 990, Part IX, Line 11g	DINING SERVICES - TOTAL EXPENSE: 1117254, PROGRAM SERVICE EXPENSE: 1049582, MANAGEMENT AND GENERAL EXPENSES: 67672, FUNDRAISING EXPENSES: ; THERAPY - TOTAL EXPENSE: 287613, PROGRAM SERVICE EXPENSE: 287613, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; PLANT REPAIRS AND MAINTENANCE - TOTAL EXPENSE: 487308, PROGRAM SERVICE EXPENSE: 487308, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; GROUNDS AND SNOW PLOWING - TOTAL EXPENSE: 180007, PROGRAM SERVICE EXPENSE: 180007, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; OTHER FEES FOR SERVICES - TOTAL EXPENSE: 651133, PROGRAM SERVICE EXPENSE: 516804, MANAGEMENT AND GENERAL EXPENSES: 134329, FUNDRAISING EXPENSES: ;
Other changes in net assets or fund balances	Form 990 , Part XI, Line 9	CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE - -3397557; TRANSFER TO MEMBER - -1052686; CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION - 417212;

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:	12000266
Software Version:	v2012.1.0

- 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

HOLY CROSS VILLAGE AT NOTRE DAME INC

Employer identification number

35-2084623

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) BROTHERS OF HOLY CROSS INC 54515 SR 933 N PO BOX 460 NOTRE DAME,IN46556	ROMAN CATHOLIC CHURCH RELIGIOUS ORDER	IN	501(C)(3)	1	CONGREGATION OF HOLY CROSS		No
(2) HOLY CROSS VILLAGE FOUNDATION 54515 SR 933 N PO BOX 303 NOTRE DAME,IN46556	SUPPORT HOLY CROSS VILLAGE AT NOTRE DAME	IN	501(C)(3)	11 - Type II	BROTHERS OF HOLY CROSS		No

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	(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

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 . . . . . . . . . . . . . . . . . . . . . . .

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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) . . . . . . . . . . . . . . . . . . . .

Yes

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) . . . . . . . . . . . . . . . . . . . . .

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

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

Yes

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

Yes

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

Yes

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

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:	12000266
Software Version:	v2012.1.0