Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
ALZHEIMER'S & DEMENTIA RESOURCE CENTER INC
Employer identification number
59-2496511
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
285,828
343,518
286,101
381,255
280,382
1,577,084
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
285,828
343,518
286,101
381,255
280,382
1,577,084
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)..
313,177
6
Public support. Subtract line 5 from line 4.
1,263,907
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..
285,828
343,518
286,101
381,255
280,382
1,577,084
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
870
3,964
3,906
4,536
1,123
14,399
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
1,660
10,458
12,118
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).
1,603,601
12
Gross receipts from related activities, etc. (see instructions)
..................
12
91,408
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here........................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
78.820 %
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
92.240 %
16a
33 1/3% support test—2012.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2011.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2008
(b) 2009
(c) 2010
(d) 2011
(e) 2012
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2012.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2011.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information.
Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2012
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
ALZHEIMER'S & DEMENTIA RESOURCE CENTER INC
Employer identification number
59-2496511
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
NOW APPROACHING ITS 30TH ANNIVERSARY, THE ALZHEIMER'S & DEMENTIA RESOURCE CENTER (ADRC) PROVIDES CAREGIVERS WITH THE SUPPORT, GUIDANCE AND RESOURCES NEEDED TO HELP COPE WITH THE DAILY CHALLENGES THEY FACE AND HELP THEM TO BETTER CARE FOR THEIR LOVED ONES. COMBINED WITH ITS ONGOING CONTRIBUTIONS TO RESEARCH CENTERS THROUGHOUT THE WORLD AND ACTIVE PARTICIPATION IN FIGHTING THE DISEASE, THE ORGANIZATION STRIVES TO PROVIDE CAREGIVERS WITH COMPASSION TODAY AND HOPE FOR TOMORROW. MORE THAN FIVE MILLION PEOPLE HAVE BEEN DIAGNOSED WITH SOME FORM OF DEMENTIA IN THE UNITED STATES, A DISEASE THAT CAN LAST FROM 5 TO 20 YEARS. ESTIMATES INDICATE THAT THE NUMBER OF PEOPLE WORLDWIDE SUFFERING FROM DEMENTIA IS EXPECTED TO DOUBLE EVERY 20 YEARS REACHING 115.4 MILLION PEOPLE BY 2050. 70% OF PATIENTS ARE CARED FOR AT HOME BY LOVED ONES PROVIDING AROUND THE CLOCK CARE AND SUPERVISION, TOTALING A STAGGERING 70-100 HOURS PER WEEK AT AN ANNUAL COST OF 60,090 PER PERSON. THE MENTAL AND EMOTIONAL HEALTH OF FAMILY CAREGIVERS IS ONE OF THE ISSUES OF PRIMARY CONCERN TO ADRC. ESTIMATES SHOW THAT BETWEEN 50% TO 70% OF CAREGIVERS HAVE CLINICALLY SIGNIFICANT SYMPTOMS OF DEPRESSION, WITH APPROXIMATELY 35% TO 50% OF THESE CAREGIVERS MEETING THE DIAGNOSTIC CRITERIA FOR MAJOR DEPRESSION. EVEN WHEN CAREGIVERS PLACE A LOVED ONE IN A PROFESSIONAL CARE FACILITY, MANY REPORT THEIR DEPRESSIVE SYMPTOMS AND ANXIETY TO BE AS HIGH AS IT WAS WHEN CARE WAS PROVIDED IN THE HOME. ADDITIONALLY, HIGH RATES OF DEPRESSIVE SYMPTOMS COMPOUNDED BY THE PHYSICAL STRAIN OF CARING FOR SOMEONE WHO CANNOT PERFORM BASIC ACTIVITIES OF DAILY LIVING ON THEIR OWN (BATHING, GROOMING, EATING, ETC.) PUTS MANY CAREGIVERS AT SERIOUS RISK FOR DETERIORATING HEALTH ISSUES. IN GENERAL, CAREGIVERS TEND TO BE IN WORSE HEALTH THAN THEIR NON-CAREGIVING COUNTERPARTS, HAVE AN INCREASED RISK OF HEART DISEASE, HAVE LOWER LEVELS OF SELF-CARE AND HIGHER RATES OF MORTALITY. ELDERLY SPOUSAL CAREGIVERS BETWEEN THE AGES OF 66 AND 96 EXPERIENCING CAREGIVER STRESS HAVE A 63% HIGHER MORTALITY RATE THAN NON-CAREGIVERS OF THE SAME AGE. ADRC'S FAMILY SERVICES DEPARTMENT OFFERS A FULL COMPLEMENT OF SUPPORTIVE SERVICES FOR CAREGIVERS AND THEIR FAMILIES INCLUDING ONE-ON-ONE EDUCATIONAL COUNSELING THROUGHOUT THE COURSE OF THE DISEASE, PROFESSIONALLY FACILITATED SUPPORT GROUPS, INFORMATION AND REFERRAL ON ALL RELATED COMMUNITY SERVICES, WORKSHOPS COVERING INDIVIDUAL TOPICS OF INTEREST TO THE CAREGIVERS AND A FULL DAY EDUCATIONAL CONFERENCE WITH PROFESSIONAL SPEAKERS COVERING A VARIETY OF IMPORTANT ISSUES. IN 2011-2012, ADRC INTRODUCED A SERIES OF CLASSES CALLED THE ABCS OF CAREGIVING TO PROVIDE CAREGIVERS WITH THE TECHNICAL SKILLS NEEDED TO PHYSICALLY CARE FOR ANOTHER ADULT WITH A CHRONIC ILLNESS. MOST CAREGIVERS ARE ILL-PREPARED FOR HANDLING THE MANY RESPONSIBILITIES ASSOCIATED WITH CARING FOR SOMEONE WITH COGNITIVE DIFFICULTIES. IN ADDITION, FAMILY CAREGIVERS RARELY REACH OUT TO OTHERS FOR A BREAK IN THEIR CAREGIVING DUTIES AND CAN BE PARTICULARLY RELUCTANT TO BRING IN OUTSIDE PROFESSIONALS WHEN THEY NEED A BREAK FROM THESE ROUND-THE-CLOCK RESPONSIBILITIES. IN ORDER TO ENCOURAGE CLASS PARTICIPANTS TO TAKE ADVANTAGE OF THE RELIEF PROFESSIONAL CAREGIVERS CAN PROVIDE FAMILY MEMBERS, ADRC OFFERS FOUR HOURS OF PAID RESPITE CARE FOR EACH OF THE FOUR TWO-HOUR CLASSES THE CAREGIVERS ATTEND., SO THE CAREGIVER CAN ATTEND CLASS AND THEN HAVE SOME TIME TO THEMSELVES. THE ADDED HOURS OF RESPITE ALLOWS PARTICIPANTS TO GO TO LUNCH WITH THEIR COLLEAGUES OR JUST TAKE SOME TIME FOR THEMSELVES BEFORE RETURNING HOME. IN 2013, WE EXPANDED OUR CAREGIVER SKILLS TRAINING TO ABCS OF CAREGIVING TO INCORPORATE SESSIONS FOR THOSE CARING FOR SOMEONE WITH ALZHEIMER'S DISEASE OR RELATED DEMENTIAS. THE EXPANDED CURRICULUM IS CALLED ABCS & XYZS OF CAREGIVING AND CONTINUES TO INCLUDE RESPITE CARE FOR THE PATIENT WHILE THEIR CAREGIVER ATTENDS CLASSES. ANOTHER NEW VENTURE FOR 2011-2012 INCLUDED A PARTNERSHIP WITH FLORIDA HOSPITAL'S ADVENTIST HEALTH SYSTEM TO PROVIDE CASE MANAGEMENT FOR AT-RISK DEMENTIA PATIENTS AND THEIR CAREGIVERS IN ORDER TO PREVENT THE TRAUMA OF PATIENT HOSPITALIZATION OR EMERGENCY ROOM ADMISSION. ADRC'S INVOLVEMENT IN THIS PILOT PROGRAM ENDED AS OF 12/31/13 ALTHOUGH WE CONTINUE TO BE A REFERRAL SOURCE FOR PATIENTS COMING THROUGH THIS PROGRAM. ADRC ALSO SPONSORS REJUVENATING "WELLNESS" EVENTS TO PROVIDE CAREGIVERS WITH MUCH NEEDED RESPITE FROM THEIR NEVER-ENDING RESPONSIBILITIES AND TO HELP ADDRESS THE SERIOUS INCIDENCES OF CLINICAL DEPRESSION AND ISOLATION IN CAREGIVERS. OUR MAJOR GOALS ARE TO HELP CAREGIVERS BE EFFECTIVE IN THEIR CARE GIVING ROLES WHILE ACKNOWLEDGING THE IMPORTANCE OF MAINTAINING THEIR OWN HEALTH, WHICH HAS THE RESIDUAL EFFECT OF IMPROVING PATIENT CARE AND REDUCING POTENTIAL PATIENT ABUSE. EACH YEAR APPROXIMATELY 60 FAMILY CAREGIVERS ARE TAKEN AWAY FOR A WEEKEND THROUGH OUR CAREGIVER RETREAT. THE WEEKEND STARTS WITH A BARBECUE FOR ALL PARTICIPANTS AT OUR OFFICE; A BUS THEN TRANSPORTS THE CAREGIVERS TO A NEARBY RESORT WHERE A FULL WEEKEND OF GROUP ACTIVITIES, ENTERTAINMENT AND SPECIAL MEALS ARE PLANNED INCLUDING GAMES AND FELLOWSHIP IN OUR HOSPITALITY SUITE. AGAIN, ADRC COVERS THE COST OF RESPITE CARE FOR THE LOVED ONES OF THOSE PARTICIPATING IN THE WEEKEND, PROVIDING AN OPPORTUNITY FOR CAREGIVERS TO DEVELOP NEW FRIENDSHIPS, REST AND REJUVENATE. STAFF MEMBERS OF THE AGENCY ALSO PROVIDE HUNDREDS OF HOURS OF FREE COMMUNITY WORKSHOPS AND PRESENTATIONS EACH YEAR ON A WIDE VARIETY OF TOPICS THROUGHOUT CENTRAL FLORIDA. PRESENTATIONS ARE PROVIDED TO FIRST RESPONDERS, SENIOR GROUPS, FAITH-BASED COMMUNITIES AND MANY OTHERS. WE ARE FOUNDING MEMBERS OF THE STATE OF FLORIDA BRAIN BANK RESEARCH PROGRAM WHICH PROVIDES FAMILIES WITH A POST MORBID AUTOPSY REPORT WHICH HELPS THEM UNDERSTAND THE TYPE(S) OF DEMENTIA WHICH AFFECTED THEIR LOVED ONE, PROVIDES THE FAMILY PHYSICIAN WITH CRITICAL INFORMATION RELATED TO HIS/HER DIAGNOSTIC PROCESS AND MAKES BRAIN TISSUE AVAILABLE THROUGH A NATIONAL TISSUE BANK THAT CAN BE ACCESSED BY RESEARCHERS WORLDWIDE. THE ALZHEIMER RESOURCE CENTER IS ALSO APPROVED BY THE STATE OF FLORIDA TO OFFER STATE- MANDATED ALZHEIMER'S TRAINING TO PROFESSIONAL CAREGIVERS AND CARE GIVING AGENCIES ON AN ANNUAL BASIS, AS REQUIRED BY FLORIDA LAW.
FIRST ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4A
GUIDELINE FOR IMPROVING DEMENTIA PATIENT CARE. DURING FISCAL YEAR 2012-2013, THE ADRC'S BRAIN BANK RESEARCH PROGRAM, WHICH HAS TRADITIONALLY ENROLLED THE MOST PARTICIPANTS OF ALL OTHER PROGRAM SITES IN THE STATE, ENROLLED 67 NEW PARTICIPANTS IN A 21 COUNTY AREA OF CENTRAL FLORIDA, REPRESENTING 59% OF ALL CANDIDATES IN THE PROGRAM STATEWIDE. ADRC'S BRAIN BANK RESEARCH PROGRAM HAS ALSO DEVELOPED KEY RESEARCH-BASED PARTNERSHIPS WITH WASHINGTON UNIVERSITY IN ST. LOUIS, INDIANA UNIVERSITY, MAYO CLINIC/JACKSONVILLE, JOHNS HOPKINS UNIVERSITY, GE HEALTHCARE RESEARCH DIVISION AND COMPASS RESEARCH, COORDINATING AUTOPSIES AND PROVIDING TISSUE SPECIMENS FOR THE ORGANIZATIONS' RESEARCH STUDIES.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
THE DRAFT VERSION OF THE FORM 990 IS REVIEWED FIRST BY THE EXECUTIVE DIRECTOR AND AN INDEPENDENT CPA. ANY CHANGES ARE SUBMITTED TO ADRC'S CPA. COPIES OF THE FINAL REVIEWED AND APPROVED 990 IS THEN PROVIDED TO ADRC'S BOARD OF DIRECTORS.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
THE BYLAWS REQUIRE DIRECTORS TO ADVISE THE BOARD ANNUALLY OF ANY POTENTIAL CONFLICTS OF INTEREST.
COMPENSATION PROCESS FOR TOP OFFICIAL
FORM 990, PAGE 6, PART VI, LINE 15A
PROCESS FOR TOP OFFICIALS: THE BOARD DETERMINES THE EXECUTIVE DIRECTOR'S SALARY BASED ON HIS/HER PERFORMANCE AND BY COMPARISON TO SALARIES IN OTHER ORGANIZATIONS AS REPORTED IN SALARY STUDIES CONDUCTED EVERY THREE YEARS BY ROLLINS COLLEGE PHILANTHROPY AND NONPROFIT LEADERSHIP ORGANIZATION IN ORLANDO, FLORIDA.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
GOVERNING DOCUMENTS ARE AVAILABLE FOR REVIEW AT THE PROGAM OFFICE, UPON REQUEST.
RECONCILIATION OF CHANGES - OTHER
FORM 990, PART XI, LINE 9
COST OF EVENT ADVERTISING REPORTED ON PART IX OF FORM 990 0 WAS NETTED AGAINST REVENUE AS COST OF EVENT ON THE 0 FINANCIAL STATEMENTS. -5,406 ROUNDING IN FINANCIAL STATEMENTS -1 UNREALIZED LOSS ON ASSETS -3,820 ROUNDING IN FINANCIAL STATEMENTS -5 COST OF EVENT ADVERTISING REPORTED ON PART IX OF FORM 990 0 WAS NETTED AGAINST REVENUE AS COST OF EVENT ON THE 0 FINANCIAL STATEMENTS. 5,406
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.