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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
WRC PENNSYLVANIA MEMORIAL HOME
Employer identification number
25-0718600
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
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—2012.
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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
114,248
165,927
224,602
120,077
121,569
746,423
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......
10,897,298
11,242,822
10,876,486
11,073,871
12,012,655
56,103,132
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.
11,011,546
11,408,749
11,101,088
11,193,948
12,134,224
56,849,555
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
0
c
Add lines 7a and 7b..
0
8
Public support (Subtract line 7c from line 6.)
56,849,555
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
11,011,546
11,408,749
11,101,088
11,193,948
12,134,224
56,849,555
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
142,559
83,134
144,774
172,988
309,337
852,792
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
142,559
83,134
144,774
172,988
309,337
852,792
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.)
..
505,031
354,763
488,766
412,627
461,403
2,222,590
13
Total support. (Add lines 9, 10c, 11, and 12.)..
11,659,136
11,846,646
11,734,628
11,779,563
12,904,964
59,924,937
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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
94.870 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
95.460 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
1.420 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
1.010 %
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
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) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
WRC PENNSYLVANIA MEMORIAL HOME
Employer identification number
25-0718600
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
THE SOLE MEMBER OF WRC PENNSYLVANIA MEMORIAL HOME IS WRC SENIOR SERVICES.
FORM 990, PART VI, SECTION A, LINE 7A
WRC SENIOR SERVICES ELECTS WRC PENNSYLVANIA MEMORIAL HOME'S BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B
WRC SENIOR SERVICES HAS THE EXCLUSIVE POWER TO DO EACH OF THE FOLLOWING WITH RESPECT TO WRC PENNSYLVANIA MEMORIAL HOME: 1. APPROVE ALL FUNDAMENTAL TRANSACTIONS OF THE CORPORATION. 2. ELECT ALL OF THE DIRECTORS. 3. APPROVE ALL OF THE OFFICERS OF THE CORPORATION. 4. REMOVE AT ANY TIME AND FROM TIME TO TIME ONE OR MORE OF THE OFFICERS AND/OR DIRECTORS OF THE CORPORATION WITHOUT ASSIGNING ANY CAUSE. 5. APPROVE ALL INDEBTEDNESS AND CONTRACTUAL COMMITMENTS OF THE CORPORATION IN EXCESS OF $5,000 WITH RESPECT TO A SINGLE TRANSACTION OR IN EXCESS OF $15,000 IN THE AGGREGATE FOR ANY ROLLING TWELVE-MONTH PERIOD OR DEFEASANCE OF ANY SUCH INDEBTEDNESS. 6. APPROVE ALL CAPITAL AND OPERATING BUDGETS OF THE CORPORATION AND AMENDMENTS THERETO. 7. APPROVE ALL UNBUDGETED EXPENDITURES OF THE CORPORATION IN EXCESS OF $5,000 WITH RESPECT TO A SINGLE TRANSACTION OR IN EXCESS OF $15,000 IN THE AGGREGATE. 8. APPROVE ANY AND ALL AMENDMENTS OF THE BYLAWS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11
WRC PENNSYLVANIA MEMORIAL HOME HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C
WRC PENNSYLVANIA MEMORIAL HOME ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM. DURING BOARD MEETINGS, IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING.
FORM 990, PART VI, SECTION B, LINE 15
THE CEO'S COMPENSATION IS PAID BY WRC SENIOR SERVICES. WRC SENIOR SERVICES' BOARD OF DIRECTORS ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT.
FORM 990, PART VI, SECTION C, LINE 18
WRC PENNSYLVANIA MEMORIAL HOME MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19
AT THIS TIME, WRC PENNSYLVANIA MEMORIAL HOME DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC.
FORM 990, PART IX, LINE 11G
CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,360,427. MANAGEMENT AND GENERAL EXPENSES 319,112. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,679,539.
FORM 990, PART XI, LINE 9:
NET ASSETS RELEASED FROM RESTRICTIONS -29,385. TEMPORARILY RESTRICTED CONTRIBUTIONS 77,879.
FORM 990, PART XII, LINE 2C:
WRC PENNSYLVANIA MEMORIAL HOME HAS AN AUDIT COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT AUDITORS. THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.
FORM 990, PAGE 1, LINE C
WRC PENNSYLVANIA MEMORIAL HOME DOES BUSINESS AS DR. ARTHUR CLIFTON MCKINLEY HEALTH CENTER, THE LAURELS LIFESTYLE IN FULL BLOOM, HIGHLAND OAKS, EDGEWOOD HEIGHTS, LAURELBROOKE PERSONAL CARE, AND RIDGMONT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.