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
THE VILLAGE AT MORRISONS COVE
Employer identification number
23-1381403
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.") .
566,849
156,826
189,989
270,028
319,636
1,503,328
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......
10,619,052
11,162,042
12,412,278
12,709,533
13,243,460
60,146,365
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
54,297
53,409
50,240
52,807
109,646
320,399
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.
11,240,198
11,372,277
12,652,507
13,032,368
13,672,742
61,970,092
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
85,000
89,981
80,500
81,331
10,774
347,586
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..
85,000
89,981
80,500
81,331
10,774
347,586
8
Public support (Subtract line 7c from line 6.)
61,622,506
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...
11,240,198
11,372,277
12,652,507
13,032,368
13,672,742
61,970,092
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
125,180
133,618
116,361
106,851
116,227
598,237
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
125,180
133,618
116,361
106,851
116,227
598,237
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
10,452
150,546
271,005
199,226
165,926
797,155
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
15,308
7,755
12,802
15,661
51,526
13
Total support. (Add lines 9, 10c, 11, and 12.)..
11,391,138
11,664,196
13,052,675
13,354,106
13,954,895
63,417,010
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
97.170 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
97.100 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
1.000 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
1.000 %
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
THE VILLAGE AT MORRISONS COVE
Employer identification number
23-1381403
Return Reference
Explanation
FORM 990 - ORGANIZATION'S MISSION
THE VILLAGE AT MORRISONS COVE, IN AFFILIATION WITH THE MIDDLE PENNSYLVANIA DISTRICT CHURCH OF THE BRETHEREN, IS ESTABLISHED TO SERVE THE MEMBERS OF THE CHURCH OF THE BRETHEREN AND OUR NEIGHBORS IN THE LARGER COMMUNITY. THE VILLAGE AT MORRISONS COVE PROVIDES A RESIDENTIAL COMMUNITY AND HEALTH CARE TO MEN AND WOMEN IN ACTIVE RETIREMENT AS WELL AS TO THOSE IN NEED OF CONVALESCENCE, ASSISTED LIVING, OR LONG TERM HEALTH CARE. BELIEVING THAT GOD CHARGES US TO CARE FOR THE WHOLE PERSON, THE VILLAGE PROVIDES SERVICES THAT ENRICH THE SPIRITUAL, EMOTIONAL, SOCIAL, INTELLECTUAL, AND PHYSICAL LIVES OF RESIDENTS.
FORM 990, PAGE 2, PART III, LINE 4A
73 INDEPENDENT LIVING COTTAGES AND A 31 UNIT INDEPENDENT LIVING APARTMENT BUILDING AND HAD 28,154 INDEPENDENT LIVING CENSUS DAYS IN 2013. THE VILLAGE ALSO OFFERS A MULTITUDE OF IN-HOME SERVICES THAT ARE NOT ONLY AVAILABLE TO OUR RESIDENTS ON THE VILLAGE CAMPUS BUT ALSO TO PEOPLE WHO LIVE WITHIN THE SURROUNDING COMMUNITIES. THESE IN-HOME SERVICES CONSIST OF HOME CARE, HOME HEALTH CARE, AND HOSPICE SERVICES. HOME CARE ("AGING-IN- PLACE") SERVICES PROVIDES IN-HOME SUPPORT SERVICES THAT CAN HELP CLIENTS MAINTAIN AN ACTIVE AND HEALTHY LIFESTYLE. THESE SERVICES CAN BE PROVIDED 24 HOURS A DAY, SEVEN DAYS A WEEK AND CAN RANGE FROM AS LITTLE AS AN HOUR TO 24 HOURS OF COMPANIONSHIP, AS NEEDED. HOME HEALTH CARE ("VILLAGE-IN- PLACE") SERVICES PROVIDES QUALITY HOME HEALTH CARE SERVICES TO CLIENTS IN THEIR OWN HOME AFTER HOSPITALIZATION, A CHANGE IN HEALTH STATUS OR WHEN THEY NEED INTERMITTENT SKILLED HOME HEALTH CARE BECAUSE THEY ARE HOMEBOUND. HOSPICE ("VILLAGE-IN-PLACE HOSPICE") SERVICES PROVIDES PALLIATIVE AND SUPPORTIVE CARE TO CLIENTS AND THEIR FAMILY IN THE PEACEFULNESS OF THEIR OWN HOME. BENEVOLENT CARE: THE VILLAGE PROVIDES CARE TO RESIDENTS WHO MEET CERTAIN CRITERIA UNDER ITS BENEVOLENT CARE POLICY AND ARE UNABLE TO PAY FOR SERVICES. BECAUSE THE VILLAGE DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE BENEVOLENT CARE, THEY ARE NOT REPORTED AS REVENUE. THE COST OF PROVIDING BENEVOLENT CARE IN BASED UPON DIRECT AND INDIRECT COSTS IDENTIFIED WITH THE SPECIFIC BENEVOLENT CARE PROVIDED. THE ESTIMATED COST OF BENEVOLENT CARE PROVIDED IN 2013 TOTALED 1,708,106.
FORM 990, PAGE 6, PART VI
THE EXECUTIVE COMMITTEE IS COMPRISED OF 4 OFFICERS AND CHAIRS OF SUB- COMMITTEES. ALL MEMBERS ARE FROM THE GOVERNING BODY. THE EXECUTIVE COMMITTEE IS PERMITTED TO VOTE ON ORGANIZATION BUSINESS WITHOUT A FULL BOARD VOTE.
FORM 990, PAGE 6, PART VI, LINE 7A
THE AFFAIRS OF THE VILLAGE AT MORRISONS COVE SHALL BE MANAGED BY A BOARD OF TRUSTEES, CONSISTING OF NOT LESS THAN 11 AND NOT MORE THAN 17. TRUSTEES WILL BE SELECTED AS FOLLOWS: AT LEAST THE SIMPLE MAJORITY TO BE ELECTED BY MIDDLE PENNSYLVANIA DISTRICT CONFERENCE, CHURCH OF THE BRETHREN; ONE TRUSTEE SHALL BE APPOINTED BY THE DISTRICT BOARD OF PENNSYLVANIA DISTRICT; ONE TRUSTEE SHALL BE APPOINTED BY THE VILLAGE AT MORRISONS COVE AUXILIARY; ONE TRUSTEE SHALL BE A RESIDENT APPOINTED BY THE BOARD; AND REMAINING TRUSTEES SHALL BE APPOINTED BY THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 11B
UPON RECEIPT OF THE FORM 990, THE CHIEF FINANCIAL OFFICER AND DIRECTOR OF FINANCE WILL REVIEW THE FORM WITH THE FINANCE COMMITTEE AND EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE WILL SIGN OFF ON THE REVIEW. THE FORM 990 WILL BE MADE AVAILABLE TO ALL BOARD MEMBERS PRIOR TO THE FILING OF THE FORM 990 WITH THE IRS.
FORM 990, PAGE 6, PART VI, LINE 12C
THE VILLAGE AT MORRISONS COVE'S CORPORATE COMPLIANCE PROGRAM STATES THE VILLAGE'S CONFLICT OF INTEREST POLICY. IN ADDITION, THE CONFLICT OF INTEREST POLICY IS ADDRESSED AT THE ANNUAL BOARD MEETING. IN THE EVENT A CONFLICT OF INTEREST ARISES INVOLVING A DIRECTOR, OFFICER, OR EMPLOYEE, ITS NATURE AND EXTENT ARE CONSIDERED BY THE BOARD OF DIRECTORS WHICH WILL DETERMINE APPROPRIATE ACTION TO BE TAKEN.
FORM 990, PAGE 6, PART VI, LINE 15A
THE VILLAGE AT MORRISONS COVE REVIEWS SALARY INFORMATION WITH AN EXTERNAL ACCOUNTING GROUP. THE GROUP USES COMPARABLE SALARIES FROM OTHER NON-PROFIT ORGANIZATIONS TO DETERMINE COMPENSATION THAT IS WITHIN FAIR VALUE RANGE. THE GROUP WORKS IN CONJUNCTION WITH THE EXECUTIVE COMMITTEE TO REVIEW DUTIES AND RESPONSIBILITIES OF THE CEO. THE COMPENSATION PACKAGE IS THEN REVIEWED BY THE FINANCIAL TEAM AND THEN AGAIN BY THE EXECUTIVE COMMITTEE BEFORE PRESENTATION TO THE CEO AND FINAL APPROVAL BY ALL PARTIES. COMPENSATION DISCUSSIONS AND DECISIONS ARE DOCUMENTED IN EXECUTIVE COMMITTEE MINUTES.
FORM 990, PAGE 6, PART VI, LINE 19
THE VILLAGE AT MORRISONS COVE MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9
UNREALIZED GAINS ON PERPETUAL TRUST HELD BY THIRD PARTY 13,695 CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT 115,364 FUNDRAISING EVENT EXPENSES 40,169 RENTAL EXPENSES 23,868 FUNDRAISING EVENT EXPENSES -40,169 RENTAL EXPENSES -23,868
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.