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
CHRISTIAN LIVING COMMUNITIES
Employer identification number
84-1176989
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.") .
338,230
8,063
430
93,626
242,556
682,905
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......
36,751,571
40,319,453
42,801,526
43,194,141
47,261,480
210,328,171
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
56,683
46,053
102,736
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.
37,146,484
40,373,569
42,801,956
43,287,767
47,504,036
211,113,812
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.)
211,113,812
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...
37,146,484
40,373,569
42,801,956
43,287,767
47,504,036
211,113,812
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
798,806
598,101
607,549
695,209
860,772
3,560,437
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
37,111
37,111
c
Add lines 10a and 10b.
835,917
598,101
607,549
695,209
860,772
3,597,548
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.)
..
450,706
71,546
4,672
575,676
634,076
1,736,676
13
Total support. (Add lines 9, 10c, 11, and 12.)..
38,433,107
41,043,216
43,414,177
44,558,652
48,998,884
216,448,036
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
97.540 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
97.540 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
1.660 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
1.900 %
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
CHRISTIAN LIVING COMMUNITIES
Employer identification number
84-1176989
Return Reference
Explanation
FORM 990, PART VI, SECTION B, LINE 11
THE FORM 990 GOES THROUGH AN INTERNAL REVIEW BY THE CFO OF CHRISTIAN LIVING COMMUNITIES. A COPY OF THE RETURN WILL BE PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS FOR COMMENTS AND CLARIFICATION.
FORM 990, PART VI, SECTION B, LINE 12C
ANNUALLY, EACH DIRECTOR AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS REVIEWS AND SIGNS A STATEMENTS WHICH AFFIRMS THAT THEY A) HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, B) HAVE READ AND UNDERSTAND THE POLICY, C) HAVE AGREED TO COMPLY WITH THE POLICY, AND D) UNDERSTAND THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT INORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES.
FORM 990, PART VI, SECTION B, LINE 15
THE ORGANIZATION'S CEO'S COMPENSATION WAS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS DERIVED FROM COMPARABILITY DATA PUT TOGETHER FROM VARIOUS SOURCES PURCHASED BY THE ORGANIZATION. OTHER OFFICERS' AND KEY EMPLOYEES' SALARIES WERE DETERMINED BY THE PRESIDENT/CEO WITH INFORMATION FROM THE SAME COMPARABILITY DATA USED ABOVE.
FORM 990, PART VI, SECTION C, LINE 19
FINANCIAL STATEMENTS AND FORM 990 RETURNS ARE MADE AVAILABLE ONLINE AND UPON REQUEST. THE ORGANIZATION HAS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES AVAILABLE TO THE PUBLIC AT ITS EXECUTIVE OFFICE.
FORM 990, PART XI, LINE 9:
CHANGE IN INVESTMENT IN AFFILIATE 52,039. CHANGE STEWARDSHIP FUND VALUE 58,291.
FORM 990, PART XII, LINE 2C
THE PROCESS IS CONSISTENT WITH PRIOR YEARS.
FORM 990 SOCIAL ACCOUNTABILITY REPORT FOR 2013
SOCIAL ACCOUNTABILITY REPORT - 2013: EXECUTIVE SUMMARY: FOR THE FISCAL YEAR 2013, CHRISTIAN LIVING COMMUNITIES ACCOUNTED FOR $3,680,281 IN CASH OR INKIND GIFTS, SUBSIDIZED SERVICES AND CARE AND FUND RAISING, AN INCREASE OF $226,360 OVER 2012. THIS IS EQUAL TO 8.0% OF OPERATING REVENUE AND 8.2% OF OPERATING EXPENSES (BEFORE AMORTIZATION AND DEPRECIATION)AND DOWN VERY SLIGHTLY FROM 2012. CASH GIFTS INCLUDED $31,385 FROM RESIDENT SUNDAY CHAPEL OFFERINGS, AN INCREASE OF OVER 9,000,WHICH SUPPORTED A WIDE VARIETY OF MINISTRIES AND CHARITABLE CAUSES SELECTED BY THE RESIDENTS. ADDITIONALLY STAFF DRIVEN EVENTS RAISED FUNDS TO THE BENEFIT OF THE ALZHEIMER'S ASSOCIATION,NATIONAL MULTIPLE SCLEROSIS SOCIETY, ANGEL TREE, PARKINSON'S ASSOCIATION AND THE AMERICAN CANCER SOCIETY. IN-KIND GIFTS WERE PROVIDED FOR TOYS FOR GOD'S KIDS, LIONS CLUB, DENVER CHRISTIAN SCHOOLS, AND KAREN NELSON MINISTRIES. TOTAL VALUE OF THESE GIFTS IS ESTIMATED AT $25,557. THE STEWARDSHIP FUND PROVIDED $2,326 FOR RESIDENT ASSISTANCE AND THE OPERATING BUDGET SUPPORTED $18,875 IN SCHOLARSHIPS TO 9 DESERVING EMPLOYEES. THE HOURS CONTRIBUTED BY OUR OUTSTANDING VOLUNTEERS ACCOUNT FOR THE MAJORITY OF IN-KIND SUPPORT. RESIDENT AND COMMUNITY VOLUNTEERS, INCLUDING OUR BOARD OF DIRECTORS, PROVIDED 37,281 HOURS OF SERVICE VALUED AT $825,401. ADDITIONALLY, EXECUTIVE STAFF PROVIDED 1,347 HOURS OF LEADERSHIP TO AGING AND HEALTH SERVICES RELATED ORGANIZATIONS SUCH AS LEADINGAGE, COLORADO COMMISSION ON AGING AND THE 9HEALTH FAIR WHICH IS VALUED AT $67,350. THE VALUE PROVIDED IN HOSTING THE 9HEALTH FAIR AT SOMEREN GLEN IS VALUED AT OVER $84,000. CLC PROVIDED $594,010 OF VALUE IN SERVICES TO THE COMMUNITY. THIS INCLUDED HOSTING THE 9HEALTH FAIR, BONFILS BLOOD DRIVES AND SUPPORTING THE FOOD PANTRY AT PINEWOOD LODGE, A COMMUNITY OF LOW INCOME SENIORS. THE LARGEST PORTION OF THE COMMUNITY SERVICES CONTRIBUTION CAME VIA THE WORK OF CLC RESIDENTS TO CLIP, SORT AND MAIL DISCOUNT COUPONS TO MILITARY FAMILIES. TOTAL REDEEMABLE VALUE OF THESE COUPONS IS ESTIMATED AT $292,700! CLC PROVIDED $1,586,994 IN UNREIMBURSED CARE AND SERVICE TO MEDICAID-ELIGIBLE RESIDENTS IN OUR HEALTH CARE PROGRAMS (SKILLED NURSING AND ASSISTED LIVING), AN INCREASE OF $42,074 OVER 2012. THIS INCLUDES SUPPORT OF RESIDENTS ENROLLED IN THE PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) OFFERED IN COLORADO THROUGH INNOVAGE. ANOTHER $73,917 OF ALLOWANCE WAS PROVIDED TO HUD-ELIGIBLE RESIDENTS AT CLERMONT PARK. FINALLY, THROUGH THE EARTHEN VESSEL DINNER AND AGED TO PERFECTION EVENTS $152,000, AN INCREASE OF MORE THAN $31,000 OVER 2012, WAS RAISED TO SUPPORT THE RESIDENT ASSISTANCE FUND AND MISSION FULFILLMENT.
FORM 990
CLC HAS A MEMBERSHIP OR AFFILIATION WITH THE FOLLOWING GROUPS: AFFORDABLE HOUSING MANAGEMENT ASSOCIATION (AHMA), LEADINGAGE, LEADINGAGECO, ARAPAHOE COUNTY COUNCIL ON AGING, ASSISTED LIVING FEDERATION FO AMERICA (ALFA) BARNABAS FOUNDATION, BETTER BUSINESS BUREAU (BBB) CENTER FOR AGING SERVICES TECHNOLOGY (CAST), CHRISTIAN REFORMED CHURCH (CRC) COLORADO COMMISSION ON AGING (CCOA), COLORADO CULTURE CHANGE COALITION (CCC), COLORADO FOUNDATION FOR MEDICAL CARE BOARD OF DIRECTORS (CFMC), COLORADO GERONTOLOGICAL SOCIETY (CGS), COUNCIL OF REFORMED CHARITIES (CORC), COVENANT HEALTH NETWORK (CHN), EAST COALITION FOR SENIORS, EDEN ALTERNATIVE, HOUSING AND URBAN DEVELOPMENT (HUD), NATIONAL AFFORDABLE HOUSING MANAGEMENT ASSOCIATION (NAHMA), NATIONAL PRIVATE DUTY ASSOCIATION (NPDA), REFORMED CHURCHES OF AMERICA (RCA), ROTARY CLUB, SOUTH METRO CHAMBER OF COMMERCE, SOUTHWEST COALITION FOR SENIORS, WEST COALITION FOR SENIORS, WOMEN IN LEADERSHIP.
FORM 990 PART IX STATEMENT OF FUNCTIONAL EXPENSES
THROUGH THE ORGANIZATION'S MISSION, ESTIMATED DIRECT AND INDIRECT COSTS OF PROVIDING CHARITY CARE HAVE BEEN ESTIMATED USING ACTUAL COSTS AND OPERATIONAL PROJECTIONS. COSTS FOREGONE APPROXIMATE $682,000 FOR THE YEAR ENDED DECEMBER 31, 2013. UNCOMPENSATED CHARGES PROVIDED TO RESIDENTS UNDER THE MEDICAID PROGRAM, WHICH IS FUNDED FROM OPERATIONS, WAS APPROXIMATELY $1,332,000 FOR THE YEAR ENDED DECEMBER 31, 2013.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.