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
FRIENDS FELLOWSHIP COMMUNITY INC
Employer identification number
35-1066778
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.") ....
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).
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 2012 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2011 Schedule A, Part II, line 14
...............
15
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.") .
114,495
66,478
214,839
85,328
35,322
516,462
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......
8,907,888
9,294,204
9,650,669
10,771,029
10,974,243
49,598,033
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
328,674
275,713
265,534
276,795
330,294
1,477,010
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.
9,351,057
9,636,395
10,131,042
11,133,152
11,339,859
51,591,505
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.)
51,591,505
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...
9,351,057
9,636,395
10,131,042
11,133,152
11,339,859
51,591,505
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
145,565
137,093
130,854
160,733
183,571
757,816
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
145,565
137,093
130,854
160,733
183,571
757,816
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
0
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
0
0
0
0
0
13
Total support. (Add lines 9, 10c, 11, and 12.)..
9,496,622
9,773,488
10,261,896
11,293,885
11,523,430
52,349,321
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
98.550 %
16
Public support percentage from 2011 Schedule A, Part III, line 15
...............
16
98.470 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f))
......
17
1.440 %
18
Investment income percentage from 2011 Schedule A, Part III, line 17
.............
18
1.530 %
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:
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.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
FRIENDS FELLOWSHIP COMMUNITY INC
Employer identification number
35-1066778
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990, PART III, LINE 1
(CONTINUED FROM PART III) WE ARE COMMITTED TO PROVIDING QUALITY SERVICES THROUGH THE PROMOTION OF DIGNITY, SECURITY AND INDEPENDENCE WITHIN A GRACIOUS ENVIRONMENT. WE ENCOURAGE EACH RESIDENT TO MAXIMIZE HIS/HER PHYSICAL, SOCIAL, SPIRITUAL, EMOTIONAL AND PSYCHOLOGICAL WELL-BEING.
PROGRAM SERVICE DESCRIPTION
FORM 990, PART III, LINE 4A
(CONTINUED FROM PART III) SERVICES PROVIDED TO ALL RESIDENTS INCLUDE 24-HOUR SECURITY, ACCESS TO EMERGENCY AND NON-EMERGENCY NURSING CARE SERVICES, TRANSPORTATION, COVERED PARKING, MAINTENANCE AND REPAIR SERVICES, RECREATIONAL ACTIVITIES AND TRIPS, AND CHAPLAINCY SERVICES FOR ALL FAITHS. RESIDENTS RESIDING IN RESIDENTIAL AND ASSISTED RESIDENTIAL APARTMENTS, THE HEALTH CARE CENTER, AND THE COURTYARDS ACCOUNT FOR ROUGHLY 65% OF THE RESIDENT POPULATION AND ARE ALSO PROVIDED MEAL AND DINING SERVICES, HOUSEKEEPING AND LAUNDRY SERVICES, PAID UTILITIES, AND CABLE TV SERVICE.
Significant changes to organizational documents
Form 990, Part VI, Section A, Line 4
THE AMENDED BYLAWS REFLECT TWO CHANGES: (1) CHANGING MEMBERSHIP CLASSES TO ONLY ONE MEMBERSHIP CLASS, VOTING, REMOVING THE ADVISORY MEMBERSHIP CLASS (2) APPOINTMENT OF TRUSTEES BY THE FRIEND OF FELLOWSHIP BOARD OF TRUSTEES.
Review of form 990 by governing body
Form 990, Part VI, Section B, Line 11b
THE 990 IS REVIEWED BY THE VP OF FINANCE AND PRESIDENT. THE COMPLETED 990 IS DISTRIBUTED TO ALL MEMBERS OF THE EXECUTIVE COMMITTEE AND BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS.
Conflict of interest policy
Form 990, Part VI, Section B, Line 12c
ANNUALLY, EVERY BOARD MEMBER AND OFFICER COMPLETES A CONFLICT OF INTEREST QUESTIONNAIRE TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. THE STATEMENTS ARE REVIEWED BY THE VP OF FINANCE. IF A CONFLICT OF INTEREST DOES EXIST THEN THE BOARD MEMBER IS NOT PERMITTED TO DELIBERATE OR VOTE ON ANY TRANSACTION OR BUSINESS RELATED TO THE CONFLICT.
Process used to establish compensation of top management official
Form 990, Part VI, Section B, Line 15a
THE COMPENSATION OF THE PRESIDENT IS REVIEWED AND DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES EACH SPRING FOR THE CURRENT CALENDAR YEAR. THE 2012-2013 CONTINUING CARE RETIREMENT COMMUNITY SALARY & BENEFITS REPORT PUBLISHED BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE IS USED TO PROVIDE COMPARABLE DATA FOR EXECUTIVE DIRECTORS IN THE MIDWEST AND NATIONALLY BASED UPON REVENUE AND TOTAL BEDS SERVED. THE DETERMINATION OF THE SALARY FOR THE PRESIDENT IS BASED UPON THE COMPARABLE DATA PROVIDED IN THE ABOVE REFERENCED REPORT AND IS DOCUMENTED IN THE APPROVED MINUTES OF THE EXECUTIVE COMMITTEE. THIS PROCESS IS DONE EVERY YEAR AND WAS LAST UNDERTAKEN IN MAY, 2013.
Process used to establish compensation of other officers/key employees
Form 990, Part VI, Section B, Line 15b
THE COMPENSATION OF THE VP OF FINANCE & DEVELOPMENT IS REVIEWED AND DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES EACH SPRING FOR THE CURRENT CALENDAR YEAR. THE 2012-2013 CONTINUING CARE RETIREMENT COMMUNITY SALARY & BENEFITS REPORT PUBLISHED BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE IS USED TO PROVIDE COMPARABLE DATA FOR CHIEF FINANCIAL OFFICERS IN THE MIDWEST AND NATIONALLY BASED UPON REVENUE AND TOTAL BEDS SERVED. THE DETERMINATION OF THE SALARY FOR THE VP OF FINANCE & DEVELOPMENT IS BASED UPON A RECOMMENDATION FROM THE PRESIDENT AND THE COMPARABLE DATA PROVIDED IN THE ABOVE REFERENCED REPORT AND IS DOCUMENTED IN THE APPROVED MINUTES OF THE EXECUTIVE COMMITTEE. THIS PROCESS IS DONE EVERY YEAR AND WAS LAST UNDERTAKEN IN MAY, 2013.
Governing documents, conflict of interest policy and financial statements available to the public
Form 990, Part VI, Section C, Line 19
FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.