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
INVERNESS VILLAGE AN OKLAHOMA NOT-FOR-P
Employer identification number
73-1539802
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.") .
187,731
264,918
452,649
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......
17,507,972
17,344,163
18,529,357
17,374,925
17,633,561
88,389,978
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.
17,695,703
17,344,163
18,529,357
17,374,925
17,898,479
88,842,627
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.)
88,842,627
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...
17,695,703
17,344,163
18,529,357
17,374,925
17,898,479
88,842,627
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
27,978
26,509
34,318
41,484
99,603
229,892
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
27,978
26,509
34,318
41,484
99,603
229,892
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.)..
17,723,681
17,370,672
18,563,675
17,416,409
17,998,082
89,072,519
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
99.740 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
99.810 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.260 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
0.190 %
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
INVERNESS VILLAGE AN OKLAHOMA NOT-FOR-P
Employer identification number
73-1539802
Return Reference
Explanation
FORM 990, PART III, LINE 4
INVERNESS VILLAGE CONTRIBUTES TIME, SPACE AND MANPOWER BACK TO THE GREATER COMMUNITY IN WHICH ITS CONTINUING CARE RETIREMENT COMMUNITY IS LOCATED. INVERNESS VILLAGE DIVIDES ITS COMMUNITY BENEFIT ACTIVITIES INTO FOUR CATEGORIES: BENEVOLENT CARE, TRAINING THE NEXT GENERATION OF SENIOR LIVING PROFESSIONALS, SERVING THE BROADER COMMUNITY AND SENIOR SERVICES, AND GOING GREEN AND SUSTAINABLE DESIGN. INVERNESS VILLAGE PROVIDES CHARITY CARE TO THOSE RESIDENTS WHOSE NEEDS EXCEED THEIR FUNDS, AND NO RESIDENT HAS EVER BEEN ASKED TO LEAVE BECAUSE OF DEPLETED FUNDS THROUGH NO FAULT OF THEIR OWN. HIGHLIGHTS OF THIS YEAR'S COMMUNITY BENEFIT ACCOMPLISHMENTS AT INVERNESS VILLAGE INCLUDE THE FOLLOWING: IN THE AREA OF TRAINING THE NEXT GENERATION OF SENIOR CARE LEADERS, INVERNESS VILLAGE ASSOCIATES PROVIDED INTERNSHIP EXPERIENCE FOR HEALTH EDUCATION & PROMOTION STUDENTS FROM OKLAHOMA STATE UNIVERSITY .THE COMMUNITY'S WELLNESS STAFF PROVIDED JOB SHADOWING OPPORTUNITIES FOR PHYSICAL THERAPY STUDENTS FROM OKLAHOMA STATE UNIVERSITY (OSU). IN MARCH A WELLNESS ASSOCIATE AT INVERNESS HELD MOCK INTERVIEWS FOR OSU STUDENTS CLOSE TO GRADUATION. INVERNESS DONATED THE USE OF THE SKILLED NURSING FACILITY AS THE SITE FOR THE CLINICAL ROTATION FOR 8 STUDENTS ENROLLED IN THE RN PROGRAM AT TULSA COMMUNITY COLLEGE. 9 INVERNESS ASSOCIATES PROVIDED SUPERVISION. CNA STUDENTS FROM TULSA TECH TOOK PART IN CLINICAL ROTATIONS IN INVERNESS'S SKILLED NURSING FACILITY. IN SUPPORT OF THE LOCAL COMMUNITY AND SENIOR SERVICES, INVERNESS VILLAGE ALSO MADE SIGNIFICANT CONTRIBUTIONS. THE CAMPUS'S WELLNESS DIRECTOR SERVED AS A GUEST LECTURER ON SEVEN OCCASIONS FOR UNDERGRADUATES AT OSU DISCUSSING TRENDS IN ACTIVE AGING AND PREPAREDNESS AS HEALTHCARE AND WELLNESS/FITNESS PROFESSIONALS. IN 2013, INVERNESS VILLAGE STAFF PARTICIPATED IN THE WALK TO END ALZHEIMER'S FUNDRAISER, RAISING FUNDS FOR THE ALZHEIMER'S ASSOCIATION. DONATED 1,250 MEDICATIONS TO INDIGENT POPULATIONS AND THE UNINSURED IN THE TULSA AREA THROUGH THE TULSA COUNTY PHARMACY. INVERNESS VILLAGE DONATED A USED REFRIGERATOR TO NEIGHBORS ALONG THE LINE, AN ORGANIZATION THAT SUPPORTS LOW INCOME FAMILIES IN WHICH SINGLE PARENT AND GRANDPARENTS ON FIXED INCOMES RAISE CHILDREN. THE INVERNESS BUS DRIVER PROVIDED TRANSPORTATION FOR RESIDENTS FROM VINTAGE HOUSING TO AREA RESTAURANTS FOR DINNER. THE WELLNESS DIRECTOR WROTE 3 ARTICLES FOR VINTAGE MAGAZINE, A PUBLICATION FROM LIFE SENIOR SERVICES. INVERNESS VILLAGE ASSOCIATES COLLECTED $600 FOR OKLAHOMA TORNADO VICTIMS. DURING THE MONTH OF FEBRUARY, INVERNESS VILLAGE ASSOCIATES AND RESIDENTS RAISED MONEY AND PROVIDED FOOD FOR THE FOOD PANTRY OF CATHOLIC CHARITIES OF TULSA. FOOD WITH A VALUE OF $1,800 WAS DONATED. ADDITIONALLY, INVERNESS VILLAGE DONATED $1,200 TO SUPPORT A CAMP FOR DISABLED CHILDREN AT HOPES'S CROSSING CAMP. INVERNESS VILLAGE DONATED 16 TURKEYS TO FEED THE HOMELESS ON THANKSGIVING. $2,250 WAS PROVIDED TO THE ROTARY CLUB OF TULSA AS A SPONSOR OF THE ANNUAL AWARDS DINNER. AND, FINALLY, IN THE AREA OF ENVIRONMENTAL SUSTAINABILITY, INVERNESS RECYCLED AN AVERAGE OF 7,500 POUNDS OF MATERIALS EACH MONTH WITH SHOW, INC., A RECYCLING COMPANY WHICH HIRES PEOPLE WITH DEVELOPMENTAL DISABILITIES.
FORM 990, PART VI, SECTION A, LINE 1
THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS CAN ACT IN PLACE OF THE BOARD BETWEEN MEETINGS. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE BOARD OF DIRECTORS. WE HAVE REPORTED EIGHT INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY. THE NON-INDEPENDENT BOARD MEMBERS CONSIST OF TWO RESIDENTS AND ONE EMPLOYEE OF INVERNESS VILLAGE.
FORM 990, PART VI, SECTION A, LINE 6
INVERNESS VILLAGE HAS ONE MEMBER, THE SOLE MEMBER IS ASBURY COMMUNITIES, INC.
FORM 990, PART VI, SECTION A, LINE 7A
ASBURY COMMUNITIES, INC. IS THE SOLE MEMBER OF INVERNESS VILLAGE AND ELECTS THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B
CERTAIN DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO ASBURY COMMUNITIES INC.'S APPROVAL. THESE DECISIONS INCLUDE (1) MANAGEMENT SERVICES RELATIONSHIPS AND CONTRACTS; (2) ANY ORGANIZATIONAL CHANGE IN GENERAL, INCLUDING MERGERS, SALES, LEASES, ETC, OF SUBSTANTIALLY ALL OF THE ASSETS AND THE CREATION OF NEW ENTITIES; (3) AMENDEMENTS TO MISSION OR VISION STATEMENTS; (4) AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11
ASBURY COMMUNITIES IS THE SOLE MEMBER OF ASBURY ATLANTIC INC., ASBURY SOLOMONS INC., INVERNESS VILLAGE, AN OKLAHOMA NOT FOR PROFIT CORPORATION AND ASBURY COMMUNITIES HCBS, INC. ASBURY COMMUNITIES HAS A SYSTEM WIDE AUDIT COMMITTEE. THE ASBURY COMMUNITIES BOARD OF DIRECTORS HAS DELEGATED A REVIEW OF THE FORM 990 TO THE SYSTEM AUDIT COMMITTEE WHICH PERFORMED THEIR REVIEW ON OCTOBER 16TH. THE ASBURY COMMUNITIES, INC., FOUNDATION, ASBURY ATLANTIC, ASBURY SOLOMONS, ASBURY COMMUNITIES HCBS, AND INVERNESS VILLAGE BOARD OF DIRECTORS WERE FORWARDED A COPY OF THEIR RESPECTIVE DRAFT FORM 990 FOR THEIR REVIEW AND PROVIDED A LINK TO RECORDING OF THE AUDIT COMMITTEE MEETING IF MEMBERS CHOSE TO LISTEN TO THE MEETINGS AS THEY REVIEWED ANY OF THE FORM 990S. ALL DIRECTORS MAY POSE QUESTIONS OR ASK FOR CLARIFICATION FROM THE STAFF AND AUDIT COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 12C
THE ASBURY COMMUNITIES CONFLICT OF INTEREST POLICY WAS APPROVED BY THE BOARD OF DIRECTORS. THE ASSISTANT GENERAL COUNSEL IS GENERALLY RESPONSIBLE FOR THE POLICY PROCESS. ALL THE ENTITIES WITHIN THE ASBURY COMMUNITIES GROUP ARE SUBJECT TO THE POLICY. ANNUALLY, THE COMPLIANCE OFFICER CONDUCTS A COMPREHENSIVE CONFLICT DISCLOSURE PROCESS COVERING ALL MEMBERS OF THE GOVERNING BOARDS, SYSTEM WIDE COMMITTEES, AND INDIVIDUALS IN MANAGEMENT POSITIONS. EACH PERSON COMPLETES A CONFLICT DISCLOSURE FORM AND IS ADVISED OF THEIR FIDUCIARY OBLIGATIONS. THE COMPLIANCE OFFICER ANALYZES ALL DISCLOSURE FORMS FOR POTENTIAL CONFLICTS, AND PREPARES A REPORT FOR THE SYSTEM-WIDE AUDIT COMMITTEE. A SUMMARY IS THEN PRESENTED TO THE BOARD OF DIRECTORS AT THE ANNUAL MEETING. WHEN A CONFLICT OF INTEREST ARISES, THE INTERESTED PERSON WILL BE PROHIBITED FROM VOTING ON THE SUBJECT MATTER.
FORM 990, PART VI, SECTION B, LINE 15
THE SYSTEM WIDE COMPENSATION COMMITTEE MEETS WITH THE INDEPENDENT COMPENSATION CONSULTANT, AND BASED ON INFORMATION PROVIDED TO THE COMMITTEE MAKES RECOMMENDATIONS REGARDING COMPENSATION AND BENEFITS TO THE EXECUTIVE COMMITTEE WHICH IS CHARGED BY THE FULL BOARD WITH MAKING DECISIONS REGARDING COMPENSATION. THE ASBURY COMMUNITIES BOARD, THE SOLE MEMBER OF INVERNESS, HAS A PRESENTATION ONCE A YEAR ON EXECUTIVE COMPENSATION AND BENEFITS. THE CHIEF PEOPLE OFFICER IS PRESENT TO GIVE BOARD MEMBERS AN OPPORTUNITY TO ASK QUESTIONS AND TO PROVIDE SALARIES AND GRADE LEVELS FOR THEIR REVIEW. THE SYSTEM WIDE COMPENSATION COMMITTEE IS COMPOSED OF 5 VOTING MEMBERS,THE CHIEF PEOPLE OFFICER (NON-VOTING), A RETAINED ATTORNEY (NON-VOTING; RECORD PROCEEDINGS IN MINUTES), AND IS ADVISED BY TOWERS WATSON (A COMPENSATION CONSULTING FIRM). THE SYSTEM WIDE COMPENSATION COMMITTEE HOLDS A MINIMUM OF 4 MEETINGS EACH YEAR (JAN, MARCH, JULY, AND NOV). IN THE NOVEMBER MEETING THEY REVIEW TOWERS WATSON ANNUAL SURVEY RESULTS AND REPORTS IN ORDER TO MAKE INFORMED RECOMMENDATIONS REGARDING SALARIES AND BENEFITS. THIS ANNUAL REVIEW ALSO ENSURES COMPLIANCE WITH IRS INTERMEDIATE SANCTIONS REQUIREMENTS. THE EXECUTIVE COMMITTEE OF ASBURY COMMUNITIES ULTIMATELY REVIEWS/APPROVES/ AND OR ADJUSTS RECOMMENDATIONS FROM THE SYSTEM WIDE COMPENSATION COMMITTEE AND SETS COMPENSATION. THE POLICY AND PROCESS WAS LAST REVIEWED IN 2013.
FORM 990, PART VI, SECTION C, LINE 19
THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE GOVERNING DOCUMENTS ARE AVAILABLE IN THE RESIDENT LIBRARIES. THE AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC VIEWING ON OUR WEBSITE.
FORM 990, PART VII, SECTION A
THE OFFICERS THAT HAVE COMPENSATION FROM RELATED ORGANIZATIONS REPORTED IN PART VII, SECTION A, COLUMN E OF THE FORM 990 PROVIDE EXECUTIVE MANAGEMENT SUPPORT AND OVERALL GUIDANCE TO INVERNESS VILLAGE, AN OKLAHOMA NOT-FOR-PROFIT CORPORATION AS WELL AS THE OTHER RELATED ORGANIZATIONS OF ASBURY COMMUNITIES, INC. THERE ARE OVER 1,900 TOTAL EMPLOYEES IN THE ASBURY COMMUNITIES, INC. SYSTEM. THE 2013 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR ASBURY COMMUNITIES, INC. HAD TOTAL REVENUES OF $173.6 MILLION AND TOTAL ASSETS IN EXCESS OF $562 MILLION.
FORM 990, PART XI, LINE 9:
CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 205,800. TRANSFER FROM ASBURY COMMUNITIES 4,800,000.
FORM 990, PART XII, LINE 2C
THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.