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
TARRANT COUNTY SENIOR LIVING CENTER INC
Employer identification number
20-8068602
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.") .
0
0
0
0
1,370
1,370
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......
2,500
2,500
615,441
7,943,807
13,153,805
21,718,053
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
0
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.
2,500
2,500
615,441
7,943,807
13,155,175
21,719,423
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.)
21,719,423
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...
2,500
2,500
615,441
7,943,807
13,155,175
21,719,423
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
0
957,592
463,015
1,025,919
218,993
2,665,519
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
0
957,592
463,015
1,025,919
218,993
2,665,519
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
125,219
157,632
282,851
13
Total support. (Add lines 9, 10c, 11, and 12.)..
2,500
960,092
1,078,456
9,094,945
13,531,800
24,667,793
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
88.048 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
76.906 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
10.806 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
21.970 %
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
TARRANT COUNTY SENIOR LIVING CENTER INC
Employer identification number
20-8068602
Return Reference
Explanation
MANAGEMENT COMPANY
FORM 990, PART VI, SECTION A, LINE 3 Greystone Management is an unrelated business organization engaged by THE BOARD OF DIRECTORS OF TARRANT COUNTY SENIOR LIVING CENTER, INC. to provide management services. Management duties include hiring and recruiting qualified personnel, preparing annual operating budget for submission to the Board of Directors, and assisting in the preparation of monthly and annual financial reporting disclosures. The Board of Directors have final authority over the approval of the annual operating budget, approval of monthly and annual financial reporting disclosures, and oversight of the management company.
CORPORATE MEMBER
FORM 990, PART VI, SECTION A, LINES 6, 7(A) AND 7(B) SENIOR QUALITY LIFESTYLES CORPORATION (SQLC) is the Organization's sole member. SQLC acts as a supporting organization, providing oversight, direction, and governance support, and will make grants and/or provide other forms of financial assistance as needed. SQLC, AS THE SOLE MEMBER, HAS AUTHORITY TO ELECT BOARD MEMBERS OF THE ORGANIZATION. SQLC, as the sole member of the organization, has all of the typical rights afforded to a member of a Texas nonprofit corporation, such as the right to approve any amendments to the articles of incorporation or bylaws, and the right to approve any proposed dissolution of the organization.
DOCUMENTATION OF COMMITTEE MEETINGS
FORM 990, PART VI, SECTION A, LINE 8B LINE 8B IS ANSWERED NO BECAUSE THERE ARE NO COMMITTEES IN PLACE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY at this time.
FORM 990 REVIEW PROCESS
FORM 990, PART VI, SECTION B, LINE 11 THE BOARD MEMBERS OF TARRANT COUNTY SENIOR LIVING CENTER, INC., SENIOR QUALITY LIFESTYLES CORPORATION AND GREYSTONE COMMUNITIES, THE MANAGEMENT COMPANY, REVIEW THE FORM 990 UPON COMPLETION. The board review and approval of the Form 990 is COMPLETED prior to filing.
COMPENSATION REVIEW
FORM 990, PART VI, SECTION B, LINE 15 THE CEO OF SENIOR QUALITY LIFESTYLES CORPORATION, ALONG WITH THE MANAGEMENT COMPANY, GREYSTONE, AND MERIT, AN INDEPENDENT PAYROLL PROCESSOR, SET THE SALARY FOR THE EXECUTIVE DIRECTOR. BOTH GREYSTONE AND MERIT PROVIDE COMPARATIVE SALARY DATA. THE EXECUTIVE DIRECTOR, GREYSTONE REGIONALS, AND MERIT SET OTHER TOP MANAGEMENT RATES BASED ON MARKET WAGES AND YEARS OF EXPERIENCE.
DOCUMENTS AVAILABLE TO PUBLIC
FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE POSTED TO NATIONALLY Recognized ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) AND ARE ALSO AVAILABLE UPON REQUEST.
BUSINESS RELATIONSHIPS
Form 990, Part VI, Section A, Line 2 THE FOLLOWING BOARD MEMBERS MAINTAIN A BUSINESS RELATIONSHIP WITH EACH OTHER DUE TO COMMON PARTICIPATION AS OFFICERS OR DIRECTORS OF VARIOUS OTHER RELATED NOT-FOR-PROFIT ENTITIES BY WHICH ONE OR MORE OF THE INDIVIDUALS IS COMPENSATED: CHARLES B. BREWER C. SCOTT SYKES BERNIE FRANCIS JOE ANDERSON MIKE BARRON DAVID GOBBLE
EMPLOYEES REPORTED THROUGH OUTSOURCED PROFESSIONAL EMPLOYER ORGANIZATION
FORM 990, PART V, LINE 2(A) The organization did not issue Form W-2s directly. THE INDIVIDUALS THAT COMPRISE THE TOTAL LISTED ON LINE 2(A) ARE CONSIDERED EMPLOYEES OF THE ORGANIZATION FOR THE PURPOSES OF PART V. HOWEVER, THE ORGANIZATION UTILIZES A PROFESSIONAL EMPLOYER ORGANIZATION, MERIT RESOURCES, INC. (EIN: 42-1368750), WHICH IS THE EMPLOYER OF RECORD, ISSUES ALL W-2S AND ACTS AS AN OUTSOURCED HUMAN RESOURCES AND PAYROLL DEPARTMENT FOR THE ORGANIZATION.
TOP MANAGEMENT AND FINANCIAL OFFICIAL
FORM 990, PART VII The executive director is the top management OFFICIAL AND TOP FINANCIAL official. Per the form instructions, THE TOP MANAGEMENT AND FINANCIAL OFFICIALS ARE deemed to be officerS.
CONFLICT OF INTEREST POLICY ENFORCEMENT AND MONITORING
FORM 990, PART VI, SECTION B, LINE 12(C) Annually the conflict of interest policy is reviewed during a board meeting, in addition to having the necessary individuals sign the disclosure statement on an annual basis. It is the expectation that management staff (community and corporate) in addition to the Management Company will bring any questionable activity to the attention of the board or AN officer.
GROSS RECEIPTS
FORM 990, PAGE 1, SECTION G Per the IRS form instructions, the amount reported in Box G for gross receipts includes security sales proceeds of $55,551,532.
PRIOR PERIOD ADJUSTMENT
FORM 990, PART XI, LINE 8 Due to a change in accounting principle, a prior period adjustment of $1,060,720 was made to reverse prior year revenues from the amortization of non-refundable entrance fee deposits. In addition, a prior period adjustment of $22,975,078 was also made to record the liability of a future service obligation. 2013 Adopted Accounting Pronouncement Disclosure In July 2012, the Financial Accounting Standards Board ("FASB") issued Health Care Entities (Topic 954): Continuing Care Retirement Communities-Refundable Advance Fees ("ASU 2012-01"). The amendments in ASU 2012-01 clarify that an entity should classify an advance fee as deferred revenue when a continuing care retirement community has a resident contract that provides for payment of the refundable advance fee upon re-occupancy by a subsequent resident, which is limited to the proceeds of re-occupancy. Refundable advance fees that are contingent upon re-occupancy by a subsequent resident but are not limited to the proceeds of re-occupancy should be accounted for and reported as a liability. The amendments in ASU 2012-01 are effective for fiscal periods beginning after December 15, 2012. The amendments in this Update should be applied retrospectively by recording a cumulative-effect adjustment to net assets as of the earliest period presented. The Organization adopted ASU 2012-01 on January 1, 2013. A prior period adjustment of $1,060,720 was recorded as a result of the clarification to the accounting treatment of refundable entrance fees. Also due to the clarification of the revenue recognition of refundable entrance fees, a prior period adjustment of $22,975,078 was made to record the liability of a future service obligation.
OTHER CHANGES IN NET ASSETS
FORM 990, PART XI, LINE 9 $15,002,246 CHANGE IN FUTURE SERVICE OBLIGATION.
CHARITY CARE
FORM 990 The Organization provides care to residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Organization does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. Such residents are identified based on financial information obtained from the resident and subsequent analyses.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.