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
BAYVIEW MANOR HOMES
Employer identification number
91-0718446
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.") .
204,306
237,169
227,366
329,888
261,089
1,259,818
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......
12,414,975
12,014,223
12,157,644
12,762,550
13,594,264
62,943,656
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
21,047
19,594
19,808
60,449
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.
12,619,281
12,251,392
12,406,057
13,112,032
13,875,161
64,263,923
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
11,975
18,815
10,350
6,025
10,865
58,030
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..
11,975
18,815
10,350
6,025
10,865
58,030
8
Public support (Subtract line 7c from line 6.)
64,205,893
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...
12,619,281
12,251,392
12,406,057
13,112,032
13,875,161
64,263,923
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
105,206
110,083
100,487
99,355
138,671
553,802
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
105,206
110,083
100,487
99,355
138,671
553,802
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.)..
12,724,487
12,361,475
12,506,544
13,211,387
14,013,832
64,817,725
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
99.060 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
99.080 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.850 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
0.850 %
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
BAYVIEW MANOR HOMES
Employer identification number
91-0718446
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 1
THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR OF THE BOARD OF TRUSTEES AND ALL OTHER OFFICERS OF THE BOARD OF TRUSTEES. A PRIMARY FUNCTION OF THE EXECUTIVE COMMITTEE IS TO ADDRESS AND TAKE ACTION ON MATTERS OF URGENCY BETWEEN REGULAR MEETINGS OF THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE HAS ALL OF THE POWERS OF THE BOARD OF TRUSTEES IN MANAGEMENT OF THE CORPORATION TO THE EXTENT PERMITTED BY LAW, AND ANY ACTION TAKEN PURSUANT TO THE FOREGOING GRANT OF AUTHORITY IS TAKEN ONLY IF THE EXECUTIVE COMMITTEE DETERMINES THAT THE ACTION IS NOT OF SUFFICIENT IMPORTANCE TO SUBMIT TO THE FULL BOARD OF TRUSTEES OR THAT IT IS NOT IN THE BEST INTERESTS OF THE CORPORATION TO DEFER ACTIONS UNTIL THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD OF TRUSTEES AND THAT IT IS NOT IN THE BEST INTERESTS OF THE CORPORATION TO CALL A SPECIAL MEETING OF THE BOARD OF TRUSTEES TO TAKE SUCH ACTION. MINUTES OF ALL SPECIAL MEETINGS OF THE EXECUTIVE COMMITTEE ARE PROVIDED TO ALL TRUSTEES, AND A FULL REPORT OF ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE IS MADE AT THE NEXT MEETING OF THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE ALSO DETERMINES MISSION AND PURPOSE; SELECTS, SUPPORTS AND EVALUATES THE CHIEF EXECUTIVE OFFICER; AND ENSURES EFFECTIVE PLANNING.
FORM 990, PART VI, SECTION A, LINE 7A
THE BISHOP OF THE UNITED METHODIST CHURCH, GREATER NORTHWEST EPISCOPAL AREA, WHICH INCLUDES THE PACIFIC NORTHWEST CONFERENCE, OR HIS/HER DESIGNEE BECOMES A VOTING MEMBER OF THE BOARD OF TRUSTEES VIA THAT POSITION. THE PRESIDENT OF THE BAYVIEW RETIREMENT COMMUNITY RESIDENTS' COUNCIL BECOMES A VOTING MEMBER OF THE BOARD OF TRUSTEES VIA THAT POSITION.
FORM 990, PART VI, SECTION B, LINE 11
THE 990 TAX RETURN WAS PREPARED AND REVIEWED BY AN INDEPENDENT CPA FIRM. THE RETURN WAS REVIEWED BY THE CFO AND THE BOARD TREASURER, THEN PRESENTED TO THE GOVERNING BOARD FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C
THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS AND KEY EMPLOYEES. THE CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED BY EACH BOARD MEMBER AND EMPLOYEES ON THE MANAGEMENT TEAM ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICTS ARE REPORTED TO THE CEO AND BOARD CHAIR WHO REVIEW IF A CONFLICT IS DETERMINED TO EXIST. THE PERSON WITH A CONFLICT WOULD BE EXCLUDED FROM VOTING ON ANY ITEM RELATED TO THE CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15A
THE COMPENSATION FOR THE CEO IS DETERMINED BY A COMMITTEE OF THE BOARD, INDUSTRY COMPARISONS ARE UTILIZED FOR BENCHMARKS. THIS PROCESS WAS LAST COMPLETED IN 2014.
FORM 990, PART VI, SECTION C, LINE 18
THE 990 IS AVAILABLE UPON REQUEST AND AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19
THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:
CHANGE IN VALUE OF SWAP AGREEMENT 159,716.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.