Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 671,636 | 971,778 | 595,956 | 351,221 | 1,095,674 | 3,686,265 |
| 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...... | 31,347,463 | 32,108,625 | 33,739,100 | 36,104,647 | 37,446,947 | 170,746,782 |
| 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. | 32,019,099 | 33,080,403 | 34,335,056 | 36,455,868 | 38,542,621 | 174,433,047 |
| 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.) | 174,433,047 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 32,019,099 | 33,080,403 | 34,335,056 | 36,455,868 | 38,542,621 | 174,433,047 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 625,726 | 732,664 | 646,407 | 611,139 | 641,222 | 3,257,158 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 625,726 | 732,664 | 646,407 | 611,139 | 641,222 | 3,257,158 |
| 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 VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 32,644,825 | 33,813,067 | 34,981,463 | 37,067,007 | 39,183,843 | 177,690,205 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 4B | SKILLED NURSING CARE: DURING 2014, THE HEALTH CARE CENTER HAD AN AVERAGE OCCUPANCY OF 121 RESIDENTS, WITH A TOTAL OF 44,317 PATIENT DAYS, INCLUDING MEDICARE, HMO, PRIVATE PAY, AND PERMANENT AND TEMPORARY ASSIGNMENT OF VILLAGE RESIDENTS. LIKE ASSISTED LIVING, SKILLED NURSING IS AVAILABLE TO RESIDENTS OF FRIENDSHIP VILLAGE, AS WELL AS TO NON-RESIDENTS IF SPACE IS AVAILABLE. IF EVER NEEDED, RESIDENTS ALSO HAVE ACCESS TO MEMORY CARE AS PART OF THEIR LIFE CARE PLAN. THE MONTESSORI PROGRAM FOR MEMORY CARE IS UNIQUE. THE FOCUS IS ON THE RESIDENT AS AN INDIVIDUAL AND CARE IS TAILORED AROUND THEIR SPECIFIC NEEDS. FRIENDSHIP VILLAGE TEMPE UNDERSTANDS AND APPRECIATES THE DIFFICULTIES FACED BY THE FAMILIES AND LOVED ONES OF THOSE SUFFERING FROM ALZHEIMER'S, DEMENTIA OR OTHER FORMS OF MEMORY LOSS. THESE CONDITIONS NOT ONLY AFFECT THE PERSON WHO HAS THEM, BUT ALSO THE PEOPLE AROUND THEM. THAT'S WHY THE FAMILY AND LOVED ONES OF RESIDENTS ARE INVOLVED IN THE PROGRAMS. THE BELIEF IS, WITH EVERYONE PARTICIPATING, THE RESIDENT'S EXPERIENCE WILL BE EVEN MORE POSITIVE AND MEANINGFUL. DEVELOPED WITH THE PRIMARY GOAL THAT EACH RESIDENT EXPERIENCE MEANINGFUL AND PURPOSEFUL ACTIVITIES, THE MONTESSORI-BASED DEMENTIA PROGRAM AT FRIENDSHIP VILLAGE MAINTAINS THE INDEPENDENCE, INDIVIDUALITY, PRIVACY, AND COMPANIONSHIP OF THE RESIDENT. THE STAFF HAS BEEN SPECIFICALLY TRAINED IN THE MONTESSORI PROGRAM, AND HAS A STRONG, CARING DESIRE TO PROVIDE RESIDENTS WITH A HIGHER QUALITY OF LIFE. |
| FORM 990, PART III, LINE 4C | ON-SITE ASSISTED LIVING APARTMENTS: A WIDE RANGE OF ON-SITE THERAPY IS AVAILABLE, INCLUDING OCCUPATIONAL, PHYSICAL, AND REHABILITATIVE. AT THE NUNNENKAMP CENTER, RESIDENTS HAVE A CUSTOMIZED TREATMENT PLAN BASED ON INDIVIDUAL NEEDS. THE HIGHLY TRAINED STAFF HAS EARNED A STELLAR REPUTATION FOR THEIR COMMITMENT TO SENIOR CARE AT THE COMMUNITY. FORM 990, PART III, LINE 4D MEMORY CARE ASSISTED LIVING: MEMORY CARE ASSISTED LIVING (ASSISTED LIVING DEMENTIA) IS FOR RESIDENTS WHO REQUIRE THE ATTENTION OF SPECIALLY-TRAINED STAFF FOR THE TREATMENT OF DEMENTIA OR COGNITIVE IMPAIRMENT. MEMORY CARE PROGRAMS PROVIDE ASSISTANCE WITH DAILY LIVING, INCLUDING THREE MEALS A DAY. STAFF IS TRAINED TO MEET THE NEEDS OF RESIDENTS IN THE DEMENTIA CARE AREAS. STAFFING IS MORE CONCENTRATED IN THE MEMORY CARE PORTION OF THE HEALTH CARE CENTER THAN IN THE NON-SPECIAL NEEDS AREAS. DURING 2014 THE MEMORY CARE PROGRAM HAD AN AVERAGE OF 23 RESIDENTS AND A TOTAL OF 8,751 DAYS OF OCCUPANCY. FORM 990, PART V, LINE 7H VEHICLE CONTRIBUTIONS: A FORM 1098-C WAS NOT FILED FOR THE VAN AND BUS CONTRIBUTIONS AS THEY WERE RECEIVED FROM A GOVERNMENT AGENCY, THE CITY OF PHOENIX. |
| FORM 990, PART VI, SECTION A, LINE 3 | DELEGATION OF MANAGEMENT DUTIES: TEMPE LIFE CARE VILLAGE HAS A MANAGEMENT CONTRACT WITH LIFE CARE SERVICES, LLC ("LCS"), UNDER WHICH LCS PROVIDES MANAGEMENT SERVICES INCLUDING, BUT NOT LIMITED TO, MARKETING, HUMAN RESOURCES, ACCOUNTING, INFORMATION TECHNOLOGY SERVICES, CLINICAL OVERSIGHT AND INSURANCE. IN ADDITION, LCS PROVIDES COMPENSATION FOR TEMPE LIFE CARE VILLAGE'S EXECUTIVE DIRECTOR AND ADMINISTRATOR OF RESIDENT SERVICES. TEMPE LIFE CARE VILLAGE ALSO REIMBURSES LCS WITH MONTHLY MANAGEMENT FEES FOR THE COMPENSATION PAID AND OTHER SERVICES PROVIDED. |
| FORM 990, PART VI, SECTION A, LINE 8B | COMMITTEE DOCUMENTATION: THERE IS NO FORMAL DOCUMENTATION OF THE COMMITTEE MEETINGS AND ACTIONS. HOWEVER, EACH COMMITTEE REPORTS ITS ACTIVITY FOR THE MONTH AT EACH MONTHLY BOARD OF DIRECTORS GENERAL MEETING. THESE REPORTS ARE DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS GENERAL MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A DRAFT OF THE 990 IS REVIEWED IN DETAIL BY THE SENIOR MANAGEMENT TEAM OF TEMPE LIFE CARE VILLAGE. AFTER THE INTERNAL REVIEW, A DRAFT COPY OF THE 990 IS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. FINALLY, A DRAFT COPY OF THE 990 IS E-MAILED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY COMPLIANCE: CONFLICT OF INTEREST FORMS ARE DISTRIBUTED ANNUALLY TO THE BOARD OF DIRECTORS. THE SENIOR MANAGEMENT TEAM REVIEWS THOSE FORMS AND INFORMS THE CHAIRMAN OF THE BOARD OF ANY CONFLICTS OF INTEREST. IF A CONFLICT ARISES, THE AFFECTED BOARD MEMBER IS REQUIRED TO ABSTAIN FROM VOTING ON THE ISSUE. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION DETERMINATION: THE ORGANIZATION'S MANAGEMENT COMPANY COMPENSATES THE CEO AND THE ADMINISTRATOR OF RESIDENT SERVICES. REIMBURSEMENT OF THEIR SALARIES AND OTHER COMPENSATION IS COVERED IN THE MANAGEMENT CONTRACT, WHICH THE BOARD APPROVED EFFECTIVE JUNE 1, 2012. ANY INCREASES ARE APPROVED AS PART OF THE ANNUAL BUDGET PROCESS DESCRIBED BELOW. THE CHIEF FINANCIAL OFFICER'S COMPENSATION IS DETERMINED BY WAGE AND SALARY SURVEYS USED BY THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT. IT IS APPROVED AS PART OF THE GENERAL BUDGET APPROVAL PROCESS BY THE BOARD FINANCE COMMITTEE AND THE ENTIRE BOARD OF DIRECTORS. APPROVAL IS RECORDED IN THE BOARD MEETING MINUTES IN NOVEMBER OF EACH YEAR. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENT AVAILABILITY: THE ORGANIZATION'S ARTICLES OF INCORPORATION AND BYLAWS, INCLUDING THE CONFLICT OF INTEREST POLICY, ARE FILED WITH THE ARIZONA CORPORATION COMMISSION. FINANCIAL REPORTS ARE PART OF THE ARIZONA DEPARTMENT OF INSURANCE ANNUAL REPORT AND ALSO REPORTED ON THE NRMSIRs (EMMA). |
| FORM 990, PART VII | BOARD MEMBER COMPENSATION: MR. MARC PULSIFER RECEIVED COMPENSATION FOR ATTORNEY SERVICES. HIS TOTAL COMPENSATION DURING 2014 WAS $1,260. HE RECEIVES NO COMPENSATION FOR HIS SERVICES AS A BOARD MEMBER. |
| FORM 990, PART VII, SECTION A | EXECUTIVE DIRECTOR COMPENSATION: THE ORGANIZATION'S EXECUTIVE DIRECTOR IS COMPENSATED BY A MANAGEMENT COMPANY. SEE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, SECTION B, LINES 15A & 15B FOR ADDITIONAL INFORMATION. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: ACTUARIAL CHANGE IN SPLIT-INTEREST AGREEMENTS $(22,799) |
| Software ID: | |
| Software Version: |