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
LJR Corporation
Employer identification number
03-0508346
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.") .
83,824
96,350
97,054
95,567
95,182
467,977
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......
30,366
33,127
34,788
34,029
35,858
168,168
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.
114,190
129,477
131,842
129,596
131,040
636,145
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.
1,189
978
3,052
5,219
c
Add lines 7a and 7b..
1,189
978
3,052
5,219
8
Public support (Subtract line 7c from line 6.)
630,926
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...
114,190
129,477
131,842
129,596
131,040
636,145
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
846
489
395
429
560
2,719
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
0
c
Add lines 10a and 10b.
846
489
395
429
560
2,719
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.)
..
593
593
13
Total support. (Add lines 9, 10c, 11, and 12.)..
115,036
129,966
132,237
130,025
132,193
639,457
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
98.670 %
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
99.090 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
0.430 %
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
0.550 %
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:
13000170
Software Version:
2013v4.0
-
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.
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
LJR Corporation
Employer identification number
03-0508346
Return Reference
Explanation
Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company
All management duties such as tenant screening, fiscal management, janitorial, and facilities management are contracted for with the parent company, Gateway Healthcare, Inc.
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder
Gateway Healthcare, Inc. (Gateway) is the sole corporate member of LJR Corporation. Effective July 1, 2013, Lifespan Corporation (Lifespan) became the sole corporate member of Gateway.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body
The bylaws of LJR confer certain reserved powers of Lifespan to provide it with the means of effective oversight, coordination and support of the system. Powers reserved to Lifespan include: to elect and remove trustees and to approve the election of and removal of certain officers. At each annual meeting of LJR's Board of Trustees, a list is compiled of the names of those persons selected to serve as Trustees of LJR so that it can be approved and submitted to Lifespan for ratification and election.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders
Lifespan has the responsibility for planning, directing, and establishing policy to assure the development and delivery of quality health and social services on an integrated, cost effective basis with each organization directly or indirectly owned or controlled by Lifespan. Powers reserved to Lifespan, in addition to those noted above, include: to approve amendment of the Articles of Incorporation and Bylaws and other Charter documents; strategic plans; to approve investment policies and any capital or operating budgets or material non-budgeted expenditures; and to authorize incurrence or guaranty of material indebtedness.
Form 990, Part VI, Line 11b: Form 990 Review Process
The preparation and filing of the Form 990 and supporting schedules is the responsibility of the Chief Financial Officer (CFO) of Gateway Healthcare, Inc. and Affiliates (Gateway). Preparation of the Form 990 is initiated by the Gateway Finance Department staff upon completion of the annual independent financial statement audit. A draft of the Form 990 is then provided to the Lifespan Tax Compliance Manager for further review and then provided to the organizations independent external accounting firm, KPMG. Once the draft Form 990 is complete, the Gateway CFO receives the return with all supporting worksheets and recommendations from KPMG for final management review. During the final management review, the Form 990 is provided to the CFO of Lifespan Corporation and Affiliates for feedback and any questions are discussed with KPMG, if necessary. Prior to filing Form 990 with the Internal Revenue Service, the CFO of Gateway will provide an electronic copy of the tax return to the Board and address the highlights of the organization for the year covered. Questions and comments from the Board to the CFO are then addressed prior to filing of the tax return. The Form 990 is then finalized to include any modifications based on comments of the Board and the Gateway CFO is authorized to file the Form 990.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
Lifespan Corporation has a Conflict of Interest Policy that is applicable to all affiliates, including LJR, and administered by Lifespan's Corporate Compliance Department as follows: Each designated person subject to Lifespan's conflict of interest policy is required to provide Lifespan with an initial disclosure statement and thereafter an annual statement attesting that: (i) the designated person has read and is familiar with this policy, and (ii) the designated person and, to the best of his/her knowledge, family members, have not in the past engaged in, are not presently engaging in, or plan to engage in, any activity which contravenes this policy.If, at any time during the course of employment or association, a designated person has reason to believe that an existing or contemplated activity may contravene this policy, the person shall submit a full written description of the activity to the Lifespan Compliance Officer or the Office of the General Counsel to seek a determination as to whether the contemplated activity does or does not contravene this policy. This requirement shall be acknowledged as part of the annual performance evaluation process. If the activity in question involves either the Chief Executive Officer, the Senior Vice President and General Counsel, or a Trustee, a full written disclosure must be made to, and a determination sought from, the Chairman of the Board of Directors of Lifespan Corporation.Annually, the Lifespan Compliance Officer shall review and report to the Lifespan Executive Corporate Compliance Committee and to the Lifespan Audit and Compliance Committee on the administration of this policy.Failure on the part of any designated person to comply with this policy, including failure to submit in a timely fashion the conflict of interest disclosure statement, will be grounds for removal from his/her position and/or termination of his/her employment with Lifespan.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
The organization makes its governing documents, conflict of interest policies, financial statements, and Form 990 returns available upon request. The organization will furnish copies to people who come to the administrative office during normal business hours or request a copy by U.S. mail.
Other Changes In Net Assets Or Fund Balances - Other Decreases
Refundable Advance = -$893900
Form 990, Part I, Line 1:
LJR Corporation (LJR) is organized for charitable purposes to provide handicapped persons with low income housing facilities and access to services which are specifically designed to meet their physical, social, and physiological needs and to promote their health, security, and happiness.
Form 990, Part III, Line 1:
LJR is organized for charitable purposes to provide handicapped persons with low income housing facilities and access to services which are specifically designed to meet their physical, social, and physiological needs and to promote their health, security, and happiness.
Form 990, Part XI, Line 9:
In 2014, LJR elected to change its method of accounting related to an interest-free capital advance received from the United States Department of Housing and Urban Development (HUD). Previously, LJR had recorded the capital advance within unrestricted net assets on the basis that the possibility of certain conditions imposed by HUD not being met was deemed to be remote. LJR has elected to reclassify the HUD capital advance as a non-current liability. While the historical approach used was considered acceptable, management of LJR believe that the change in accounting method is preferable and more appropriate in light of HUD's compliance requirements, as it recognizes the obligation to meet these requirements. As a result of the accounting methodology change, LJR has recorded a non-current liability of $893,900, correspondingly reducing beginning unrestricted net assets by the same amount.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.