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.") . | 481,777 | 335,228 | 473,915 | 574,491 | 262,174 | 2,127,585 |
| 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...... | 8,458,415 | 8,856,224 | 9,123,039 | 9,434,126 | 9,914,321 | 45,786,125 |
| 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. | 8,940,192 | 9,191,452 | 9,596,954 | 10,008,617 | 10,176,495 | 47,913,710 |
| 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.) | 47,913,710 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 8,940,192 | 9,191,452 | 9,596,954 | 10,008,617 | 10,176,495 | 47,913,710 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 237,520 | 252,723 | 205,918 | 283,069 | 272,018 | 1,251,248 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 237,520 | 252,723 | 205,918 | 283,069 | 272,018 | 1,251,248 |
| 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 VI.) .. | 103,131 | 128,967 | 223,714 | 252,358 | 163,509 | 871,679 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 9,280,843 | 9,573,142 | 10,026,586 | 10,544,044 | 10,612,022 | 50,036,637 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 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) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 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 |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | ALLIANCE JOINT VENTURE - 2010 AMOUNT: $ 23,512. 2011 AMOUNT: $ 30,951. 2012 AMOUNT: $ 32,468. 2013 AMOUNT: $ 34,063. 2014 AMOUNT: $ 35,503. MISCELLANEOUS INCOME - 2010 AMOUNT: $ 79,619. 2011 AMOUNT: $ 98,016. 2012 AMOUNT: $ 191,246. 2013 AMOUNT: $ 218,295. 2014 AMOUNT: $ 128,006. |
| 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 I, DOING BUSINESS AS: | TIMBERCREST RETIREMENT COMMUNITY TIMBERCREST CHURCH OF THE BRETHREN HOME TIMBERCREST TIMBERCREST HOME FORM 990, PART III, LINE 1, ORGANIZATION MISSION STATEMENT: TIMBERCREST - CHURCH OF THE BRETHREN HOME, INC., IN NORTH MANCHESTER, INDIANA, WAS FOUNDED BY AND IS WHOLLY OWNED AND OPERATED BY AND UNDER THE AUSPICES OF THE CHURCH OF THE BRETHREN IN INDIANA. TIMBERCREST, A NOT-FOR-PROFIT CHARITABLE ORGANIZATION, IS A MINISTRY OF THE CHURCH, PROVIDING INDEPENDENT AND CONGREGATE RESIDENTIAL LIVING AND COMPREHENSIVE PERSONAL CARE AND HEALTH CARE SERVICES TO SENIOR ADULTS. AS A MINISTRY OF THE CHURCH, TIMBERCREST EXISTS TO PROVIDE A LOVING AND ENRICHING COMMUNITY THROUGH ITS CHRISTIAN VALUES AND HERITAGE. THESE UNDERLYING VALUES ARE EMPHASIZED IN ALL ASPECTS OF THE ORGANIZATION, FROM BROAD POLICY DECISIONS BY THE BOARD OF DIRECTORS TO DAY-TO-DAY INTERACTIONS AMONG STAFF AND RESIDENTS. THE DIGNITY AND THE WHOLENESS OF EACH INDIVIDUAL IS THE PRIMARY FOCUS, WITH THE FACILITIES, THE ENVIRONMENT, THE PROGRAMMING, AND THE STAFFING DESIGNED TO MEET PHYSICAL, SOCIAL, EMOTIONAL, AND SPIRITUAL NEEDS. TIMBERCREST IS DESIGNED TO BE ATTRACTIVE AND AFFORDABLE TO RESIDENTS WITH A WIDE RANGE OF FINANCIAL RESOURCES. TIMBERCREST ALSO PROVIDES CHARITABLE ASSISTANCE TO RESIDENTS WITH INSUFFICIENT FUNDS, WITHIN THE BOUNDS OF TIMBERCREST'S FINANCIAL RESOURCES AND SECURITY. |
| FORM 990, PART III, LINE 3 | DURING 2014, TIMBERCREST ENTERED INTO AN ARRANGEMENT TRANSFERRING THE LICENSED RESIDENTIAL CARE FACILITY AND LICENSED SKILLED NURSING FACILITY AND ASSOCIATED REVENUE TO WOODLAWN HOSPITAL (THE HOSPITAL), AN INDIANA COUNTY HOSPITAL AND TAX-EXEMPT GOVERNMENT AGENCY. AS PART OF THE ARRANGEMENT, TIMBERCREST ENTERED INTO LEASE AND MANAGEMENT AGREEMENTS LEASING THE RESIDENTIAL CARE AND LICENSED SKILLED NURSING FACILITIES TO THE HOSPITAL WHILE TIMBERCREST CONTINUES TO MANAGE THESE FACILITIES. FROM THE REVENUE GENERATED, THE HOSPITAL PAYS TIMBERCREST FOR THE PROVISION OF MANAGEMENT SERVICES INCLUDING COMPENSATION FOR THE ASSOCIATED OPERATING EXPENSES INCURRED AS WELL AS DEFINED MANAGEMENT FEES; USAGE OF THE LEASED FACILITIES; AND THE ROYALTY FEE. THE MANAGEMENT FEES CONSIST OF A BASE FEE, A SUBORDINATED MANAGEMENT FEE, AND IF APPLICABLE, AN INCENTIVE MANAGEMENT FEE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS ORGANIZED AS A NON-PROFIT ORGANIZATION WITH TWO MEMBERS: NORTHERN DISTRICT OF THE CHURCH OF THE BRETHREN AND SOUTH/CENTRAL DISTRICT CHURCH OF THE BRETHREN. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH CHURCH OF THE BRETHREN DISTRICT APPOINTS/ELECTS SIX TRUSTEES TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 WILL BE SUBMITTED TO STAFF FOR REVIEW. IT WILL THEN BE SUBMITTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND FOR A RECOMMENDATION FOR APPROVAL TO THE BOARD OF DIRECTORS. IT WILL THEN BE PRESENTED TO THE BOARD OF DIRECTORS FOR FINAL REVIEW AND FOR ACTION ON THE FINANCE COMMITTEE'S RECOMMENDATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | MEMBERS OF THE BOARD OF DIRECTORS, MEMBERS OF STANDING AND ADVISORY COMMITTEES, AND KEY EMPLOYEES OF TIMBERCREST MUST DIRECT THEIR CONDUCT, AND EXERCISE THEIR POWERS RELATING TO TIMBERCREST, IN THE INTEREST OF TIMBERCREST AND NOT IN THEIR OWN INTEREST OR IN THE INTEREST OF ANOTHER ENTITY OR PERSON. SAID OTHER ENTITIES OR PERSONS SHALL INCLUDE ORGANIZATIONS, BUSINESSES, VENDORS, RESIDENTS, AND/OR EMPLOYEES OF TIMBERCREST. ALL MEMBERS OF THE BOARD OF DIRECTORS, MEMBERS OF STANDING AND ADVISORY COMMITTEES, AND KEY EMPLOYEES OF TIMBERCREST SHALL BE REQUIRED TO ATTEST ANNUALLY TO THEIR FAMILIARITY WITH TIMBERCREST'S POLICY PERTAINING TO CONFLICTS OF INTEREST AND SHALL BE REQUIRED TO DISCLOSE ANY KNOWN, ACTUAL, OR POTENTIAL CONFLICTS OF INTEREST. ACTUAL OR POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED IMMEDIATELY AND THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT MAY BE PROHIBITED FROM VOTING ON THE MATTER OR ISSUE BEFORE THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CHAIR OF THE BOARD OF DIRECTORS REVIEWS SALARY SURVEYS AS AVAILABLE. ONE IS CONDUCTED BY THE SAMARITAN ALLIANCE WHICH PROVIDES SALARY AND BENEFIT DATA FOR COMPARABLE POSITIONS IN COMPARABLE ORGANIZATIONS IN COMPARABLE ECONOMIC MARKET AREAS. THE CHAIR OF THE BOARD ALSO HAS ACCESS TO SALARY INFORMATION FOR COMPARABLE POSITIONS AS REPORTED ON THE 990S OF COMPARABLE ORGANIZATIONS. THE CHAIR WILL DISCUSS THIS INFORMATION WITH THE EXECUTIVE COMMITTEE OF THE BOARD AND THEN THE BOARD OF DIRECTORS. AT TIMES THIS INFORMATION MAY BE SHARED DIRECTLY WITH THE BOARD OF DIRECTORS WITHOUT THE ADDITIONAL REVIEW BY THE EXECUTIVE COMMITTEE. THE BOARD WILL BE PRESENTED WITH A RECOMMENDATION THAT RECOGNIZES THE TENURE AND SKILLS OF THE EXECUTIVE ADMINISTRATOR; THAT IS REASONABLE IN COMPARISON WITH OTHER TIMBERCREST STAFF; AND IS REASONABLE AND COMPETITIVE IN COMPARISON TO COMPARABLE POSITIONS IN THE INDIANA MARKET AREA. THE BOARD OF DIRECTORS MAKES THE FINAL DECISION REGARDING THE EXECUTIVE ADMINISTRATOR'S SALARY, BENEFITS, AND OTHER COMPENSATION. THE BOARD MAKES THIS DECISION ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | TIMBERCREST'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR REVIEW BY THE PUBLIC UPON REQUEST. THESE MAY BE REVIEWED IN PERSON BETWEEN THE HOURS OF 8:30 A.M. AND 5:00 P.M., MONDAY THROUGH FRIDAY. REQUESTS FOR HARD COPIES WILL BE HONORED. A FEE OF $0.10 PER COPIED PAGE WILL BE CHARGED. ELECTRONIC (PDF) COPIES OF THE DOCUMENT ARE ALSO AVAILABLE UPON REQUEST. THERE IS NO CHARGE FOR PDF FILES. |
| FORM 990, PART XI, LINE 2C, OVERSIGHT OF AUDIT: | THE FINANCE COMMITTEE PROVIDES OVERSIGHT OF THE FINANCIAL AUDIT THROUGH SELECTION OF THE AUDITORS AND REVIEW OF THE ANNUAL AUDIT. THE BOARD OF DIRECTORS HAS FINAL APPROVAL AND THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
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