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.") . | 2,581 | 2,850 | 2,380 | 3,338 | 3,062 | 14,211 |
| 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...... | 17,040,495 | 16,992,885 | 17,459,341 | 18,144,955 | 19,496,971 | 89,134,647 |
| 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. | 17,043,076 | 16,995,735 | 17,461,721 | 18,148,293 | 19,500,033 | 89,148,858 |
| 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.) | 89,148,858 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 17,043,076 | 16,995,735 | 17,461,721 | 18,148,293 | 19,500,033 | 89,148,858 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 4,803 | 4,462 | 4,000 | 2,628 | 1,925 | 17,818 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 4,803 | 4,462 | 4,000 | 2,628 | 1,925 | 17,818 |
| 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.).. | 17,047,879 | 17,000,197 | 17,465,721 | 18,150,921 | 19,501,958 | 89,166,676 |
| 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 |
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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 |
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| Return Reference | Explanation |
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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, LINE 1 | ORGANIZATION MISSION: WILLOW HEALTH CARE, INC. WILL ASSUME A LEADERSHIP ROLE IN PROVIDING A CONTINUUM OF CARE TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. OUR CONTINUUM OF CARE WILL BE ADAPTED TO SUCCESSFULLY ANTICIPATE CHANGE IN THE HEALTH NEEDS OF THE COMMUNITY. THE RANGE OF SERVICES WILL ENCOMPASS GENERAL AND SPECIALIZED SERVICES PROVIDING: LONG TERM SKILLED NURSING, POST-ACUTE CARE, REHABILITATION (INPATIENT AND OUTPATIENT), HOUSING, WELLNESS, TRANSPORTATION, NUTRITION, INDEPENDENT LIVING AND ASSISTED LIVING. |
| FORM 990, PART I, LINE 6 | TOTAL NUMBER OF VOLUNTEERS: TOTAL NUMBER OF VOLUNTEERS INCLUDES NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS AND MEMBERS OF THE COMMUNITY WHO VOLUNTEER THEIR TIME TO SERVE RESIDENTS AND PARTICIPATE IN SPECIAL ACTIVITIES, INCLUDING BINGO, DINNERS, ETC. |
| FORM 990, PART III, LINE 2 | SIGNIFICANT PROGRAM SERVICE: THE ORGANIZATION OWNS AND OPERATES AN INDEPENDENT LIVING COMPLEX IN MTN. VIEW, MISSOURI CALLED PARK RIDGE APARTMENTS. |
| FORM 990, PART III, LINES 4A, 4B, & 4C | PROGRAM SERVICE DESCRIPTIONS: OUR SKILLED NURSING FACILITIES ARE ACTIVE IN THE COMMUNITIES THEY OPERATE IN. WE PARTICIPATE IN MANY COMMUNITY EVENTS AND OFFER A CONTINUUM OF CARE TO THE COMMUNITY MEMBERS. OUR FACILITIES OFFER EXTENSIVE THERAPY SERVICES INCLUDING AN ACUTE REHAB UNIT AT ONE FACILITY OFFERED TO OUR INPATIENT RESIDENTS. WE ALSO OFFER A FULL RANGE OF OUTPATIENT THERAPY SERVICES, INCLUDING AQUATIC THERAPY SERVICES AT THE INDOOR THERAPY POOL, AT ONE LOCATION. WE HAVE EXCELLENT DIETARY DEPARTMENTS OFFERING A FULL RANGE OF BAKED GOODS AND A SODA SHOP WITH LUNCH OPTIONS FOR OUR RESIDENTS, STAFF, AND VISITORS. ALL THREE OF OUR FACILITIES CURRENTLY OFFER LOCKED SPECIAL CARE UNITS WITH SERVICES GEARED TOWARDS MEETING THE SPECIAL NEEDS OF PATIENTS WITH DEMENTIA. WE HAVE MID LEVEL PRACTITIONERS AVAILABLE IN OUR FACILITIES SEVERAL TIMES A WEEK TO ADDRESS CONCERNS OF FAMILIES AND THE NURSING STAFF WITH OUR RESIDENT NEEDS, AS WELL AS PHYSICIANS VISITS MONTHLY. OUR ASSISTED LIVING FACILITIES OFFER APARTMENTS FOR OUR RESIDENTS OFFERING ALL THE AMENITIES OF HOME. DINING SERVICES ARE AVAILABLE AT ALL THREE MEALS, ACTIVITIES ARE PLANNED ON SITE AND OUT IN THE COMMUNITIES, ASSISTANCE WITH MEDICATIONS, AND SECURITY ARE ALL AVAILABLE. THESE FACILITIES OFFER THE INDEPENDENCE OF YOUR OWN APARTMENT, BUT THE SAFETY OF HAVING STAFF AVAILABLE FOR THE THINGS YOU NEED ON A DAILY BASIS. BEAUTY SHOP SERVICES ARE ALSO AVAILABLE ON SITE FOR THE RESIDENTS. THE HOME HEALTH AGENCY IS ACTIVELY INVOLVED IN THE APPROVED COUNTIES OF SERVICE. THE AGENCY PARTICIPATES IN HEALTH FAIRS HELD IN OUR AREA MEETING THE COMMUNITY, OFFERING FREE BLOOD PRESSURE CHECKS AND INFORMATION REGARDING THE OPTIONS OF CARE THEY HAVE AVAILABLE TO PEOPLE IN THEIR HOMES. OUR NURSES, THERAPISTS, AND CARE GIVERS TAKE AN ACTIVE ROLE IN MEETING THE NEEDS OF THEIR CLIENTS IN THEIR HOMES. THE AGENCY WORKS WITH THE CLIENT'S PHYSICIANS AND FAMILY MEMBERS TO OFFER TO THE CLIENT THE BEST CARE OPTIONS POSSIBLE FOR THAT CLIENT'S NEEDS, WHILE ALLOWING THEM TO HAVE THE LUXURY OF REMAINING OR RETURNING TO THEIR HOME AFTER A MEDICAL PROCEDURE. |
| FORM 990, PART III, LINE 4D | PROGRAM SERVICE DESCRIPTION: WILLOW HEALTH CARE, INC. OWNS AND OPERATES AN INDEPENDENT LIVING COMPLEX IN MTN. VIEW, MISSOURI, HOWELL COUNTY; PARK RIDGE APARTMENTS SHOWED OCCUPANCY OF 434 DAYS IN FISCAL YEAR ENDING JUNE 30, 2015. |
| FORM 990, PART VI, SECTION A, LINES 6, 7A & 7B | CORPORATE MEMBERSHIP: MEMBERSHIPS QUALIFICATIONS: (1) TO MAKE APPLICATION FOR MEMBERSHIP, (2) TO BE INTERESTED IN THE PROVISION OF HEALTH SERVICES, (3) TO BE A CONTRIBUTOR TO THE FUND DRIVE, (4) TO BE APPROVED BY THE BOARD OF DIRECTORS, (5) TO BE OF LEGAL VOTING AGE. MEMBERSHIP FEES: MEMBERSHIP FEES ARE TO BE DETERMINED BY THE BOARD OF DIRECTORS AT THE BEGINNING OF THE FISCAL YEAR. MEMBERSHIP VOTING RIGHTS: EACH MEMBER SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS. ALL MEMBERS VOTE ON THE BOARD OF DIRECTOR MEMBERS AT THE ANNUAL MEMBERSHIP MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT VERSION OF FORM 990 IS FIRST REVIEWED BY THE VP OF FINANCE AND THEN PROVIDED TO THE BOARD OF DIRECTORS FOR FULL REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST POLICY IS ANNUALLY REVIEWED WITH THE BOARD AND EACH BOARD MEMBER MUST SIGN THE POLICY NOTING THEIR UNDERSTANDING AND COMPLIANCE WITH SUCH. ANY CONFLICT OF INTEREST IS BROUGHT OUT AT THAT TIME AND A WRITTEN DISCLOSURE IS SIGNED BY THE BOARD MEMBER INVOLVED, WHICH SPECIFICALLY STATES THE NATURE OF THE CONFLICT AND THAT THEY WILL ABSTAIN FROM VOTING ON ANY MATTER RELATED TO THIS CONFLICT. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION REVIEW POLICIES: ANNUALLY, COMPENSATION COMPARISONS ARE OBTAINED THROUGH INDUSTRY PUBLICATIONS AND ANNUALLY THE BOARD IS PRESENTED WITH A COMPARISON OF SALARIES BASED ON THIS DATA FOR ALL KEY POSITIONS, INCLUDING THE ORGANIZATION'S EXECUTIVE MANAGEMENT, OTHER OFFICERS AND KEY EMPLOYEES. INDIVIDUAL COMPENSATION LEVELS ARE REVIEWED AND APPROVED BY THE BOARD AS A PART OF THE ANNUAL BUDGET REVIEW AND APPROVAL. THIS APPROVAL IS DOCUMENTED IN THE MINUTES OF THE BOARD. SALARIES OF ALL ADMINISTRATIVE AND MANAGEMENT EMPLOYEES ARE REVIEWED ANNUALLY BY THE EXECUTIVE STAFF. A COMPARISON OF THESE WAGE LEVELS IS MADE WITH INDUSTRY PUBLICATIONS AND ALL ARE PRESENTED TO THE BOARD OF DIRECTORS AND APPROVED AS A PART OF THE ANNUAL BUDGET PROCESS. |
| FORM 990, PART VI, LINE 19 | DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST. |
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