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.") . | 239,521 | 73,219 | 167,494 | 85,997 | 54,169 | 620,400 |
| 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...... | 21,833,932 | 22,389,189 | 24,276,294 | 21,610,852 | 20,576,438 | 110,686,705 |
| 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. | 22,073,453 | 22,462,408 | 24,443,788 | 21,696,849 | 20,630,607 | 111,307,105 |
| 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.) | 111,307,105 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 22,073,453 | 22,462,408 | 24,443,788 | 21,696,849 | 20,630,607 | 111,307,105 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 817,850 | 439,023 | 424,220 | 316,180 | 345,956 | 2,343,229 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 817,850 | 439,023 | 424,220 | 316,180 | 345,956 | 2,343,229 |
| 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.) .. | 184,728 | 162,182 | 230,547 | 330,700 | 327,345 | 1,235,502 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 23,076,031 | 23,063,613 | 25,098,555 | 22,343,729 | 21,303,908 | 114,885,836 |
| 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 |
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| Return Reference | Explanation |
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| 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, LINE 1 | ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES (CONT'D) CAN ENRICH AND ENHANCE THEIR LIVES, COMBINED WITH THE SAFETY, SECURITY AND HEALTHCARE OPTIONS. |
| FORM 990, PART I, LINE 22 | DESCRIPTION OF NEGATIVE ASSETS AT SEPTEMBER 30, 2015, ORCHARD COVE HAD A NEGATIVE ACCUMULATED NET ASSET BALANCE OF $(80,546,742). ORCHARD COVE OPERATES A CONTINUING CARE RETIREMENT COMMUNITY (CCRC). IT IS THE NATURE OF CCRC ORGANIZATIONS TO HAVE NEGATIVE NET ASSET BALANCES BECAUSE OF THE NATURE OF THEIR FINANCING. WHEN NEW RESIDENTS MOVE INTO A CCRC, THEY PAY ENTRANCE FEE THAT IS 50-90% (GENERALLY 90%) REFUNDABLE AT THE TERMINATION OF THE CONTRACT. THE CCRC HOLDS THOSE FUNDS IN ITS RESERVES AND RECORDS A LIABILITY FOR BOTH THE REFUNDABLE AND THE NON-REFUNDABLE PORTIONS OF THE ENTRANCE FEE. THE NON-REFUNDABLE PORTION OF THE ENTRANCE FEE IS THEN AMORTIZED INTO INCOME BASED ON THE EXPECTED REMAINING ACTUARIAL LIFE OF THE RESIDENT. REFUNDABLE AMOUNTS ARE PAID TO THE PREVIOUS RESIDENT AFTER THEIR UNIT HAS BEEN RE-OCCUPIED BY A NEW RESIDENT. THE BUSINESS MODEL FOR CCRCS TREATS THESE ENTRANCE FEES AS THE EQUITY CONTRIBUTION OF EACH OF THE RESIDENTS IN THE PROJECT. REFUNDABLE ENTRANCE FEES TURN OVER BUT ARE NOT AMORTIZED OR OTHERWISE PAID DOWN. HOWEVER, BECAUSE THE "EQUITY" CONTRIBUTION FROM AN INDIVIDUAL RESIDENT IS NOT PERMANENT AND IS REPAYABLE FROM THE PROCEEDS OF THE ENTRANCE FEE FROM THE SUBSEQUENT RESIDENT, ACCOUNTING RULES REQUIRE THAT THESE AMOUNTS BE SHOWN AS LIABILITIES. AT 9/30/15 ORCHARD COVE HAD LIABILITIES ON ITS BALANCE SHEET OF $93,183,221 AND $7,011,885 FOR REFUNDABLE AND NON-REFUNDABLE ENTRANCE FEES, RESPECTIVELY. THESE LIABILITIES DO NOT IMPACT CASH FLOWS OR COVENANT CALCULATIONS ON EXISTING CREDITOR AGREEMENTS FOR ORCHARD COVE. FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION (CONT'D) THE MISSION IS TO PROVIDE CONDITIONS THAT FOSTER INDEPENDENCE, HEALTH AND SECURITY FOR PERSONS 62 YEARS OF AGE AND OLDER. ORCHARD COVE ALSO HAS A WELLNESS CENTER FOR THE USE OF MEMBERS AND A HOME HEALTH AGENCY WHICH PROVIDES SERVICES TO MEMBERS AND PEOPLE IN THE COMMUNITY DISCHARGED FROM OTHER HEBREW SENIORLIFE, INC. FACILITIES. FORM 990, PART III, LINE 3 CEASE CONDUCTING OF PROGRAM SERVICE EFFECTIVE MARCH 31, 2015, THE MEDICARE CERTIFIED HOME HEALTH AGENCY ACTIVITY WAS TRANSFERRED TO HEBREW SENIORLIFE HOSPICE CARE, INC. Form 990, Part III, Line 4d Description of Other Program Services Other program services are those revenues and expenses associated with program services but not directly related to one of the three major categories of Independent & Assistance in Living, Healthcare Center or Home Health. This may include services and/or costs related to the onsite Wellness Center or those so closely intermingled they cannot be accurately ALLOCATED. |
| FORM 990, PART VI, LINE 6 | DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS HEBREW SENIORLIFE IS THE SOLE CORPORATE MEMBER OF ORCHARD COVE, INC. AND PROVIDES MANAGEMENT SUPPORT AS NEEDED AND FUNDRAISING SERVICES TO ORCHARD COVE AND TO ITS OTHER AFFILIATES. |
| FORM 990, PART VI, LINE 7A | DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THE HEBREW SENIORLIFE BOARD CHAIR APPOINTS THE MEMBERS OF THE ORCHARD COVE, INC. BOARD OF DIRECTORS WITH THE ADVICE AND CONSENT OF THE HEBREW SENIORLIFE BOARD MEMBERS. |
| FORM 990, PART VI, LINE 7B | DESCRIPTION OF CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS ULTIMATE GOVERNANCE OF THE CORPORATION RESTS WITH THE BOARD OF DIRECTORS OF THE COMPANY'S SOLE CORPORATE MEMBER, HEBREW SENIORLIFE, INC. |
| FORM 990, PART VI, LINE 11 | DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 PREPARATION OF THE FORM 990 BEGINS INTERNALLY WITH HEBREW SENIORLIFE STAFF AND ERNST & YOUNG PREPARING THE FORM WITH INPUT PROVIDED BY HEBREW SENIORLIFE. ALL FORMS 990 AND 990T OF THE AFFILIATES OF HEBREW SENIORLIFE, INC. (HSL IS THE SOLE CORPORATE MEMBER OF EACH AFFILIATE) WILL BE REVIEWED PRIOR TO FILING BY THE AUDIT COMMITTEE OF HEBREW SENIORLIFE, INC. SUBSEQUENT TO SUCH REVIEW AND PRIOR TO FILING COPIES WILL BE PROVIDED TO THE APPROPRIATE GOVERNING BOARD OF DIRECTORS FOR EACH AFFILIATE. THE GOVERNING BOARDS WILL HAVE 5 DAYS TIME IN WHICH TO VIEW THE FULL RETURNS PRIOR TO THEIR FILING. |
| FORM 990, PART VI, LINE 12C | DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST THE BOARD OF ORCHARD COVE, INC. VOTED TO ADOPT THE HEBREW SENIORLIFE CONFLICT OF INTEREST POLICY. MONITORING AND DEALING WITH POTENTIAL OR ACTUAL CONFLICTS INDIVIDUALS COVERED UNDER THE CONFLICT OF INTEREST POLICY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE THE EXISTENCE OR POSSIBILITY OF A CONFLICT OF INTEREST AND SHALL BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE HEBREW SENIORLIFE CONFLICTS COMMITTEE. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY PROVIDES THAT ANNUALLY, EACH COVERED PERSON SHALL SIGN A STATEMENT AFFIRMING THAT SUCH PERSON RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, READ AND UNDERSTANDS THE POLICY AND AGREES TO COMPLY WITH THE POLICY. THE SIGNED STATEMENT AFFIRMS THAT THE PERSON UNDERSTANDS ORCHARD COVE IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, ORCHARD COVE MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. WHO IS COVERED THE CONFLICT OF INTEREST POLICY COVERS ALL DIRECTORS, OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, PERSONS SERVING IN SENIOR STAFF POSITIONS OUTLINED IN AN EXHIBIT ATTACHED TO THE CONFLICT OF INTEREST POLICY, AND ANY OTHER PERSON WHO IS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF ANY OF THE ORGANIZATION OR ANY OF ITS AFFILIATES. LEVEL AT WHICH DETERMINATIONS OF CONFLICT ARE MADE AND WHICH ACTUAL CONFLICTS ARE REVIEWED THE HEBREW SENIORLIFE CONFLICTS COMMITTEE IS RESPONSIBLE FOR DETERMINING IF A CONFLICT OF INTEREST EXISTS AND EVALUATING WHETHER THE ORGANIZATION WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A TRANSACTION THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. THE CONFLICTS COMMITTEE REPORTS ITS FINDINGS TO THE BOARD OF DIRECTORS WHO ARE RESPONSIBLE FOR MAKING A FINAL DETERMINATION ON THE CONFLICT. RESTRICTIONS ON CONFLICTED PERSONS ALL COVERED PERSONS ARE RESTRICTED FROM ENTERING INTO A TRANSACTION WITHOUT DISCLOSING THE ACTUAL OR POTENTIAL CONFLICT TO THE HEBREW SENIORLIFE CONFLICT COMMITTEE AND OBTAINING APPROVAL OF THE BOARD OF DIRECTORS. COVERED PERSONS WITH A CONFLICT MUST LEAVE THE ROOM WHEN TRANSACTIONS GIVING RISE TO THE CONFLICT ARE UNDER DISCUSSION BY THE BOARD OF DIRECTORS. Form 990, Part VI, Lines 13 & 14 Whistleblower and document retention and destruction policies The board of Orchard Cove, Inc. voted to adopt the Hebrew Seniorlife, Inc. whistleblower and document retention and destruction policies. |
| FORM 990, PART VI, LINE 15B | OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THE COMPENSATION COMMITTEE OF THE HEBREW SENIORLIFE BOARD, WITH THE ASSISTANCE OF INDEPENDENT, EXPERT CONSULTANTS, HAS REVIEWED THE PRESIDENT/CEO'S TOTAL COMPENSATION AND THE COMPENSATION OF ALL OFFICERS AND KEY EMPLOYEES AS WELL AS HIGHLY COMPENSATED EMPLOYEES (>$150,000) OF HSL AND ITS AFFILIATES. THE FULL HSL BOARD FURTHER REVIEWED AND APPROVED THE COMPENSATION OF THE HIGHLY COMPENSATED EMPLOYEES OF HSL AND ITS AFFILIATES. ALL OF THESE COMMITTEE MEMBERS ARE INDEPENDENT DIRECTORS. INDEPENDENT CONSULTANTS WERE HIRED BY THE COMPENSATION COMMITTEE AND ASSISTED WITH THE COMPENSATION REVIEW. DOCUMENTATION AND RECORDS OF COMPENSATION COMMITTEE MEETINGS ARE MAINTAINED WITH RESPECT TO DELIBERATIONS AND COMPENSATION DECISIONS. |
| FORM 990, PART VI, LINE 19 | AVAILABILITY OF GOVERNING DOCUMENTSS, CONFLICT OF INTEREST POLICY, & FIN STATEMENTS TO GENERAL PUBLIC THE ORGANIZATION'S TAX RETURNS ARE AVAILABLE AT GUIDESTAR. GOVERNING DOCUMENTS ARE AVAILABLE AT THE COMMONWEALTH OF MASSACHUSETTS' WEBSITE. THE TAX RETURNS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ALSO AVAILABLE UPON REQUEST AT THE OFFICES OF HSL AT 1200 CENTRE ST. BOSTON, MA 02131 OR BY TELEPHONE AND E-MAIL. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCES NET CHANGE IN VALUE OF ASSETS HELD BY HSL ($11,053) Transfer of Net assets to Hebrew Seniorlife Hospice Care, Inc ($134,343) --------------------------------------------------------------------- Total Other Changes in Net Assets ($145,396) |
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