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.") . | 27,725 | 12,524 | 8,302 | 11,675 | 6,879 | 67,105 |
| 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...... | 12,075,898 | 12,134,064 | 11,867,584 | 12,034,253 | 11,223,802 | 59,335,601 |
| 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. | 12,103,623 | 12,146,588 | 11,875,886 | 12,045,928 | 11,230,681 | 59,402,706 |
| 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.) | 59,402,706 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 12,103,623 | 12,146,588 | 11,875,886 | 12,045,928 | 11,230,681 | 59,402,706 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 2,995 | 2,409 | 1,764 | 786 | 293 | 8,247 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 2,995 | 2,409 | 1,764 | 786 | 293 | 8,247 |
| 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.) .. | 35,319 | 36,917 | 35,454 | 34,155 | 40,297 | 182,142 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 12,141,937 | 12,185,914 | 11,913,104 | 12,080,869 | 11,271,271 | 59,593,095 |
| 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) |
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| 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 |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME | OTHER INCOME INCLUDES MISCELLANEOUS REVENUE SUCH AS BARBER & BEAUTY, EMPLOYEE & GUEST MEALS, TRANSPORTATION REVENUE AND OTHER REVENUE |
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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 III, LINE 2 | ON MARCH 1, 2015, CALVERT COUNTY NURSING CENTER, INC. BECAME AN AFFILIATE OF ASBURY COMMUNITIES, INC. ACOMM IS NOW A SUPPORTING ORGANIZATION OF CCNC. FOR THE PERIOD PRIOR TO AFFILIATION, CCNC CONTRACTED WITH THE ASBURY GROUP TO PERFORM MANAGEMENT SERVICES. THE MANAGEMENT SERVICES AGREEMENT ENDED WHEN CCNC AFFILIATED WITH THE ASBURY SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS CAN ACT IN PLACE OF THE BOARD BETWEEN BOARD MEETINGS. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 3 | CALVERT COUNTY NURSING CENTER'S BOARD OF DIRECTORS ENTERED INTO AN AFFILIATE AGREEMENT WITH ASBURY COMMUNITIES. ASBURY COMMUNITIES, INC. PROVIDES SUPPORT THROUGH ITS EXECUTIVE MANAGEMENT FUNCTIONS AS WELL AS POLICY AND OVERALL GUIDANCE TO CALVERT COUNTY NURSING CENTER. THE SERVICES PROVIDED ARE FINANCE, LEGAL, ACCOUNTING, HUMAN RESOURCES, COMMUNICATIONS, INFORMATION TECHNOLOGY, GOVERNANCE SUPPORT AND MARKETING SUPPORT. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION HAS MADE SIGNIFICANT CHANGES TO THE ORGANIZATIONAL DOCUMENTS INCLUDING THE BOARD OF DIRECTORS MAY CONSIST OF NO MORE THAN 15 INDIVIDUALS. ALSO DURING THE YEAR, CALVERT COUNTY NURSING CENTER BECAME AFFILIATED WITH ASBURY COMMUNITIES, INC., AND AT THAT TIME THEY REVISED THEIR BYLAWS. |
| FORM 990, PART VI, SECTION A, LINE 6 | AT THE TIME CCNC JOINED THE ASBURY SYSTEM, ASBURY COMMUNITIES BECAME THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | AT THE TIME CCNC JOINED THE ASBURY SYSTEM, ASBURY COMMUNITIES BECAME THE SOLE MEMBER WITH THE ABILITY TO ELECT THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11 | ASBURY COMMUNITIES, INC. IS THE SOLE MEMBER OF ASBURY ATLANTIC, INC., ASBURY-SOLOMONS, INC., INVERNESS VILLAGE, AN OKLAHOMA NOT FOR PROFIT CORPORATION, CALVERT COUNTY NURSING CENTER, INC., AND ASBURY HCBS, INC. ASBURY COMMUNITIES, INC. HAS A SYSTEM WIDE AUDIT COMMITTEE. THE ASBURY COMMUNITIES, INC. BOARD OF DIRECTORS HAS DELEGATED A REVIEW OF THE FORM 990 TO THE SYSTEM AUDIT COMMITTEE WHICH PERFORMED THEIR REVIEW ON APRIL 20. THE CCNC BOARD OF DIRECTORS WERE FORWARDED A COPY OF THE 990 FOR THEIR REVIEW. ALL DIRECTORS MAY POSE QUESTIONS OR ASK FOR CLARIFICATION FROM STAFF AND AUDIT COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED AND DISCUSSED ANNUALLY AT A REGULARLY SCHEDULED BOARD MEETING. EACH BOARD MEMBER IS REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT, DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST. DURING THE YEAR, ANY NEW VENDORS ARE INVESTIGATED TO INSURE THAT THERE ARE NO CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICT OF INTEREST IS DISCUSSED WITH THE FULL BOARD AND THE PROPER DUE DILIGENCE IS PERFORMED TO INSURE THAT COST OF SERVICES IS EQUAL TO OR LESS THAN MARKET AND THAT PROPER QUALIFICATIONS ARE MET. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS HAS THE ULTIMATE AUTHORITY OVER THE CEO/ADMINISTRATOR'S COMPENSATION. COMPENSATION IS DETERMINED BASED ON A REVIEW OF PERFORMANCE UTILIZING COMPARABLE DATA FROM VARIOUS SOURCES, SUCH AS SALARY SURVEYS AND OTHER SIMILAR ENTITIES' FORM 990 REPORTING. THE BOARD OF DIRECTORS APPROVES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES THROUGH THE BUDGET APPROVAL PROCESS. COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES IS DETERMINED BASED ON A REVIEW OF INDIVIDUAL PERFORMANCE UTILIZING COMPARABLE COMPENSATION DATA FROM VARIOUS SOURCES. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL REQUIRED DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII, SECTION A | THE OFFICERS THAT HAVE COMPENSATION FROM RELATED ORGANIZATIONS REPORTED IN PART VII, SECTION A, COLUMN E OF THE FORM 990 PROVIDE EXECUTIVE MANAGEMENT SUPPORT AND OVERALL GUIDANCE TO CALVERT COUNTY NURSING CENTER AS WELL AS THE OTHER RELATED AND SUPPORTED ORGANIZATIONS OF ASBURY COMMUNITIES, INC. THERE ARE OVER 2,100 TOTAL EMPLOYEES IN THE ASBURY COMMUNITIES, INC. SYSTEM. THE 2014 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR ASBURY COMMUNITIES, INC. HAD TOTAL REVENUES OF $179.2 MILLION AND TOTAL ASSETS IN EXCESS OF $568 MILLION. |
| FORM 990, PART VII, SECTION A | THE EXECUTIVE DIRECTOR OF CCNC IS AN EMPLOYEE OF A RELATED ORGANIZATION HOWEVER HER HOURS WERE SPENT AT CCNC. THE RELATED ORGANIZATION WAS REIMBURSED. |
| FORM 990, PART XI, LINE 9: | TAX-EXEMPT INHERENT CONTRIBUTION 4,128,893. |
| FORM 990, PART XI | ON MARCH 1, 2015, CALVERT COUNTY NURSING CENTER, INC. (CCNC), A TAX-EXEMPT, MARYLAND NON-STOCK CORPORATION, WAS ACQUIRED BY ASBURY COMMUNITIES INCORPORATED (ACOMM), A 501(C)(3) TAX-EXEMPT ORGANIZATION LOCATED IN MARYLAND. ACOMM PROVIDES ADMINISTRATIVE AND MANAGEMENT SERVICES TO SUPPORTED ORGANIZATIONS, SPECIFICALLY CONTINUING CARE RETIREMENT COMMUNITIES. EFFECTIVE MARCH 1, 2015, ACOMM SERVES AS THE SUPPORTING ORGANIZATION FOR CCNC. BOTH ENTITIES BELIEVE THAT THIS AFFILIATION IS IN THE BEST INTERESTS OF THEIR RESIDENTS, STAFF, THEIR CHARITABLE PURPOSE, MISSION AND VISION, AND WITH THE GREATER COMMUNITY WHICH THEY EACH SERVE. AN INHERENT CONTRIBUTION WAS RECOGNIZED IN THE ACQUISITION. |
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