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 (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 68,503 | 127,926 | 124,155 | 155,894 | 129,989 | 606,467 |
| 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...... | 10,562,140 | 11,097,819 | 11,208,374 | 11,225,994 | 11,492,539 | 55,586,866 |
| 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. | 10,630,643 | 11,225,745 | 11,332,529 | 11,381,888 | 11,622,528 | 56,193,333 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | 0 | 0 | 0 | 0 | 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 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public support. (Subtract line 7c from line 6.) | 56,193,333 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 10,630,643 | 11,225,745 | 11,332,529 | 11,381,888 | 11,622,528 | 56,193,333 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 202,158 | 102,344 | 115,851 | 94,956 | 107,880 | 623,189 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 17,190 | 17,190 | ||||
| c | Add lines 10a and 10b. | 202,158 | 102,344 | 115,851 | 94,956 | 125,070 | 640,379 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 306 | 306 | ||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 150,044 | 168,803 | 217,890 | 171,215 | 199,367 | 907,319 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 10,983,151 | 11,496,892 | 11,666,270 | 11,648,059 | 11,946,965 | 57,741,337 |
| 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 | ||||
| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, 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 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part III, Line 12 Other Income | DESCRIPTION - , COLUMN A - 150044.0, COLUMN B - 168803.0, COLUMN C - 217890.0, COLUMN D - 171215.0, COLUMN E - 199367.0, COLUMN F - 907319.0; |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |
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 4a PROGRAM SERVICE DESCRIPTION | HUBBARD HILL ESTATES, INC. (HUBBARD HILL) IS A FULL-SERVICE RETIREMENT COMMUNITY DESIGNED AS A CONTINUING CARE CAMPUS. HUBBARD HILL PROVIDES RESIDENTS WITH A VARIETY OF LIVING ARRANGEMENTS RANGING FROM PRIVATE HOUSES TO A SKILLED MEDICARE CERTIFIED HEALTH CENTER WITH 24 HOUR PROFESSIONAL NURSING CARE. A FULL-TIME WELLNESS/ACTIVITIES DIRECTOR AND STAFF PROVIDE A FULL RANGE OF RECREATIONAL AND WELLNESS PROGRAMS. SOCIAL WORKERS PROVIDE FOR SOCIAL SERVICES NEEDS. PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPIES ARE AVAILABLE IN THE HEALTHCARE CENTER'S FULLY EQUIPPED THERAPY CENTER FOR INPATIENT AND OUTPATIENT THERAPY SERVICES. RESIDENTS HAVE ACCESS TO A BEAUTY SALON, MASSAGE THERAPY AND REFLEXOLOGY THERAPY. A FULL-TIME CHAPLAIN IS ALSO AVAILABLE. HUBBARD HILL HAS A TOTAL OF 251 INDIVIDUAL LIVING UNITS WITHIN THE CONTINUUM OF CARE ACCOMMODATIONS. THERE ARE 87 INDIVIDUAL INDEPENDENT DWELLINGS THAT OFFER MAINTENANCE-FREE LIVING TO RESIDENTS AND PROVIDE OPTIONAL ACCESS TO ALL SERVICES PROVIDED AT HUBBARD HILL INCLUDING MEALS. THE ROUTINE MAINTENANCE FEE INCLUDES LAWN CARE, SNOW REMOVAL, TRASH COLLECTION, AND CITY WATER. OTHER SERVICES ARE ALSO AVAILABLE. HUBBARD HILL PROVIDED 47,281 RESIDENT DAYS OF SERVICE TOWARD INDEPENDENT CARE DURING THE YEAR ENDED JUNE 30, 2016. THE RESIDENTIAL HALLS, LICENSED BY THE STATE FOR RESIDENTIAL CARE, HAVE 98 APARTMENTS DESIGNED FOR RESIDENTS REQUIRING SOME ASSISTANCE WITH ACTIVITIES OF DAILY LIVING. HUBBARD HILL PROVIDES ASSISTANCE SUCH AS DRESSING, BATHING, MEDICATION MANAGEMENT, AND OTHER LIMITED NURSING SERVICES TO RESIDENTS WHO NEED ASSISTANCE. MONTHLY SERVICES AVAILABLE INCLUDE THREE MEALS PER DAY FROM A SELECTIVE MENU, HOUSEKEEPING SERVICES, MAINTENANCE SERVICES, BED AND BATH LINEN SERVICES, AND PERSONAL LAUNDRY SERVICES. WASHERS AND DRYERS ARE AVAILABLE IN EACH HALL FOR RESIDENTS DESIRING TO DO THEIR OWN PERSONAL LAUNDRY. ADDITIONAL ASSISTED LIVING SERVICES ARE AVAILABLE TO ANY RESIDENT IN ANY APARTMENT IN THE RESIDENCE HALLS FOR AN ADDITIONAL FEE. UTILITIES, PHONES WITH LOCAL CALL ACCESS AND TRANSPORTATION TO LOCAL APPOINTMENTS ARE ALSO PROVIDED. A LICENSED NURSE IS ON DUTY 24 HOURS A DAY FOR ASSESSMENT, EVALUATION, AND SUPERVISION OF RESIDENTS' NEEDS. AN RN SERVES AS DIRECTOR OF NURSING WHO PROVIDES OVERSIGHT THROUGHOUT THE WEEK, ALONG WITH AN ADMINISTRATOR. HUBBARD HILL PROVIDED 38,219 RESIDENT DAYS OF SERVICE TOWARD ASSISTED LIVING CARE DURING THE FISCAL YEAR ENDED JUNE 30, 2016. HUBBARD HILL ALSO OPERATES A 66 BED SKILLED NURSING FACILITY THAT PROVIDES DEDICATED REHABILITATION AND LONG TERM CARE. ALL HEALTHCARE ROOMS ARE CERTIFIED FOR MEDICARE SERVICES. 10 BEDS ARE ALSO CERTIFIED FOR MEDICAID SERVICES. NURSING CARE IS PROVIDED 24 HOURS PER DAY. THE ADMINISTRATOR AND DIRECTOR OF NURSING HEAD A STAFF THAT INCLUDES REGISTERED NURSES, LICENSED PRACTICAL NURSES & CERTIFIED NURSING ASSISTANTS. SEVERAL CONSULTANTS, INCLUDING A DIETITIAN, PHARMACISTS, PSYCHIATRIST, PHYSICIANS, AND THERAPISTS ARE ALSO ON STAFF. HUBBARD HILL PROVIDED 20,924 RESIDENT DAYS FOR HEALTHCARE INCLUDING 8,073 MEDICARE DAYS, 2,368 MEDICAID DAYS, AND 10,483 PRIVATE PAY DAYS DURING THE FISCAL YEAR ENDED JUNE 30, 2016. |
| Form 990, Part IV, Line 28a Business Transactions | The organization uses an independent contractor, Morganroth Consulting, to provide financial management and consulting. Morganroth provides Lori Farkas, who receives compensation from her entity for her work performed not only for Hubbard Hill Estates, but also for work provided for other unrelated organizations. Ms. Farkas is not compensated directly by Hubbard Hill Estates. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | BOARD MEMBERS: SHIRLEY MARKS AND J.R. ROHRER - Family relationship |
| Form 990, Part VI, Line 3 Delegation of management duties | The organization uses independent contractor, Morganroth to assist in financial management. Duties include financial reporting and analysis, board reporting on financial related matters, audit compliance, and other financial matters. This contractor regularly meets with the CEO on all financial matters. Final authority and decisions on all financial matters remains with the CEO. This contractor provides input to financial staff evaluations and supervision, but are not responsible for those activities. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | The Conference of the Missionary Church, North Central District, Inc., a related party, has authority to approve 2/3 of the governing body. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A final draft of the full Form 990, including all applicable schedules, is provided to each member of the governing body prior to its filing with the IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The organization requires all officers and directors of the board, as well as key employees and other interested persons, to annually review the conflict of interest policy and to document in writing any potential conflicts. A detailed questionnaire is also completed by each board member. Executive and financial management review the questionnaires for any potential conflicts. If a conflict does exist, that person must notify the board and/or excuse him or herself from the board meeting prior to discussion on the conflicting topic. That person will not be permitted to vote on any decisions regarding the conflicting issue. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The CEO's compensation is reviewed annually by the Evaluation Committee, which is made up of individuals from the governing board. This committee compares current compensation to compensation data for similar Continuing Care Retirement Community (CCRC) institutions. The committee looks at size, state, and other trends to ensure that compensation is aligned with similar organizations. Once the evaluation committee reviews performance and comparable compensation data, a compensation package which includes base rate is submitted to the full board for approval and bonus compensation is submitted to the finance committee for approval. This review process was last completed during fiscal year 2016 and was documented in the board meeting minutes. |
| Form 990, Part VI, Line 19 Required documents available to the public | Governing documents, conflict of interest policies, and financial statements are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time. |
| Form 990, Part VII, Section A, Line 1a Compensation of Officers,etc | Joe Wenger, a board member, devoted approx 40 hours per week during the year to Missionary Church, a related tax-exempt organization |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | - Total Revenue: 39450, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 39450; |
| Form 990, Part IX, Line 11g Other Fees | Other Professional Fees - Total Expense: 215336, Program Service Expense: 200987, Management and General Expenses: 14349, Fundraising Expenses: ; Dietary Services - Total Expense: 1278475, Program Service Expense: 1278475, Management and General Expenses: , Fundraising Expenses: ; Rehab Therapy Staffing - Total Expense: 938643, Program Service Expense: 938643, Management and General Expenses: , Fundraising Expenses: ; |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |