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.") . | 0 | 0 | 0 | 0 | 0 | 0 |
| 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...... | 3,983,500 | 4,129,713 | 4,373,101 | 4,554,118 | 5,061,538 | 22,101,970 |
| 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. | 3,983,500 | 4,129,713 | 4,373,101 | 4,554,118 | 5,061,538 | 22,101,970 |
| 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.) | 22,101,970 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 3,983,500 | 4,129,713 | 4,373,101 | 4,554,118 | 5,061,538 | 22,101,970 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | 0 | 0 | 812 | 157 | 969 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 0 | 0 | 0 | 812 | 157 | 969 |
| 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 | 0 | 0 | 0 | 0 | 0 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 3,983,500 | 4,129,713 | 4,373,101 | 4,554,930 | 5,061,695 | 22,102,939 |
| 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 | ||||
| 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 |
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| Return Reference | Explanation |
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| 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 I, Line 1 BRIEF MISSION | Chestnut Square at The Glen Association (CSG) is a fifteen-year-old, faith-based, non-profit organization whose primary mission is to provide quality residential, hospitality, and ancillary programs for independent seniors. All services demonstrate commitment to the housing, social, and spiritual needs of older adults, and are provided in an appropriate environment with dignity and respect, regardless of the residents' race, color, national origin, religion, sex, sexual orientation, gender identity, and ethnicity. The CSG mission also includes education on senior care and health issues, advocacy, and responsible stewardship of its resources as it serves clients as well as local civic groups, faith congregations, and others in the larger community. CSG is a division of Bethany Methodist Corporation, an Illinois not-for-profit organization. |
| Form 990, Part VI, Line 15 Compensation of Officers | THE COMPENSATION OF THE CEO AND CFO OF THIS ORGANIZATION IS PAID BY BETHANY HOMES & METHODIST HOSPITAL, A RELATED TAX-EXEMPT ENTITY. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | The sole member of Chestnut Square at the Glen Association is Bethany Methodist Corporation, an Illinois not-for-profit corporation. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | The Board of Directors of Chestnut Square at the Glen Association shall be appointed by the Board of Directors of the sole member, Bethany Methodist Corporation, an Illinois not-for-profit corporation. The sole member shall appoint members to the filing organization's Board of Directors from among those persons nominated by the nominating committee of the sole member. Members of the Board shall me community, business, civic or religious leaders, or persons with an expertise or interest in the field of health care. The President of the Corporation shall be an ex officio member of the Board of Directors. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A copy of Form 990, with a description of its purpose and how the organization addresses its requirements, is distributed to the Board of Directors. The completed Form 990 is reviewed with the Board of Directors as a part of the annual Senior Management Report to the Board. Format and content are addressed and questions and discussion entertained. Following response to any questions, a Board resolution is sought to formally adopt the contents of Form 990 for release to governmental authorities and for availability to the general public in compliance with regulations and best practices. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Members of the Board of Directors, corporate officers and employees are required to avoid all situations that may, in fact or appearance, present as a conflict of interest. Corporate Bylaws require that all actual, potential, direct, apparent, and indirect conflicts be disclosed in full and in writing. An annual, formal, and written disclosure statement is completed by all members of the Board, corporate officers, and key employees. Board members who believe they may be involved in a conflict of interest related to a given issue are required to abstain from voting or taking other official action related to that issue. Corporate officers and key employees who believe they may be involved in a conflict of interest related to a particular issue will recuse themselves from taking any official action related to that issue. The Board of Directors retains responsibility for establishing any additional guidelines necessary to resolve a conflict of interest. Policies regarding potential conflicts of interest are included in the regularly-scheduled, formal review conducted through the Corporate Compliance Program, which includes oversight by the organization's Compliance Officer, the Compliance Committee, and external legal counsel. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The Executive Committee and Compensation Committee of the Board of Directors are both led by the Chairman of the Board of Directors. Those Committees, in consultation with the CEO and senior managers, establish annual organizational objectives, which are reported to and approved by the full Board of Directors. Those Committees also conduct an annual evaluation of the achievement of the objectives and report their findings to the full Board of Directors. The Board retains an independent, external, nationally-recognized executive-compensation consulting firm to advise members' on the annual review and reasonableness of compensation prior to approval of the CEO's and senior managers' compensation. Principals of that firm work with Committee members in examining comparability data and ensuring that compensation is granted in compliance with regulatory and ethical standards, as well as industry norms. The Committee's recommendations for compensation are reviewed and ratified by the full Board of Directors. |
| Form 990, Part VI, Line 19 Required documents available to the public | These documents are available to the general public as provided for under the respective federal regulations. |
| Software ID: | 15000238 |
| Software Version: | 2015v3.0 |