Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 131,448 | 258,563 | 113,927 | 267,119 | 391,841 | 1,162,898 |
| 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 | 14,348,552 | 15,185,015 | 15,504,622 | 17,401,888 | 19,095,025 | 81,535,102 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 144,083 | 141,702 | 259,472 | 305,105 | 259,167 | 1,109,529 |
| 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 | 14,624,083 | 15,585,280 | 15,878,021 | 17,974,112 | 19,746,033 | 83,807,529 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 5,000 | 10,000 | 8,300 | 69,825 | 19,432 | 112,557 |
| 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.. | 5,000 | 10,000 | 8,300 | 69,825 | 19,432 | 112,557 |
| 8 | Public support. (Subtract line 7c from line 6.) | 83,694,972 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 14,624,083 | 15,585,280 | 15,878,021 | 17,974,112 | 19,746,033 | 83,807,529 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 287,476 | 326,130 | 283,618 | 260,551 | 411,240 | 1,569,015 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 287,476 | 326,130 | 283,618 | 260,551 | 411,240 | 1,569,015 |
| 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.) .. | 5,123 | 233 | 2,720 | 1,034 | 7,831 | 16,941 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 14,916,682 | 15,911,643 | 16,164,359 | 18,235,697 | 20,165,104 | 85,393,485 |
| 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) |
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| 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): |
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| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISC INCOME - 2013 AMOUNT: $ 5,123. 2014 AMOUNT: $ 233. 2015 AMOUNT: $ 2,720. 2016 AMOUNT: $ 1,034. 2017 AMOUNT: $ 7,831. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | ALL DIRECTORS HAVE THE SAME VOTING RIGHTS. THE BYLAWS GIVE THE EXECUTIVE COMMITTEE THE POWER TO ACT WITH THE FULL AUTHORITY OF THE BOARD BETWEEN MEETINGS. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE MUST BE REPORTED AT THE NEXT BOARD OF DIRECTORS MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | HOMESTEAD VILLAGE'S CFO PERFORMS THE INITIAL COMPANY REVIEW OF THE FORM 990 PREPARED BY INDEPENDENT ACCOUNTANTS. THE FORM 990 IS THEN PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW. AFTER THE FINANCE COMMITTEE'S REVIEW, EVERY MEMBER OF THE BOARD OF DIRECTORS RECEIVES A COPY OF THE FORM 990 FOR REVIEW BEFORE THE RETURN IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ARTICLE III, SECTION 13 OF HOMESTEAD VILLAGE'S BY-LAWS DEALS WITH CONFLICT OF INTEREST FOR BOARD MEMBERS. ALL MEMBERS OF THE BOARD OF DIRECTORS SHALL BE APPRISED OF THE FIDUCIARY OBLIGATIONS OF THEIR POSITION AS A MEMBER OF THE BOARD AND OF THEIR RESPONSIBILITY TO THE CORPORATION TO REFRAIN FROM PARTICIPATING IN ANY ACTION THAT IS A CONFLICT OF INTEREST IN THEIR DIRECTOR RELATIONSHIP TO THE CORPORATION. EACH MEMBER OF THE BOARD SHALL BE REQUIRED TO EXECUTE ANNUALLY A CONFLICT OF INTEREST STATEMENT IN A FORM TO BE PREPARED AND MAINTAINED BY THE OFFICE OF THE PRESIDENT OF THE CORPORATION. DIRECTORS ARE REQUIRED TO DISCLOSE ANY RELATIONSHIPS THEY MAY HAVE WITH OTHER DIRECTORS, OFFICERS, AND ENTITIES THAT DO BUSINESS WITH HOMESTEAD VILLAGE, ETC. ANY DIRECTOR OR OFFICER WITH A CONFLICT WILL ABSTAIN FROM VOTING ON ANY MATTER THAT INVOLVES THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE PERFORMANCE OF HOMESTEAD VILLAGE'S CEO. IT USES THE LEADING AGE SALARY SURVEY AS A GUIDE WHEN DETERMINING THE RATE OF INCREASE IN THE CEO'S COMPENSATION. INCREASES ARE MERIT-BASED AND THE PROCESS INCLUDES A REVIEW BY THE EXECUTIVE COMMITTEE OF THE GOALS SET FOR THE PRESIDENT FOR THE PAST YEAR AND THE PROGRESS MADE TOWARD ACHIEVING THOSE GOALS. NEW GOALS FOR THE UPCOMING YEAR ARE ESTABLISHED AS PART OF THE REVIEW PROCESS. THE CHAIRMAN OF THE BOARD OF DIRECTORS COMMUNICATES IN WRITING TO THE CHIEF FINANCIAL OFFICER ANY INCREASE IN COMPENSATION FOR THE PRESIDENT. THE CHIEF FINANCIAL OFFICER SHARES THE COMMUNICATION WITH HOMESTEAD VILLAGE'S DIRECTOR OF HUMAN RESOURCES. ALL OTHER EMPLOYEES OF HOMESTEAD VILLAGE HAVE THEIR PERFORMANCE REVIEWED ANNUALLY BY THEIR SUPERVISORS. PAY INCREASES ARE DETERMINED BY THE RESULTS OF THAT REVIEW. ANY PAY INCREASE OR DECREASE VARYING FROM THE COMPANY MEDIAN MUST BE APPROVED BY THE CEO. THE DIRECTOR OF HUMAN RESOURCES ALSO EXAMINES THE ANNUAL PERFORMANCE REVIEWS. THE CEO AND DIRECTOR OF HUMAN RESOURCES COMPARE WAGE AND SALARY LEVELS ANNUALLY TO INDUSTRY AVERAGES USING A TRADE ASSOCIATION SALARY SURVEY. A NEW BOARD COMMITTEE HAS BEEN FORMED TO DEAL WITH HUMAN RESOURCE ISSUES AND WILL BECOME INVOLVED IN SALARY DECISIONS FOR KEY EMPLOYEES. THE OCCURRENCE OF THEIR MEETING IS RECORDED IN THE MINUTES OF THE SUBSEQUENT MEETING OF THE FULL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTING FEES: PROGRAM SERVICE EXPENSES 2,130,918. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,130,918. AMBULANCE SERVICES: PROGRAM SERVICE EXPENSES 1,029. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,029. BEAUTY/BARBER: PROGRAM SERVICE EXPENSES 87,847. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 87,847. LABORATORY AND RADIOLOGY: PROGRAM SERVICE EXPENSES 28,341. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,341. OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 98,771. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 98,771. PHARMACY FEES: PROGRAM SERVICE EXPENSES 163,099. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 163,099. PHYSICAL AND SPEACH THERAPY: PROGRAM SERVICE EXPENSES 707,403. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 707,403. CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 102,871. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,871. |
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| Software Version: |