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.") . | 2,581 | 185,978 | 36,395 | 9,920 | 115,962 | 350,836 |
| 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 | 30,972,666 | 32,495,173 | 35,113,565 | 35,671,198 | 37,147,810 | 171,400,412 |
| 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 | 30,975,247 | 32,681,151 | 35,149,960 | 35,681,118 | 37,263,772 | 171,751,248 |
| 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.) | 171,751,248 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 30,975,247 | 32,681,151 | 35,149,960 | 35,681,118 | 37,263,772 | 171,751,248 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 558,820 | 517,325 | 600,102 | 633,181 | 799,126 | 3,108,554 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 558,820 | 517,325 | 600,102 | 633,181 | 799,126 | 3,108,554 |
| 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.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 31,534,067 | 33,198,476 | 35,750,062 | 36,314,299 | 38,062,898 | 174,859,802 |
| 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 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) |
||||
| 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 |
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| Return Reference | Explanation |
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| 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 V, LINES 1 AND 2: | DUNWOODY VILLAGE HAS TWO ACTIVE EMPLOYER IDENTIFICATION NUMBERS (EIN). THE FORM 990 IS FILED UNDER EIN 23-1379512, THE 1099S, W-2S AND OTHER PAYROLL TAX FILINGS ARE ALL FILED UNDER EIN 23-1888807. DUNWOODY VILLAGE IS IN THE PROCESS OF CONSOLIDATING THE EINS WITHOUT CAUSING CONCERN OR FUTURE ISSUES FOR THE ORGANIZATION OR ITS EMPLOYEES. THE CONSOLIDATION PROCESS HAS BEEN DELAYED DUE TO THE IMPACTS OF COVID-19. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL BE COMPOSED OF THE OFFICERS OF THE CORPORATION AND OTHER TRUSTEES THAT MAY BE NAMED TO THE COMMITTEE BY THE CHAIR. THE EXECUTIVE COMMITTEE: (A) SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION AND SHALL: (I) ACT AS AN ETHICS COMMITTEE WHEN NEEDED TO DEVELOP POLICIES AND GUIDELINES FOR HANDLING OF ETHICAL ISSUES AND REVIEW AND GIVE CONSULTATION INVOLVING ETHICAL DIFFICULTIES. (II) CONDUCT PERFORMANCE REVIEW OF PRESIDENT CHIEF EXECUTIVE OFFICER. (III) MONITOR EFFECTIVENESS AND APPROVE INCENTIVE COMPENSATION OF EMPLOYEES UNDER INCENTIVE COMPENSATION PROGRAMS. (IV) REVIEW AND RECOMMEND TO THE BOARD CHANGES TO THE HUMAN RESOURCES POLICY AND BENEFIT PLANS OF THE CORPORATION. (V) SUCH OTHER DUTIES AND FUNCTIONS AS MAY BE ASSIGNED BY THE BOARD. (B) THE EXECUTIVE COMMITTEE, HOWEVER, SHALL NOT HAVE ANY POWER OR THE AUTHORITY AS TO THE FOLLOWING: (I) THE FILLING OF VACANCIES IN THE BOARD OF TRUSTEES. (II) THE ADOPTION, AMENDMENT OR REPEAL OF (THE) BYLAWS OF THE CORPORATION. (III) THE AMENDMENT OR REPEAL OF ANY RESOLUTION OF THE BOARD. (IV) ACTION ON MATTERS ASSIGNED BY (THE) BYLAWS OR RESOLUTION OF THE BOARD OF TRUSTEES TO ANOTHER COMMITTEE OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND THEN REVIEWED BY THE FINANCE COMMITTEE. IN ADDITION, ALL VOTING BOARD MEMBERS WILL RECEIVE A COPY OF THE FORM 990 PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE. FOR THE 2019 FORM 990, IN ORDER TO HONOR A DONOR REQUEST FOR ANONYMITY THE COPY OF THE FORM 990 REVIEWED BY THE FINANCE COMMITTEE AND RECEIVED BY THE BOARD WILL HAVE THE SCHEDULE B DONOR NAMES AND ADDRESSED REDACTED. |
| FORM 990, PART VI, SECTION B, LINE 12C | DUNWOODY VILLAGE REQUIRES THAT EACH TRUSTEE, OFFICER, EMPLOYEE AND MEMBER OF THE CLINICAL STAFF CONDUCT THEIR AFFAIRS IN AN ETHICAL MANNER AND IN A WAY THAT AVOIDS CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICT OF INTEREST THAT THE MEMBERS OF DUNWOODY VILLAGE AND ITS RELATED PARTIES MAY HAVE IS DISCLOSED IN WRITING TO THE CORPORATE COMPLIANCE OFFICER. IF A CONFLICT OF INTEREST SHOULD ARISE FROM A VOTING BOARD MEMBER, THAT BOARD MEMBER WOULD BE PROHIBITED FROM VOTING ON THOSE SPECIFIC CONFLICTING MATTERS. USE OF POSITION TO SECURE ANY SPECIAL DISCOUNT OR OTHER FAVORABLE TREATMENT FROM ANY PERSON OR ORGANIZATION WITH WHICH DUNWOODY VILLAGE DOES OR IS SEEKING TO DO BUSINESS WITH IS PROHIBITED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMPENSATION PHILOSOPHY APPLIES TO THE PRESIDENT/CEO, OTHER OFFICERS AND ANY KEY EMPLOYEES. THE EXECUTIVE COMPENSATION PHILOSOPHY IS TO MAINTAIN A PACKAGE OF SALARY AND BENEFITS THAT WILL ENSURE THAT DUNWOODY VILLAGE WILL CONSISTENTLY ATTRACT AND RETAIN COMPETENT EXECUTIVE MANAGEMENT. AT LEAST EVERY OTHER YEAR SALARY AND BENEFITS PAID BY SIMILAR ORGANIZATIONS WILL BE REVIEWED THROUGH WAGE AND BENEFITS SURVEYS BY THE HUMAN RESOURCES DIRECTOR. THE HUMAN RESOURCES DIRECTOR WILL ADVISE THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES HOW THE EXECUTIVE COMPENSATION COMPARES WITH THAT BEING PAID BY SIMILAR ORGANIZATIONS FOR SIMILAR POSITIONS. EMPLOYEE COMPENSATION IS ALSO REVIEWED AND COMPARED WITH NATIONAL AND STATE ASSOCIATIONS WAGE SURVEYS OF SIMILAR CCRC ENTITIES. FOR OTHER OFFICER AND KEY EMPLOYEE POSITIONS THE PRESIDENT/CEO ALSO WORKS WITH THE EXECUTIVE COMMITTEE AND COMPARABILITY DATA PULLED BY THE HUMAN RESOURCES DIRECTOR TO DETERMINE APPROPRIATE COMPENSATION. REVIEW OF THE PRESIDENT/CEO COMPENSATION IS COMPLETED ANNUALLY BY THE BOARD OF TRUSTEES. REVIEW OF 2018 PERFORMANCE AND COMPENSATION OF CONTROLLER, DIRECTOR OF OPERATIONS AND THE PRESIDENT/CEO OCCURED IN MARCH 2019. THE EXECUTIVE COMMITTEE HAD A TELEPHONE MEETING TO DISCUSS 2019 PERFORMANCE AND COMPENSATION OF THE DIRECTOR OF OPERATIONS AND THE PRESIDENT/CEO IN MARCH 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS ARE INCLUDED IN THE DUNWOODY ANNUAL REPORT BOOKLET. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE OF INTEREST RATE SWAP -129,732. |
| Software ID: | |
| Software Version: |