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)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 118,925 | 43,172 | 115,660 | 1,716,608 | 67,180 | 2,061,545 |
| 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 | 10,439,405 | 10,233,068 | 10,740,872 | 9,022,568 | 9,600,318 | 50,036,231 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 218,897 | 238,424 | 304,019 | 173,693 | 213,793 | 1,148,826 |
| 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 | 10,777,227 | 10,514,664 | 11,160,551 | 10,912,869 | 9,881,291 | 53,246,602 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | 7,450 | 1,440 | 3,360 | 2,700 | 14,950 |
| 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 | 7,450 | 1,440 | 3,360 | 2,700 | 14,950 |
| 8 | Public support. (Subtract line 7c from line 6.) | 53,231,652 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 10,777,227 | 10,514,664 | 11,160,551 | 10,912,869 | 9,881,291 | 53,246,602 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 187,690 | 228,347 | 140,358 | 327,140 | 328,297 | 1,211,832 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 187,690 | 228,347 | 140,358 | 327,140 | 328,297 | 1,211,832 |
| 11 | Net income from unrelated business activities not included on 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.).. | 10,964,917 | 10,743,011 | 11,300,909 | 11,240,009 | 10,209,588 | 54,458,434 |
| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | 21014044 |
| Software Version: | 2021v4.2 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 1 ORGANIZATION'S MISSION | (CONTINUED FROM PART III) WE ENCOURAGE EACH RESIDENT TO MAXIMIZE HIS OR HER PHYSICAL, SOCIAL, SPIRITUAL, EMOTIONAL AND PSYCHOLOGICAL WELL-BEING. |
| Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION | (CONTINUED FROM PART III) SERVICES PROVIDED TO ALL RESIDENTS INCLUDE 24-HOUR SECURITY, ACCESS TO EMERGENCY AND NON-EMERGENCY NURSING CARE SERVICES, TRANSPORTATION, COVERED PARKING, MAINTENANCE AND REPAIR SERVICES, RECREATIONAL ACTIVITIES AND TRIPS, AND CHAPLAINCY SERVICES FOR ALL FAITHS. RESIDENTS RESIDING IN RESIDENTIAL AND ASSISTED RESIDENTIAL APARTMENTS, THE HEALTH CARE CENTER, AND THE COURTYARDS ACCOUNT FOR ROUGHLY 56% OF THE RESIDENT POPULATION AND ARE ALSO PROVIDED MEAL AND DINING SERVICES, HOUSEKEEPING AND LAUNDRY SERVICES, PAID UTILITIES, AND CABLE TV SERVICE. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | The executive Committee shall consist of the Chairman, Vice Chairman, Secretary and Treasurer of the corporation, and one (1) other trustee selected by the board. A majority of the executive committee shall be members of the religious society of friends. The executive committee shall not have authority to amend the by-laws, but shall exercise all other powers of the board of trustees between meeting of said board, except the power to fill vacancies in its own membership. |
| Form 990, Part VI, Line 4 Significant changes to organizational documents | The organization made the following changes to the bylaws during the fiscal year. Below are the significant changes: - The principal purpose of this corporation is to own and operate a Senior Living Life Care Community, which qualifies as a continuing care retirement community under Indiana law. - Each voting member shall have one vote. - Do not need to have 13 trustees specifically anymore. - The Chairperson shall determine the order of proceedings at meetings of the Board of Trustees. - All officers, except the President, shall be Trustees. - Changes were made to the duties of the President. - The Vice President role has been removed. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | The 990 is reviewed by the VP of Finance and President. The completed 990 is distributed to all members of the Executive Committee and board of trustees prior to filing with the IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Annually, every Board member and Officer completes a conflict of interest QUESTIONNAIRE TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. The statements are reviewed by the VP of Finance. If a conflict of interest does exist then the Board member is not permitted to deliberate or vote on any transaction or business related to the conflict. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The compensation of the President is reviewed and determined by the Executive Committee of the Board of Trustees each spring for the current calendar year. The 2021-2022 Continuing Care Retirement Community Salary & Benefits Report published by the Hospital & Healthcare Compensation Service is used to provide comparable data for Executive Directors in the Midwest and nationally based upon revenue and total beds served. The determination of the salary for the President is based upon the comparable data provided in the above referenced report and is documented in the approved minutes of the Executive Committee. This process is done every year and was last undertaken in March 2022. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | The compensation of the VP of Finance & Development is reviewed and determined by the Executive Committee of the Board of Trustees each spring for the current calendar year. The 2021-2022 Continuing Care Retirement Community Salary & Benefits Report published by the Hospital & Healthcare Compensation Service is used to provide comparable data for Chief Financial Officers in the Midwest and nationally based upon revenue and total beds served. The determination of the salary for the VP of Finance & Development is based upon a recommendation from the President and the comparable data provided in the above referenced report and is documented in the approved minutes of the Executive Committee. This process is done every year and was last undertaken in March 2022. |
| Form 990, Part VI, Line 19 Required documents available to the public | Financial statements, governing documents, and conflict of interest policies 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 VIII, Line 11d Other Miscellaneous Revenue | Misc. Revenue - Total Revenue: 114865, Related or Exempt Function Revenue: 114865, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part X, Line 20 TAX-EXEMPT BOND LIABILITIES | FRIENDS FELLOWSHIP COMMUNITY, INC. ENTERED INTO A TAX-EXEMPT BOND PURCHASE FOR $9,175,000 ON DECEMBER 21, 2018 . THE OUTSTANDING BALANCE ON THE 2018 SERIES REVENUE BOND WAS $8,325,000 LESS THE UNAMORTIZED FINANCING COSTS OF $186,928 FOR A NET AMOUNT OF $8,138,072. |
| Software ID: | 21014044 |
| Software Version: | 2021v4.2 |