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HENRY FORD VILLAGE: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HENRY FORD VILLAGE (EIN 38-3087328)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201203199349304615
Schema version
2011v1.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-14T14:15:28-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1200 OTTAWA AVE NW STE 300AddressLine1
CityGRAND RAPIDSCity
StateMIState
ZIP Code49503ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN383087328EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HENRY FORD VILLAGE INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% DAVID HENRYInCareOfName
Name ControlHENRNameControl
Phone3135841000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line115101 FORD ROADAddressLine1
CityDEARBORNCity
StateMIState
ZIP Code48126ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSTAN CLOUSEName
TitleEXECUTIVE DIRECTORTitle
Date Signed2012-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKathleen GuiderName
Phone6167747000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonStan ClouseNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line115101 FORD ROADAddressLine1
CityDEARBORNCity
StateMIState
ZIP Code48126ZIPCode
FieldValueIRS element (for citing)
Gross Receipts64120260GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionPROMOTION OF HEALTH FOR THE ELDERLY BY PROVIDING A CONTINUING CARE RESIDENTIAL COMMUNITY LOCATED IN DEARBORN, MI WITH RECREATIONAL, SOCIAL, AND RELIGIOUS ACTIVITES FOR RESIDENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees721TotalNbrEmployees
Total Nbr Volunteers454TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3443190ContributionsGrantsPriorYear
Contributions Grants Current Year372331ContributionsGrantsCurrentYear
Program Service Revenue Prior Year33648041ProgramServiceRevenuePriorYear
Program Service Revenue CY36721957ProgramServiceRevenueCY
Investment Income Prior Year780988InvestmentIncomePriorYear
Investment Income Current Year1242683InvestmentIncomeCurrentYear
Other Revenue Prior Year-130510OtherRevenuePriorYear
Other Revenue Current Year-19371OtherRevenueCurrentYear
Total Revenue Prior Year37741709TotalRevenuePriorYear
Total Revenue Current Year38317600TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year18204452SalariesEtcPriorYear
Salaries Etc Current Year18405022SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year20252461OtherExpensePriorYear
Other Expenses Current Year19013452OtherExpensesCurrentYear
Total Expenses Prior Year38456913TotalExpensesPriorYear
Total Expenses Current Year37418474TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-715204RevenuesLessExpensesPriorYear
Revenues Less Expenses CY899126RevenuesLessExpensesCY
Total Assets BOY125877313TotalAssetsBOY
Total Assets EOY115565326TotalAssetsEOY
Total Liabilities BOY145701132TotalLiabilitiesBOY
Total Liabilities EOY135454346TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-19823819NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-19889020NetAssetsOrFundBalancesEOY
Mission DescriptionPROMOTION OF HEALTH FOR THE ELDERLY BY PROVIDING A CONTINUING CARE RESIDENTIAL COMMUNITY LOCATED IN DEARBORN, MI WITH RECREATIONAL, SOCIAL, AND RELIGIOUS ACTIVITIES FOR RESIDENTS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense36048672Expense
Revenue36721957Revenue
DescriptionHENRY FORD VILLAGE, INC. IS A MICHIGAN NON-STOCK CORPORATION ESTABLISHED TO OPERATE A NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY LOCATED IN DEARBORN, MICHIGAN. THE PROPERTY IS PRESENTLY ZONED FOR APPROXIMATELY 856 INDEPENDENT LIVING UNITS (INCLUDING THREE GUEST ROOMS), 96 ASSISTED LIVING UNITS AND 89 SKILLED NURSING BEDS. AS OF DECEMBER 31, 2011 THERE WERE 836 OCCUPIED UNITS, WHICH CONSISTED OF 676 INDEPENDENT LIVING UNITS, 76 ASSISTED LIVING UNITS AND 84 SKILLED NURSING BEDS. 1,178 INDIVIDUALS WERE SERVED IN 2011.Description
Total Program Service Expense36048672TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109646NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees721NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionstrueNonDeductibleContributions
Non Deductible DisclosuretrueNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDAVID HENRYNamePerson
Telephone Number3138467270TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line115101 FORD ROADAddressLine1
CityDEARBORNCity
StateMIState
ZIP Code48126ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
LARRY VIDOVIC
MEMBER4.0X000
KAREN ROSS
MEMBER4.0X000
WALTER TALAMONTI
MEMBER4.0X000
LYNN FORD ALANDT
HONORARY MEMBER4.0X000
GARY GLENN
MEMBER4.0X000
JOHN BYRNE
MEMBER4.0X000
GARY KUHLMANN
MEMBER4.0X000
STAN CLOUSE
EXECUTIVE DIRECTOR40.0X146750031821
ROBERT SOWISLO
MEMBER4.0X000
KEN HOLLOWAY
MEMBER4.0X000
BOB MUELLER
CHAIRPERSON4.0X000
JENNIE KLEPINGER
CHIEF FINANCIAL OFFICER40.08553107166X
SUSAN ROSS
TREASURER40.074714022779X
FieldValueIRS element (for citing)
Total Reportable Comp From Org306995TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation61766TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LIFE CARE SERVICES LLC
CAPITAL SQUARE 400 LOCUST SUITE 8DES MOINESIA503092334MANAGEMENT SERVICES1470833
GERARD MCMAHON
38623 DEERWOOD CTNORTHVILLEMI48167BUILDING IMPROVEMENT193718
DRIVEN SOLUTIONS
320 W NINE MILE ROAD SUITE BFERNDALEMI48220ADVERTISING/MARKET.307099
TOP FABRICATORS
3726 MONROEDEARBORNMI48124INSTALLATION658607
GLYNNDEVINS ADVERTISING MARKETING
11230 COLLEGE BOULEVARDOVERLAND PARKKS66210ADVERTISING/MARKET.194393
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations200004RelatedOrganizations
All Other Contributions172327AllOtherContributions
Total Contributions372331TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NON-REFUNDABLE DEPOSIT62300019864921986492
OCCUPANCY REVENUE6230002481936724819367
ANCILLARY FEES62300061603846160384
RESIDENT FEE AMORTIZATION62300033389523338952
LEASE REVENUE623000123008123008

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column293754TotalRevenueColumn
Related Or Exempt Function Income293754RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue36721957TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column475864TotalRevenueColumn
Exclusion$475,864ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities26569479Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities25802660Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities766819Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column766819TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionREALIZED LOSS ON FORWARD CONTRACT FOR UTILITIESDescription
Total Revenue Column-19371TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue-19371TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column38317600TotalRevenueColumn
Related Or Exempt Function Income36721957RelatedOrExemptFunctionIncome
Exclusion$475,864ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total548542Total
Program Services0ProgramServices
Management And General548542ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total13980761Total
Program Services13980761ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2716122Total
Program Services2580316ProgramServices
Management And General135806ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1159597Total
Program Services1090021ProgramServices
Management And General69576ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total628286Total
Program Services628286ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total173536Total
Program Services20113ProgramServices
Management And General153423ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total88225Total
Program Services88225ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total67542Total
Program Services67542ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total410226Total
Program Services292778ProgramServices
Management And General117448ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1099906Total
Program Services1099906ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total254504Total
Program Services198488ProgramServices
Management And General56016ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total170021Total
Program Services0ProgramServices
Management And General170021ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1822819Total
Program Services1822819ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total94717Total
Program Services71313ProgramServices
Management And General23404ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total3036590Total
Program Services3036590ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5084860Total
Program Services5084860ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total427569Total
Program Services427569ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BLDG, GROUNDS & MAINTENANCE95112492915321971
RESIDENT RELATIONS38380321856195
REAL ESTATE TAXES505637505637
SUPPLIES3843419382343319986

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total316091Total
Program Services268677ProgramServices
Management And General47414ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total37418474Total
Program Services36048672ProgramServices
Management And General1369802ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY665030BOY
EOY939540EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2967878BOY
EOY3090662EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2220806BOY
EOY2643634EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY995821BOY
EOY683077EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY131864BOY
EOY125084EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY265309BOY
EOY635241EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis155864846LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec60442834LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY98753246BOY
EOY95422012EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY17439385BOY
EOY9220221EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2437974BOY
EOY2805855EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY125877313BOY
EOY115565326EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3337705BOY
EOY3985292EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY41900872BOY
EOY41561628EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY937997BOY
EOY890023EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2411027BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY97113531BOY
EOY89017403EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY145701132BOY
EOY135454346EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-20045439BOY
EOY-20122563EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY221620BOY
EOY233543EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-19823819BOY
EOY-19889020EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY125877313BOY
EOY115565326EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses899126ReconcilationRevenueExpenses
Reconcilation Other Changes-964327ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years149844CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years53861CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years58514CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19513CurrentTaxYearMinus1Year
Current Tax Year372331CurrentTaxYear
Total654063Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years36840352CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years37070973CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years38253483CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year37071718CurrentTaxYearMinus1Year
Current Tax Year36721957CurrentTaxYear
Total185958483Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years36990196CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years37124834CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years38311997CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year37091231CurrentTaxYearMinus1Year
Current Tax Year37094288CurrentTaxYear
Total186612546Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Total0Total
FieldValueIRS element (for citing)
Public Support Total509186612546PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1020634CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years546176CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years530106CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year537747CurrentTaxYearMinus1Year
Current Tax Year475864CurrentTaxYear
Total3110527Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1020634CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years546176CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years530106CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year537747CurrentTaxYearMinus1Year
Current Tax Year475864CurrentTaxYear
Total3110527Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year-130510CurrentTaxYearMinus1Year
Current Tax Year-19371CurrentTaxYear
Total-149881Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years38010830CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years37671010CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years38842103CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year37498468CurrentTaxYearMinus1Year
Current Tax Year37550781CurrentTaxYear
Total189573192Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98438PublicSupportPercentage509
Prior Year Support Percentage0.96799PriorYearSupportPercentage
Investment Income Percentage0.01641InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.02070PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance221620BeginningOfYearBalance
Contributions111704Contributions
Investment Earnings Or Losses24659InvestmentEarningsOrLosses
Other Expenditures124440OtherExpenditures
End Of Year Balance233543EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance-4090BeginningOfYearBalance
Contributions157031Contributions
Investment Earnings Or Losses229794InvestmentEarningsOrLosses
Other Expenditures161115OtherExpenditures
End Of Year Balance221620EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance88701BeginningOfYearBalance
Contributions132475Contributions
Investment Earnings Or Losses-73678InvestmentEarningsOrLosses
Other Expenditures151588OtherExpenditures
End Of Year Balance-4090EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance235262BeginningOfYearBalance
Contributions122547Contributions
Investment Earnings Or Losses-145116InvestmentEarningsOrLosses
Other Expenditures123992OtherExpenditures
End Of Year Balance88701EndOfYearBalance

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4992523OtherCostOrOtherBasis
Book Value4992523BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis142321635OtherCostOrOtherBasis
Depreciation53701275Depreciation
Book Value88620360BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis269497OtherCostOrOtherBasis
Depreciation268098Depreciation
Book Value1399BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis4508609OtherCostOrOtherBasis
Depreciation3784180Depreciation
Book Value724429BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3772582OtherCostOrOtherBasis
Depreciation2689281Depreciation
Book Value1083301BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings95422012TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
RESIDENT DEPOSITS$87,205,551
OTHER NON-CURRENT LIABILITIES$0
FUNDS HELD FOR RESIDENTS$86,218
REFUNDS DUE TO RESIDENTS$974,033
CLAIMS RESERVE$587,170
ACCOUNTS PAYABLE - RELATED PARTY$164,431
FieldValueIRS element (for citing)
Total Of Amounts89017403TotalOfAmounts
Total Revenue38317600TotalRevenue
Total Expenses37418474TotalExpenses
Excess Or Deficit For Year899126ExcessOrDeficitForYear
Net Unrealized GL On Investments-976250NetUnrealizedGLOnInvestments
Total Adjustments-976250TotalAdjustments
Excess Or Deficit Per FS-77124ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt35493995TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-976250NetUnrealizedGainsInvestments
Revenue Not Rptd F990-976250RevenueNotRptdF990
Revenue Subtotal36470245RevenueSubtotal
Other Revenues Not Included1847355OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1847355RevenueNotRptdOnFinStmt
Total Revenue Per Form99038317600TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt35571119TotExpensesEtcAuditedFinclStmt
Expenses Subtotal35571119ExpensesSubtotal
Other Expenses Not Included1847355OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1847355ExpensesNotRptdOnFinStmt
Total Expenses Per Form99037418474TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF REVENUESCHEDULE D, PAGE 4, PART XII, LINE 4BCHANGE IN REALIZED GAIN/LOSS ON INVESTMENTS $766,819, CHANGE IN REALIZED GAIN/LOSS ON FORWARD CONTRACT ($19,371), MARKETING COSTS $1,099,906.
RECONCILIATION OF EXPENSESSCHEDULE D, PAGE 4, PART XIII, LINE 4BCHANGE IN REALIZED GAIN/LOSS ON INVESTMENTS OF $766,819, CHANGE IN REALIZED GAIN/LOSS ON FORWARD CONTRACT OF ($19,371), AND MARKETING COSTS OF $1,099,906.
FIN 48 DISCLOSUREFORM 990, SCHEDULE D, PAGE 4, PART XIVIN 2008, HENRY FORD VILLAGE, INC. ADOPTED FINANCIAL ACCOUNTING STANDARDS BOARD'S (FASB) STANDARD RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE ADOPTION OF THIS STANDARD DID NOT HAVE A MATERIAL EFFECT ON THE FINANCIALS STATEMENTS AND HFV DID NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS.
ENDOWMENT FUNDS990, SCHEDULE D, PART V, LINE 4HENRY FORD VILLAGE, INC. ADMINISTERS THREE ENDOWMENT FUNDS WITH THE PURPOSE TO CARRY OUT THE CHARITABLE PURPOSE OF HENRY FORD VILLAGE, INC.: 1) THE BENEVOLENT CARE FUND, 2) THE SCHOLARSHIP FUND, AND 3) THE STAFF APPRECIATION FUND. THE TOTAL ASSETS IN ALL THREE FUNDS AT 12/31/2011 WAS $233,543, which is comprised of $41,655 in the staff appreciation fund and a $191,888 interest in the net assets of the henry ford village foundation.
ESCROW ACCOUNTSFORM 990, SCHEDULE D, PAGE 2, PART IVResidents are required to remit entrance deposits, which may vary in amount depending upon the unit to be occupied. Prospective residents are required to make certain installment payments prior to the final settlement of the given unit. These amounts are included in escrow cash and advance deposits in the accompanying balance sheets. Deposit timing differences may cause escrow cash not to be equal to advance deposits. As of 12/31/2011, Escrow cash and advance deposits were $1,054,146 and $890,023, respectively.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JENNIE KLEPINGER
74375011156000007166092697000
SUSAN ROSS
68911058030000022779097493000
STAN CLOUSE
12037502637500000318210178571000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierCONTINGENT FEES BASED ON REVENUEIdentifier
Return ReferenceFORM 990, SCHEDULE J, PAGE 1, LINE 5AReturnReference
ExplanationHENRY FORD VILLAGE, INC. (HFV) HAd CONTRACTED WITH Erickson Living Management, LLC (ELM) TO PROVIDE MANAGEMENT SERVICES AND CERTAIN ADMINISTRATIVE SUPPORT UNDER A MANAGEMENT AGREEMENT that expired on November 30, 2010 but was extended through December 31, 2010. On December 1, 2010, HFV contracted with Life Care Services (LCS) for management services. The LCS contract term is for five years. HFV pays a monthly management fee equal to the greater of $50,000 or 2% of operating revenues through May 31, 2011. Management fees due on and after June 1, 2011 will vary based upon quarterly operating results of the prior period. For the period December 1, 2011 through November 30, 2012, management fees paid will not be less than $450,000 and will not exceed $899,000. In subsequent years, the minimum and maximum payment shall be adjusted based on an agreed-upon index. Compensation paid to LCS was $628,286 during 2011. The executive director, associate executive director, administrator and IT director are employees of LCS, but their salaries and related employee benefits are reimbursed by HFV. Other corporate services that HFV may obtain are not required contractually and will be on an as needed basis.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1EDC OF CITY OF DEARBORNBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521310485IssuerEIN
CUSIP Number242563AWYCUSIPNumber
Date Issued2008-10-01DateIssued
Issue Price42535000IssuePrice
Description Of PurposeREFINANCE A 1998 VAR. RATE BONDDescriptionOfPurpose
DefeasedtrueDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds41842922TotalProceeds
Amount In Reserve Fund3317550AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow34540625RefundingEscrow
Issuance Costs From Proceeds836858IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures3147889CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent3984747AmountUnspent
Year Of Subst Completion2008YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Engage Bond Counsel ContractsfalseEngageBondCounselContracts
Any Research AgreementsfalseAnyResearchAgreements
Engage Bond Counsel ResearchfalseEngageBondCounselResearch
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SECTION B. POLICIESFORM 990, PAGE 6, PART VI, SECTION B, QUESTION 11ADAVID HENRY (DIRECTOR OF FINANCE) AND A MEMBER OF THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEW THE 2011 form 990 PRIOR TO FILING.
SECTION B. POLICIESFORM 990, PAGE 6, PART VI, SECTION B, QUESTION 12CCOMPLIANCE WITH THE CONFLICT OF INTEREST, WHISTLEBLOWER, AND DOCUMENT RETENTION AND DESTRUCTION POLICIES WAS MONITORED BY THE MANAGEMENT COMPANY, LIFE CARE SERVICES, LLC. BOARD MEMBERS SIGN A CONFLICT OF INTEREST FORM ON AN ANNUAL BASIS.
SECTION B. POLICIESFORM 990, PAGE 6, PART VI, SECTION B, QUESTION 15BMANAGEMENT (HENRY FORD VILLAGE, INC. & LIFE CARE SERVICES, LLC) CONDUCTS MARKET SURVEYS ON AN ANNUAL BASIS TO DETERMINE IF AN EQUITY ADJUSTMENT IS NEEDED. BASED ON THIS INFORMATION MANAGEMENT RECOMMENDS ANNUAL SALARIES, TYPICALLY A % INCREASE OVER PRIOR YEAR. THE BOARD APPROVES THE BUDGET ON AN ANNUAL BASIS.
PART XFORM 990, PAGE 11, PART X, LINE 7PROMISSORY NOTES RECEIVABLE CONSIST OF SHORT-TERM RECEIVABLES RELATED TO THE PAYMENT OF THE FINAL INSTALLMENT OF A RESIDENT DEPOSIT. OFTEN THERE IS A TIMING DIFFERENCE BETWEEN THE SALE OF THE PROSPECTIVE RESIDENT'S HOME AND THE DUE DATE OF THE FINAL INSTALLMENT ON THE RESIDENT DEPOSIT. IN THESE CASES, A SHORT-TERM PROMISSORY NOTE IS ISSUED TO THE RESIDENT. IF THE RESIDENT PAYS THE NOTE ON OR BEFORE THE AGREED UPON DUE DATE, NO INTEREST IS CHARGED. IF THE RESIDENT DOES NOT PAY THE NOTE BY THE AGREED UPON DUE DATE, INTEREST IS CHARGED FROM THE DAY THE NOTE WAS ISSUED, THROUGH THE DATE OF PAYMENT. SOME PROMISSORY NOTES ARE EXTENDED WITH OR WITHOUT INTEREST WITH MANAGEMENT APPROVAL. PROMISSORY NOTES RECEIVABLE WERE $25,000 AS OF DECEMBER 31, 2011.
PART XFORM 990, PAGE 11, PART X, LINE 15Deferred financing costs related to the 2008 issuance of bonds totaled $1,004,757 and will be amortized over the bond term of 35 years. Amortization of deferred financing costs in the year ended December 31, 2011 was $43,819. Deferred financing fees, net of accumulated amortization, was $861,835 as of December 31, 2011. Other assets included on line 15 include: Interest in net assets of Charitable Foundation $191,888 Other designated Funds -$2,263,142 Restricted Funds $3,865,626
PART XFORM 990, PAGE 11, PART X, LINE 25RESIDENTS ARE REQUIRED TO REMIT ENTRANCE DEPOSITS, WHICH VARY IN AMOUNT DEPENDING ON THE UNIT TO BE OCCUPIED. RESIDENT DEPOSITS ARE REFUNDABLE WHEN THE UNIT HAS BEEN VACATED AND RELEASED, ALL OUTSTANDING OBLIGATIONS OF THE RESIDENT HAVE BEEN PAID, AND THE UNIT HAS BEEN RE-SETTLED AND PAID FOR BY A NEW RESIDENT. AMORTIZATION OF RESIDENT DEPOSITS IS RECOGNIZED AS OPERATING REVENUE ON A STRAIGHT-LINE BASIS OVER A 40-YEAR PERIOD OR THE REMAINING USEFUL LIFE OF THE BUILDINGS. NET RESIDENT DEPOSITS LIABILITY WAS $87,205,551 AS OF DECEMBER 31, 2011.
SCHEDULE OSCHEDULE O, GENERAL INFORMATIONLife Care Services, LLC IS A FOR-PROFIT Iowa LIMITED LIABILITY COMPANY WHICH OPERATES AND MANAGES a variety of CONTINUING CARE RETIREMENT COMMUNITIES nationwide, INCLUDING HENRY FORD VILLAGE, INC. effective December 1, 2010. HENRY FORD VILLAGE, INC. IS GOVERNED BY AN INDEPENDENT BOARD OF DIRECTORS AND IS ADVISED BY A RESIDENTS COUNCIL ELECTED BY THE HENRY FORD VILLAGE COMMUNITY. THREE MEMBERS OF THE HENRY FORD VILLAGE BOARD ALSO SERVE ON THE HENRY FORD VILLAGE FOUNDATION BOARD OF DIRECTORS.
SCHEDULE OSCHEDULE O, GENERAL INFORMATIONOn December 1, 2010, HFV contracted with Life Care Services (LCS) for management services and terminated its relationship with Erickson Living Management, LLC on December 31, 2010. The LCS contract term is for five years. HFV pays a monthly management fee equal to the greater of $50,000 or 2% of operating revenues through May 31, 2011. Management fees due on and after June 1, 2011 will vary based upon quarterly operating results of the prior period. Management fees incurred related to LCS for the year ended December 31, 2011 were $1,470,833. For the period December 1, 2011 through November 30, 2012, management fees paid will not be less than $450,000 and will not exceed $899,000. In subsequent years, the minimum and maximum payment shall be adjusted based on an agreed-upon index. The executive director, associate executive director, administrator and IT director are employees of LCS, but their salaries and related employee benefits are reimbursed by HFV. Other corporate services that HFV may obtain are not required contractually and will be on an as needed basis.
SCHEDULE OFORM 990, PAGE 9, PART VIII, LINE 2EHENRY FORD VILLAGE, INC. LEASES SPACE TO VARIOUS ENTITIES FOR THE PROVISION OF SERVICES SUCH AS PHYSICIAN CARE, DENTAL CARE, AND COSMETOLOGY SERVICES. THESE SERVICES ARE PROVIDED solely FOR THE CONVENIENCE OF THE RESIDENTS OF HENRY FORD VILLAGE.
SECTION C. DISCLOSUREPAGE 6, PART VI, LINE 18THE ORGANIZATION'S FORM 990 IS AVAILABLE UPON REQUEST. DAVID HENRY, HENRY FORD VILLAGE DIRECTOR OF FINANCE, HAS PUBLIC INSPECTION COPIES AVAILABLE AT 15101 FORD ROAD, DEARBORN, MI 48126.
SECTION B. POLICIESFORM 990, PAGE 6, PART VI, SECTION B, QUESTION 16a & 16bHFV participates in a high deductible (pooled) professional and general liability insurance plan with Erickson Living Management, LLC (ELM) and other communities managed by ELM. The plan has a $1,000,000 deductible with a $3,000,000 professional and general liability aggregate. To the extent a participant incurs a loss, all participants will share in paying for that loss, subject to the deductible and the aggregate limits. This program covered incurrence periods from 2004 to 2010. In 2011, HFV enrolled in a more traditional insurance plan. HFV participates in a high deductible (non-pooled) workers compensation plan with ELM and other communities managed by ELM. The program has a $250,000 deductible per occurrence and an $8,076,000 aggregate. Participants are responsible for 100% of their specific losses. This program covered incurrence periods from 2004 to 2010. In 2011, HFV enrolled in a more traditional insurance plan. The cost of these plans is included in salaries, wages and benefits, and insurance expense in the statements of operations.
PART VFORM 990, PAGE 5, PART V, LINES 6A & 6BHENRY FORD VILLAGE, INC. HAS AN ANNUAL CAMPAIGN TO RAISE FUNDS FOR THE STAFF APPRECIATION FUND, WHICH PROVIDES END-OF-THE-YEAR BONUS CHECKS TO HENRY FORD VILLAGE, INC. EMPLOYEES. CONTRIBUTORS ARE NOTIFIED THAT DONATIONS TO THE FUND ARE NON TAX-DEDUCTIBLE.
PART XIPART XI, LINE 5, OTHER CHANGES IN NET ASSETS OR FUND BALANCESTHIS AMOUNT REFLECTS PRIOR-PERIOD RESTATEMENTS OF ACCUMULATED DEPRECIATIION, DEPRECIATION EXPENSE, AND UNRESTRICTED NET DEFICIT.
SCHEDULE OPRIOR PERIOD ADJUSTMENTCertain errors resulting from an understatement of depreciation expense in prior years were discovered during the current year. Accordingly, an adjustment of ($2,852,966) was made to HFV's accumulated depreciation and unrestricted net deficit as of December 31, 2009. In addition, the 2010 financial statements have been restated to reflect an additional $842,309 of depreciation expense. The original unrestricted net deficit of $16,350,164 reported in the 2010 financial statements has been increased by $3,695,275, resulting in the restated balance of ($20,045,439).

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HENRY FORD VILLAGE FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line115101 FORD ROADAddressLine1
CityDEARBORNCity
StateMIState
ZIP Code48126ZIPCode
FieldValueIRS element (for citing)
EIN542159197EIN
Primary ActivitiesSUPPORTPrimaryActivities
Legal Domicile StateMILegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status11PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HENRY FORD VILLAGE FOUNDATION
C200004AUDITED F.S.
HENRY FORD VILLAGE FOUNDATION
D658077AUDITED F.S.
HENRY FORD VILLAGE FOUNDATION
K
HENRY FORD VILLAGE FOUNDATION
M
HENRY FORD VILLAGE FOUNDATION
N