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FRIENDSHIP VILLAGE OF DUBLIN OHIO INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
FRIENDSHIP VILLAGE OF DUBLIN OHIO INC (EIN 31-0986918)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201241359349305024
Schema version
2010v3.4
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)
Timestamp2012-05-14T15:07:49-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line165 EAST STATE ST STE 600AddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310986918EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FRIENDSHIP VILLAGE OF DUBLIN OHIO INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFRIENameControl
Phone6147641600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16000 RIVERSIDE DRIVEAddressLine1
CityDUBLINCity
StateOHState
ZIP Code43017ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN A SCHWARCKName
TitleEXECUTIVE DIRECTORTitle
Phone6147641600Phone
Date Signed2012-05-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBERNIE OSTROWSKIName
Phone6148493000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN A SCHWARCKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16000 RIVERSIDE DRIVEAddressLine1
CityDUBLINCity
StateOHState
ZIP Code43017ZIPCode
FieldValueIRS element (for citing)
Gross Receipts18852615GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.FVDUBLIN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1979YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionPROVIDED 255 INDEPENDENT LIVING RESIDENCY APARTMENTS, 46 ASSISTED LIVING RESIDENCY APARTMENTS (INCLUDING 13 MEMORY LOSS UNITS), AND MAINTAINED A 60 BED SKILLED NURSING FACILITY. PROVIDED HOME HEALTH SERVICES TO OUR RESIDENCES. PROVIDED ACTIVITIES AND PROGRAMS, INCLUDING A WELLNESS CENTER, TO ENHANCE RESIDENT OVERALL HEALTH AND QUALITY OF LIFE. PROVIDED USE OF FACILITIES TO RESIDENT FAMILIES FOR FAMILY GATHERINGS, MEMORIAL SERVICES, AND TO VARIOUS AGED AND HEALTH ASSOCIATIONS FOR MEDICAL EVENTS AND EXHIBITS.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees382TotalNbrEmployees
Total Nbr Volunteers41TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year140730ContributionsGrantsPriorYear
Contributions Grants Current Year91404ContributionsGrantsCurrentYear
Program Service Revenue Prior Year17196081ProgramServiceRevenuePriorYear
Program Service Revenue CY17859600ProgramServiceRevenueCY
Investment Income Prior Year1115006InvestmentIncomePriorYear
Investment Income Current Year823074InvestmentIncomeCurrentYear
Other Revenue Prior Year56395OtherRevenuePriorYear
Other Revenue Current Year51810OtherRevenueCurrentYear
Total Revenue Prior Year18508212TotalRevenuePriorYear
Total Revenue Current Year18825888TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY8000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7955766SalariesEtcPriorYear
Salaries Etc Current Year8212023SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year114794TotalFundrsngExpCurrentYear
Other Expense Prior Year7538723OtherExpensePriorYear
Other Expenses Current Year7422387OtherExpensesCurrentYear
Total Expenses Prior Year15498989TotalExpensesPriorYear
Total Expenses Current Year15642410TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3009223RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3183478RevenuesLessExpensesCY
Total Assets BOY72744461TotalAssetsBOY
Total Assets EOY73566620TotalAssetsEOY
Total Liabilities BOY59612566TotalLiabilitiesBOY
Total Liabilities EOY55422170TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY13131895NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY18144450NetAssetsOrFundBalancesEOY
Mission DescriptionTO ENHANCE THE QUALITY OF LIFE FOR OLDER ADULTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense13116399Expense
Grants18000Grants
Revenue17859600Revenue
DescriptionOPERATION OF HEALTH CENTER, A SKILLED NURSING FACILITY, WHICH HAS 60 BEDS. OPERATION OF ASSISTED LIVING FACILITY, WHICH HAS 46 APARTMENTS. PROVIDED HOME HEALTH SERVICES TO ALL RESIDENTS.Description
Total Program Service Expense13116399TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109681NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees382NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JOHN LOFTUSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6147641600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16000 RIVERSIDE DRIVEAddressLine1
CityDUBLINCity
StateOHState
ZIP Code43017ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
KATHLEEN MCGINNIS
DIRECTOR1.00X000
G ROBERT BOWERS
CHAIRMAN3.00X000X
CHARLES E ANSLEY
TREASURER1.50X000X
GEORGE J ARNOLD
DIRECTOR1.00X000
J CHRISTOPHER SCOTT
DIRECTOR1.00X000
KATHIE CHESNUT
DIRECTOR1.00X000
JOHN GOFF
DIRECTOR1.00X000
BRIGGS HAMOR
DIRECTOR1.00X000
OWEN JOHNSON
DIRECTOR1.00X000
WILLIAM JN KONIEWICH
CHAIRMAN-ELECT3.00X000X
CHARLES B STEARNS
DIRECTOR1.00X000
MARGARET TEAFORD
DIRECTOR1.00X000
JAMES WINFREE
DIRECTOR1.00X000
DR BRUCE WALL
DIRECTOR1.00X000
RONALD J BACHMAN
DIRECTOR1.00X000
CHARLES S DEROUSIE
SECRETARY1.00000X
JOHN A SCHWARCK
EXECUTIVE DIRECTOR40.00170323043208X
JOHN LOFTUS
CONTROLLER40.0099105013630X
DONALD M PAUL
DIETARY DIRECTOR40.00119663015056X
FieldValueIRS element (for citing)
Total Reportable Comp From Org389091TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation71894TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LIFE CARE SERVICES
CAPITAL SQUAREDES MOINESIA50309MGT. CONSULTIVE SERVICES284917
LIFE CARE SERVICES
CAPITAL SQUAREDES MOINESIA50309MANAGEMENT278150
AJ GALLAGHER RISK MANAGEMENT
TWO PIERCE PLACEITASCAIL601433141INSURANCE BROKER224648
PHYSICAL THERAPY CONSULTIVE SERVICES
1223 NEIL AVECOLUMBUSOH43201PHYSICAL, OCCUPATIONAL THERAPY216965
LIFE SAFETY SYSTEMS
19870 BARKER ROADMARYSVILLEOH43040EMERGENCY NURSE CALL SYSTEM118294
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions91404AllOtherContributions
Total Contributions91404TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RESIDENCY SERVICES5311101629295016292950
MEDICARE/MEDICAID PMTS53111015666501566650
FieldValueIRS element (for citing)
Total Program Service Revenue17859600TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column313846TotalRevenueColumn
Exclusion$313,846ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real66945Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real25562Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real41383Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column41383TotalRevenueColumn
Exclusion$41,383ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities510393Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other1165Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities510393Securities
Other-1165Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column509228TotalRevenueColumn
Exclusion$509,228ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER INCOMEDescription
Business Code900099BusinessCode
Total Revenue Column10427TotalRevenueColumn
Exclusion$10,427ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue10427TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18825888TotalRevenueColumn
Related Or Exempt Function Income17859600RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$874,884ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total8000Total
Program Services8000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total298710Total
Management And General298710ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6425567Total
Program Services5680362ProgramServices
Management And General677029ManagementAndGeneral
Fundraising68176Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total74515Total
Program Services51727ProgramServices
Management And General22788ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total936411Total
Program Services836654ProgramServices
Management And General97764ManagementAndGeneral
Fundraising1993Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total476820Total
Program Services421130ProgramServices
Management And General50660ManagementAndGeneral
Fundraising5030Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total270736Total
Management And General270736ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total93435Total
Management And General93435ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total60638Total
Management And General60638ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total85179Total
Management And General85179ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total267287Total
Program Services232662ProgramServices
Management And General34625ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1328498Total
Program Services1074988ProgramServices
Management And General253510ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1202972Total
Program Services1058615ProgramServices
Management And General132327ManagementAndGeneral
Fundraising12030Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total37937Total
Program Services30629ProgramServices
Management And General7308ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total13741Total
Program Services10831ProgramServices
Management And General2910ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total398642Total
Program Services350805ProgramServices
Management And General43851ManagementAndGeneral
Fundraising3986Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1552029Total
Program Services1365786ProgramServices
Management And General170723ManagementAndGeneral
Fundraising15520Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total223166Total
Program Services157827ProgramServices
Management And General65339ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
FOOD11012141101214
LETTER OF CREDIT FEE712687712687
RECRUITING351811528019901
CHARITABLE GIVING80598059
BAD DEBT EXPENSE62776277

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total24709Total
Program Services925ProgramServices
Management And General23784ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total15642410Total
Program Services13116399ProgramServices
Management And General2411217ManagementAndGeneral
Fundraising114794Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY74296BOY
EOY96280EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY30610514BOY
EOY20181583EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY697406BOY
EOY715802EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY66177BOY
EOY71773EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY237054BOY
EOY68095EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis52020825LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec23858206LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY29129200BOY
EOY28162619EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY8343290BOY
EOY20596101EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY536560BOY
EOY677509EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3049964BOY
EOY2996858EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY72744461BOY
EOY73566620EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5085002BOY
EOY4960020EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY20557558BOY
EOY19573594EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY30695000BOY
EOY28005000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3275006BOY
EOY2883556EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY59612566BOY
EOY55422170EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12711339BOY
EOY17705747EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY187175BOY
EOY196995EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY233381BOY
EOY241708EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13131895BOY
EOY18144450EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY72744461BOY
EOY73566620EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3183478ReconcilationRevenueExpenses
Reconcilation Other Changes1829077ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years76292CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years54137CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years43501CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year140730CurrentTaxYearMinus1Year
Current Tax Year91404CurrentTaxYear
Total406064Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15053583CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16195455CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16922002CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year17196081CurrentTaxYearMinus1Year
Current Tax Year17859600CurrentTaxYear
Total83226721Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years15129875CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16249592CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years16965503CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year17336811CurrentTaxYearMinus1Year
Current Tax Year17951004CurrentTaxYear
Total83632785Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years23517CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3475CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4075CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4600CurrentTaxYearMinus1Year
Current Tax Year4415CurrentTaxYear
Total40082Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years23517CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3475CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4075CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4600CurrentTaxYearMinus1Year
Current Tax Year4415CurrentTaxYear
Total40082Total
FieldValueIRS element (for citing)
Public Support Total50983592703PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1176801CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1273080CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years899728CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year538584CurrentTaxYearMinus1Year
Current Tax Year380791CurrentTaxYear
Total4268984Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1176801CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1273080CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years899728CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year538584CurrentTaxYearMinus1Year
Current Tax Year380791CurrentTaxYear
Total4268984Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10569CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13175CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years333014CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15569CurrentTaxYearMinus1Year
Current Tax Year10427CurrentTaxYear
Total382754Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years16317245CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17535847CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years18198245CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year17890964CurrentTaxYearMinus1Year
Current Tax Year18342222CurrentTaxYear
Total88284523Total
FieldValueIRS element (for citing)
Public Support Percentage5090.94690PublicSupportPercentage509
Prior Year Support Percentage0.93880PriorYearSupportPercentage
Investment Income Percentage0.04840InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.05450PriorYrInvestIncomePercentage
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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$448OtherActivitiesAmount
Total Lobbying Expenditures IIB448TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationTHE ORGANIZATION IS A MEMBER OF AOPHA; A PORTION OF DUES PAYMENTS TO AOPHA GOES TOWARD LOBBYING ACTIVITIES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance428237BeginningOfYearBalance
Contributions100460Contributions
Investment Earnings Or Losses7124InvestmentEarningsOrLosses
Grants Or Scholarships6000GrantsOrScholarships
Other Expenditures29954OtherExpenditures
End Of Year Balance499868EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance329472BeginningOfYearBalance
Contributions101369Contributions
Investment Earnings Or Losses10181InvestmentEarningsOrLosses
Grants Or Scholarships4500GrantsOrScholarships
Other Expenditures8285OtherExpenditures
End Of Year Balance428237EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance295564BeginningOfYearBalance
Contributions42964Contributions
Investment Earnings Or Losses13783InvestmentEarningsOrLosses
Grants Or Scholarships4500GrantsOrScholarships
Other Expenditures18339OtherExpenditures
End Of Year Balance329472EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis753331OtherCostOrOtherBasis
Book Value753331BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis42650008OtherCostOrOtherBasis
Depreciation18510999Depreciation
Book Value24139009BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8617486OtherCostOrOtherBasis
Depreciation5347207Depreciation
Book Value3270279BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings28162619TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
GIFT ANNUITY PAYABLE$314,242
ADVANCE ENDOWMENT CONTRACTS & DEPOSITS$291,465
ENDOWMENT REFUNDS PAYABLE$208,939
REFUNDABLE ENDOWMENTS - R.O.C.$2,068,910
FieldValueIRS element (for citing)
Total Of Amounts2883556TotalOfAmounts
Total Revenue18825888TotalRevenue
Total Expenses15642410TotalExpenses
Excess Or Deficit For Year3183478ExcessOrDeficitForYear
Net Unrealized GL On Investments1674691NetUnrealizedGLOnInvestments
Prior Period Adjustments-3195PriorPeriodAdjustments
Other$157,581OtherAmount
Total Adjustments1829077TotalAdjustments
Excess Or Deficit Per FS5012555ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt20678759TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1674691NetUnrealizedGainsInvestments
Other Revenues158684OtherRevenues
Revenue Not Rptd F9901833375RevenueNotRptdF990
Revenue Subtotal18845384RevenueSubtotal
Other Revenues Not Included-19496OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-19496RevenueNotRptdOnFinStmt
Total Revenue Per Form99018825888TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt15648638TotExpensesEtcAuditedFinclStmt
Other Expenses Included6228OtherExpensesIncluded
Expenses Not Rptd F9906228ExpensesNotRptdF990
Expenses Subtotal15642410ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99015642410TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE FVD RESIDENTS' BENEVOLENT FUND WAS CREATED AS A TERM FUND, ALLOWING FOR ONLY THE INTEREST INCOME TO BE SPENT. THE PRIMARY USE FOR THIS FUND IS TO PROVIDE REVENUE TO OFFSET THE COST FOR LIFE CARE RESIDENTS WHO HAVE OUTLIVED THEIR PERSONAL FINANCIAL MEANS. THE JOHN SCHWARCK SCHOLARSHIP FUND WAS CREATED TO SUPPORT SELECTED EMPLOYEES AND/OR THEIR LEGAL DEPENDENTS AS THEY SEEK A COLLEGE EDUCATION. THE FVD MEMORIAL FUND EXISTS TO PROVIDE REVENUE TO PURCHASE ITEMS OF BENEFIT TO RESIDENTS THROUHOUT THE VILLAGE. THE FVD HEALTH SERVICES FUND WAS CREATED TO PROVIDE ADDITIONAL FINANCIAL RESOURCES TO HELP SECURE THE PRESENT AND FUTURE HEALTH AND COMFORT OF THE RESIDENTS. UNLESS OTHERWISE INDICATED, CONTRIBUTIONS TO THE FVD HEALTH SERVICES FUND WILL BE DIRECTED TOWARD PURCHASING SPECIALIZED EQUIPMENT, FACILITIES IMPROVEMENTS AND RELATED EXPENDITURES IN THE FOLLOWING AREAS: -HEALTH CENTER/LONG-TERM NURSING CARE -THE MEADOWS (ASSISTED LIVING/RESIDENTIAL CARE/MEMORY LOSS CARE) -HOME SERVICES -WELLNESS CENTER
PART XI, LINE 8 - OTHER ADJUSTMENTS:NET UNREALIZED GAIN ON SWAP FMV ADJUSTMENT 157,581.
PART XII, LINE 2D - OTHER ADJUSTMENTS:UNREALIZED GAIN ON SWAP FMV 157,581. LOSSES ON RESTRICTED INVESTMENTS -1,969. ANNUITY PAYMENTS IN EXCESS OF INTEREST EARNED -1,991. RECLASSIFIED RENTAL EXPENSES 5,063.
PART XII, LINE 4B - OTHER ADJUSTMENTS:LOSS ON SALE OF FIXED ASSETS -1,165. PRESENT VALUE ADJUSTMENT OF ENDOWMENT ANNUITY PAYABLE -47,314. BIRCHTON, LLC NET GAIN NOT INCLUDED IN FINANCIAL STATEMENTS 32,943. OTHER EXPENSES -3,960.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:LOSS ON SALE OF FIXED ASSETS 1,165. RECLASSIFIED RENTAL EXPENSES 5,063.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantJOHN SCHWARCK SCHOLARSHIPS AWARDED TO THE EMPLOYEES (AND/OR THEIR LEGAL DEPENDENTS) OF FRIENDSHIP VILLAGE OF DUBLIN OHIO INC. WHO ARE PURSUING A COLLEGE EDUCATION.TypeOfGrant
Number Of Recipients4NumberOfRecipients
Amount Of Cash Grant8000AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: IT IS THE ROLE OF THE SCHOLARSHIP SELECTION COMMITTEE TO DETERMINE WHICH CANDIDATE(S) FROM A QUALIFIED POOL OF APPLICANTS WILL RECEIVE SCHOLARSHIPS IN ANY GIVEN YEAR. IT IS THE ROLE OF THE CHARITABLE GIVING ADVISORY COMMITTEE (CGAC) TO DETERMINE THE AGGREGATE AMOUNT TO BE DISTRIBUTED BY THE SCHOLARSHIP SELECTION COMMITTEE. THE COMMITTEE WILL REVIEW APPLICATIONS AND THE SCHOOLS LISTED TO DETERMINE ELIGIBILITY. FRIENDSHIP VILLAGE OF DUBLIN OHIO INC. FOLLOWS ITS JOHN SCHWARCK SCHOLARSHIP FUND SPENDING PROCEDURE THROUGHOUT THE ENTIRE PROCESS FROM SELECTION TO ISSUANCE OF FUNDS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonJOHN A SCHWARCKNamePerson
Base Compensation Filing Org122442BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org27517BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org20364OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org31782DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org11426NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org213531TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

CUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
FRANKLIN COUNTY OHIO
353180GG12004-09-0113805000REFUND AND RETIRE THE OUTSTANDING PRINCIPAL AMOUNT OF THE 1997 REVENUE BONDS000
FRANKLIN COUNTY OHIO
353180GH92004-12-0119820000FUND CONSTRUCTION OF THE 51-UNIT INDEPENDENT-LIVING WING000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapital ExpendituresCapitalExpenditures
138050001340420940079119911011
198200005130002006101119307000

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000010.000000.000000.000001
000010.000000.000000.000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
MORGAN STANLEY
11117.00000000000000000
(no name)
110000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3LIFE CARE SERVICES PROVIDES THE EXECUTIVE DIRECTOR FOR THE ORGANIZATION AS WELL AS THE MARKETING DIRECTOR. IN ADDITION, LIFE CARE SERVICES PROVIDES ACCOUNTING SOFTWARE, IT SUPPORT, HUMAN RESOURCES, AND OTHER SUPPORT SERVICES.
FORM 990, PART VI, SECTION B, LINE 11ONLY THE CHAIR OF THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES IS GIVEN A COPY OF THE FORM 990 TO REVIEW PRIOR TO FILING.
ALL CLASSES OF EMPLOYEES ARE INCLUDED IN THE CONFLICT OF INTEREST POLICY. TRAINING IS PROVIDED ANNUALLY TO ALL EMPLOYEES ON DISCLOSURE OF UNETHICAL PRACTICES AND POSITIVE WORKFORCE ENVIRONMENT. A QUESTIONNAIRE IS SENT TO ALL BOARD MEMBERS ANNUALLY REQUIRING SIGNATURE OF THE FORM AND DISCLOSURE OF ANY CONFLICT OF INTEREST. THESE FORMS ARE MONITORED BY THE BOARD SECRETARY. THIS PROCESS IS GOVERNED BY DEPARTMENT MANAGERS AND THE EXECUTIVE DIRECTOR. SHOULD A CONFLICT OF INTEREST BE IDENTIFIED, IT IS DISCUSSED WITH THE EXECUTIVE DIRECTOR AND NECESSARY ACTION IS TAKEN TO ELIMINATE THE CONFLICT OF INTEREST. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST ON A SPECIFIC ISSUE, THEY ABSTAIN FROM VOTING.FORM 990, PART VI, SECTION B, LINE 12C
THE EXECUTIVE DIRECTOR IS EVALUATED ANNUALLY BY THE LIFE CARE SERVICES REGIONAL DIRECTOR & BOARD OF TRUSTEES. LOCAL WAGE AND SALARY SURVEYS ARE USED WHEN EVALUATING AMOUNTS OF INCREASES DURING THE BUDGET PREPARATION PROCESS. THE BOARD FINANCE COMMITTEE REVIEWS AND APPROVES BUDGETED INCREASES ANNUALLY AS PART OF ITS ANNUAL BUDGET REVIEW. COMPENSATION DECISIONS ARE REFLECTED IN THE MINUTES OF THE FINANCE COMMITTEE MEETINGS. A BOARD COMMITTEE REVIEWS THE COMPENSATION GRANTED TO THE EXECUTIVE DIRECTOR IN ADDITION TO THE REGIONAL DIRECTOR OF LIFE CARE SERVICES, HIS IMMEDIATE SUPERVISOR. THIS PROCESS WAS LAST UNDERTAKEN IN EARLY 2011.FORM 990, PART VI, SECTION B, LINE 15
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC REVIEW BY APPOINTMENT AT 6000 RIVERSIDE DR, DUBLIN, OH 43017.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 1,674,691. PRIOR PERIOD ADJUSTMENTS: -3,195. NET UNREALIZED GAIN ON SWAP FMV ADJUSTMENT 157,581. TOTAL TO FORM 990, PART XI, LINE 5: 1,829,077.FORM 990, PART XI, LINE 5:
THE ORGANIZATION HAS AN AUDIT COMMITTEE WHICH OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990, PART XI, LINE 2C:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1BIRCHTON LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16000 RIVERSIDE DRIVEAddressLine1
CityDUBLINCity
StateOHState
ZIP Code43017ZIPCode
FieldValueIRS element (for citing)
Primary ActivitiesHOLD AND DEVELOP REAL ESTATEPrimaryActivities
Legal Domicile StateOHLegalDomicileState
Total Income53442TotalIncome
EOY Assets516071EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA