2017-07-31T17:47:18-05:00 2016-12-31 420714325 RSM US LLP 100 INTERNATIONAL DRIVE SUITE 1400 BALTIMORE MD 21202 990 2016-01-01 522126751 SEABROOK VILLAGE INC SEAB 7326432000 3000 ESSEX ROAD TINTON FALLS NJ 07753 BARBARA BISGAIER TREASURER 7326432000 2017-07-31 1 JULIA FLANNERY CPA P00928918 4102469300 108.171.131.189 2017-07-31 15:52:38 ED P 1F6429F47CD852903688965D63EDB3355B9BF040 CDBA28A911E66288058FA62898B1BC86E1332D72 2016 2021-01-29 14:40:06Z FREDERICK W HAAS 3000 ESSEX ROAD TINTON FALLS NJ 07753 62654771 0 X WWW.NATIONALSENIORCAMPUSES.ORG X 1998 MD PROVIDE A HOME FOR SENIORS THAT SATISFIES THEIR THREE PRIMARY NEEDS. 9 9 1103 443 0 0 506391 424174 57374028 61373948 742917 393658 452443 443828 59075779 62635608 127517 99386 0 0 26584212 28022985 0 0 106865 37901306 34184865 64613035 62307236 -5537256 328372 274968205 278726115 333416177 337988153 -58447972 -59262038 X OUR MISSION IS TO PROVIDE AN ACTIVE AND ENGAGED QUALITY OF LIFE FOR RESIDENTS AND FUTURE RESIDENTS THROUGH APPROPRIATE HIGH QUALITY PROGRAMS, SERVICES, AND FACILITIES, AND A FULL CONTINUUM OF HEALTH CARE, AND WHERE FEASIBLE, A LIFELONG COMMITMENT WHILE MAINTAINING AFFORDABILITY AND LONG-TERM FINANCIAL STABILITY OF THE COMMUNITY. 0 0 58524392 99386 61373948 SEABROOK VILLAGE PROVIDES SERVICES NEEDED BY SENIOR RESIDENTS, WHO RESIDE IN 1,023 INDEPENDENT LIVING UNITS, 90 ASSISTED LIVING UNITS, AND 82 SKILLED NURSING BEDS. THE SERVICES WE PROVIDE TO OUR RESIDENTS INCLUDE, BUT ARE NOT LIMITED TO HOUSING, FOOD, MEDICAL, SECURITY AND MAINTENANCE SERVICES, RECREATIONAL AND PASTORAL ACTIVITIES. 58524392 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 114 0 1 1103 1 0 0 0 0 0 1 1 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X X MARY WINDSOR 4104022364 701 MAIDEN CHOICE LANE BALTIMORE MD 21228 FRED HAAS CHAIRPERSON 1.00 10.00 X X 11875 65000 0 ARNOLD SPEERT PRESIDENT/VICE CHAIR 1.00 5.00 X X 7500 32500 0 JEANNE MCARTHUR SECRETARY 5.00 0.00 X X 10000 0 0 FRED GRUEL TREASURER 1.00 5.00 X X 7500 27500 0 STANLEY ELWELL DIRECTOR 1.00 10.00 X 7500 35000 0 BARBARA BISGAIER DIRECTOR 0.40 5.40 X 6875 52500 0 MARY COLINS DIRECTOR 1.00 6.00 X 7500 31875 0 CAROLYN MARKEY DIRECTOR (BEG 4/1/16) 1.00 12.00 X 5000 50625 0 WILLOW PASLEY DIRECTOR (BEG 4/1/16) 1.00 12.00 X 5000 63750 0 JOHN HALL ASSISTANT TREASURER 0.50 7.50 X 0 0 0 CHRIS RATHMANN ASSISTANT TREASURER 0.50 7.50 X 0 0 0 JAMES WALTER ASSISTANT TREASURER 0.50 7.50 X 0 0 0 ARTHUR SPARKS EXECUTIVE DIRECTOR (THRU 2/6/16) 40.00 X 58073 0 46 TODD DELANEY EXECUTIVE DIRECTOR 40.00 X 161844 0 21469 NEAL FIORE DIRECTOR OF FINANCE 40.00 X 144944 0 18115 PAULA DIGERNESS ASSOCIATE EXECUTIVE DIRECTOR 40.00 X 192774 0 16209 KAREN KOLLMER PROJECT MANAGER 40.00 X 143595 0 1022 JERRY MCDONALD ASSOCIATE EXECUTIVE DIRECTOR (THRU 9/11/16) 40.00 40.00 X 81294 40408 6018 LAURIE WILLIAMSON PERSONAL MOVING CONSULTANT 40.00 X 123327 0 12028 MINDY BOWENS DIR. OF NURSING CONTINUING CARE 40.00 X 120167 0 3437 DARSHANA PATEL REHABILITATION MANAGER 40.00 X 111762 0 10306 1206530 399158 88650 13 0 1 0 ERICKSON LIVING MANAGEMENT LLC 701 MAIDEN CHOICE LANE BALTIMORE MD 21228 MANAGEMENT 2232158 DAVE BIERBACH 5080 HOMESTEAD AVE PENNSAUKEN NJ 08190 HOME RENOVATIONS 1147018 SAPPHIRE BUILDERS PO BOX 354 EATONTOWN NJ 07724 CONSTRUCTION 452923 MP CONSULTING SERVICES LLC 4213 BELMAR BOULEVARD WALL TOWNSHIP NJ 07753 CONSTRUCTION 289440 ELECTRIC MOTOR REPAIR CO 9100 YELLOW BRICK ROAD SUITE H ROSEDALE MD 21237 MAINTENANCE 231010 19 424174 424174 RESIDENT FEES 623311 53268014 53268014 ANCILLARY FEES 623311 8012686 8012686 CONTRACT REVENUE 623311 59182 59182 RESIDENT DEPOSITS 623311 31366 31366 PROCESSING FEES 623311 2700 2700 61373948 399811 399811 433474 0 433474 433474 433474 101 6254 0 -6254 101 -6153 -6153 23263 12909 10354 10354 62635608 61373948 0 837486 7665 7665 91721 91721 682224 682224 21093529 20413520 608893 71116 310531 262914 45597 2020 4164525 3919529 238088 6908 1772176 1658815 107858 5503 2232158 2232158 6199 75 6124 63318 63318 27405 27405 4802783 4107258 694270 1255 1628646 1628646 5439679 5315631 116351 7697 5998342 5997186 1155 1 145367 95679 49485 203 979300 979300 9377456 9377456 559730 559730 ADMINISTRATIVE 1342863 304056 1032001 6806 EQUIPMENT RENTAL 880569 866439 14121 9 LOSS IN INTEREST SWAP 332826 332826 RESIDENT RELATIONS 301610 243856 52407 5347 66614 66614 62307236 58524392 3675979 106865 6470 6470 31157306 27221575 2710326 3024709 2048384 2368300 140359 121516 297158 268259 304749113 80685621 228022769 224063492 9696874 21651794 888559 0 274968205 278726115 5099877 4527167 58958804 1047500 949600 61668221 265600579 273552582 333416177 337988153 X -59776824 -60731350 1169901 1310361 158951 158951 -58447972 -59262038 274968205 278726115 X 328372 5249 -1589226 441539 X 0 1 X 1 0 X 483906 449229 419867 506391 424174 2283567 57716079 58562605 56386205 57374028 61396898 291435815 58199985 59011834 56806072 57880419 61821072 293719382 125000 100000 100000 100000 100000 525000 0 125000 100000 100000 100000 100000 525000 293194382 897082 962071 972172 1196042 833285 4860652 897082 962071 972172 1196042 833285 4860652 1000 750 1750 59097067 59974905 57778244 59077211 62654357 298581784 0.98200 0.98270 0.01630 0.01550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 17210958 17210958 276476241 74629055 201847186 7476187 5196752 2279435 3585727 859814 2725913 224063492 BENEFICIAL INTEREST IN COMERICA LEGACY FOUNDATION 41340 F BENEFICIAL INTEREST IN NATIONAL CCRC BUSINESS TRUST 1 21610454 F 21651794 RESIDENT DEPOSITS 262508935 RESIDENT REFUNDS 7648370 EMPLOYEE HEALTH PLAN 1164544 FUNDS HELD FOR RESIDENTS 160908 UNCLAIMED PROPERTY 4592 DEFERRED MANAGEMENT FEES 111608 MARKETING FEE DEFERRED 42518 ACCRUED LIABILITY ON SWAP AGREEMENT 1911107 273552582 X 63877044 5249 1236187 1241436 62635608 0 62635608 63101884 794648 794648 62307236 0 62307236 PART IV, LINE 2B: PROSPECTIVE RESIDENTS ARE REQUIRED TO MAKE CERTAIN INSTALLMENT PAYMENTS PRIOR TO THE FINAL SETTLEMENT OF THE GIVEN UNIT. THOSE ADVANCE DEPOSITS ARE REPORTED ON FORM 990, PART X, LINE 21. PART X, LINE 2: SEABROOK VILLAGE, INC. ("SBV") IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THE APPLICABLE STATE INCOME TAX REGULATIONS. TINTON FALLS CAMPUS, LLC ("TFC") IS A SINGLE MEMBER LIMITED LIABILITY COMPANY AND HAS ELECTED TO BE DISREGARDED FOR FEDERAL AND STATE INCOME TAX PURPOSES. TFC'S FINANCIAL STATEMENT ACTIVITY IS REFLECTED ON SBV'S BOOKS AND RECORDS. MANAGEMENT HAS EVALUATED SBV'S TAX POSITIONS AND HAS CONCLUDED THAT SBV HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: TRNA ADJUSTMENT 268,358. CHANGE IN BENEFICIAL INTEREST IN NATIONAL CCRC BUSINESS TRUST I 954,920. GAMING EXPENSES NETTED WITH REVENUE 12,909. PART XII, LINE 2D - OTHER ADJUSTMENTS: TRNA ADJUSTMENT 268,358. REVERSAL OF PRIOR AMORTIZATION 191,500. UNREALIZED LOSS ON INTEREST SWAP 321,881. GAMING EXPENSES NETTED WITH REVENUE 12,909. 23263 513 1946 3930 6520 0 23263 513 1946 3930 6520 12909 10354 NJ 0 A LICENCE WAS NOT REQUIRED FOR AN ANNUAL CASINO NIGHT. 0 0 0 1.00000 ANN MARIE MATTHEWS 3000 ESSEX ROAD TINTON FALLS NJ 07753 0 TUMBLING DICE ENTERTAINMENT INC 4250 THE ORGANIZATION CONTRACTED WITH TUMBLING DICE ENTERTAINMENT TO PROVIDE SERVICES FOR THE ANNUAL EVENT. THE CONTRACTOR PROVIDED STAFF, TABLES, EQUIPMENT, ETC. X 0 1 EDUCATIONAL SCHOLARSHIPS - SEE PART IV 76 91721 SCHEDULE I, PART I, LINE 2 SCHOLAR CANDIDATES MUST BE CURRENTLY EMPLOYED YEAR-ROUND AT SEABROOK VILLAGE. ONLY MEDICAL LEAVES OF ABSENCE ARE ALLOWABLE DURING THE TWO YEARS. OTHER REQUESTS FOR A LEAVE OF ABSENCE WILL BE REVIEWED AND DETERMINED CASE BY CASE. A SCHOLAR CANDIDATE MUST HAVE BEEN EMPLOYED BY SEABROOK VILLAGE ON OR BEFORE SEPTEMBER 30, 2016. THE CANDIDATE MUST ALSO ACHIEVE 1,000 HOURS OF WORK DURING A TIME SPAN THAT BEGINS NO EARLIER THAN JUNE 1, 2016 OF THEIR JUNIOR YEAR OF HIGH SCHOOL (300 OF 1,000 HOURS MUST BE COMPLETED BY THE END OF THEIR JUNIOR YEAR OF HIGH SCHOOL TO QUALIFY). ANY HOURS WORKED PRIOR TO JUNE 1, 2016 DO NOT COUNT TOWARDS THE 1,000 HOURS REQUIREMENT. CANDIDATES MUST ACHIEVE THE 1,000 HOUR REQUIREMENT AS WELL AS FULFILL THE TWO-YEAR MINIMUM EMPLOYMENT REQUIREMENT. CANDIDATES MUST BE IN "GOOD STANDING" FROM THEIR ORIGINAL DATE OF HIRE THROUGH THEIR LAST DAY OF WORK. TO MAINTAIN "GOOD STANDING," SCHOLAR CANDIDATES, AS EMPLOYEES, MUST ABIDE BY ALL EMPLOYMENT POLICIES AND PROCEDURES, TO INCLUDE GIVING TWO WEEKS NOTICE TO THEIR SUPERVISOR WHEN TERMINATING EMPLOYMENT. SCHOLAR CANDIDATES MUST COMPLETE EACH STEP AS OUTLINED IN THE PROGRAM DESCRIPTION BY THE RESPECTIVE DUE DATE. FURTHERMORE, CANDIDATES MUST TURN IN PROOF OF FULL-TIME STATUS WITHIN THE DATES SPECIFIED IN THE PROGRAM DESCRIPTION FOR EACH SPRING AND FALL SEMESTER THEY ATTEND SCHOOL. FAILURE TO DO SO WILL DISQUALIFY THE SCHOLAR THAT SEMESTER AND WILL COUNT TOWARDS ONE OF THE TWO ALLOWABLE SEMESTER LAPSES. CANDIDATES SHOULD INTEND TO GO TO COLLEGE OR TRADE SCHOOL AFTER HIGH SCHOOL. SCHOLAR CANDIDATES MUST ATTEND SCHOOL FULL-TIME (12 CREDIT HOURS EACH SEMESTER) AFTER HIGH SCHOOL. SCHOLAR CANDIDATES MUST BE ACCEPTED AND/OR REGISTERED IN THE FALL OF 2016 AT A TRADE SCHOOL, COLLEGE, OR UNIVERSITY TO BENEFIT. (IN EXCEPTIONAL CASES, A SCHOLAR CANDIDATE MAY ARRANGE TO START SCHOOL UP TO TWO SEMESTERS AFTER BEING INDUCTED INTO THE PROGRAM, BUT THEY MUST MAKE ARRANGEMENTS WITH THE RESIDENT LIFE DEPARTMENT. THESE TWO SEMESTERS WILL COUNT AS THE TWO ALLOCABLE SEMESTER LAPSES.) SCHOLARS WHO LAPSE FROM THE PROGRAM FOR MORE THAN A TOTAL OF TWO SEMESTERS AFTER BEING INDUCTED INTO THE PROGRAM ARE NO LONGER ELIGIBLE TO RECEIVE THE AWARD. X X X 0 0 0 0 0 0 0 0 0 TODD DELANEY EXECUTIVE DIRECTOR 141532 0 20000 0 312 0 750 0 20719 0 183313 0 0 0 NEAL FIORE DIRECTOR OF FINANCE 144432 0 0 0 512 0 750 0 17365 0 163059 0 0 0 PAULA DIGERNESS ASSOCIATE EXECUTIVE DIRECTOR 128107 0 0 0 64667 0 0 0 16209 0 208983 0 0 0 SCHEDULE J, PART II: ALL INDIVIDUALS LISTED IN SCHEDULE J, PART II ARE EMPLOYEES OF ERICKSON LIVING MANAGEMENT, LLC ("ELM"), AN UNRELATED ORGANIZATION TO SEABROOK VILLAGE, INC., IN ACCORDANCE WITH THE MANAGEMENT AGREEMENT BETWEEN SEABROOK VILLAGE, INC. AND ELM. SEE SCHEDULE O EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 3. THEREFORE, FOR IRS MATCHING PURPOSES, ELM IS THE ISSUER OF THESE FORMS W-2. UNDER THE MANAGEMENT AGREEMENT, SEABROOK VILLAGE, INC. REIMBURSES ELM FOR THE COST OF SERVICES PERFORMED FOR SEABROOK VILLAGE, INC. A NEW JERSEY ECONOMIC DEVELOPMENT AUTHORITY 222045817 2016-09-01 61775000 REFUND PRIOR ISSUE PRE-2003 0 0 0 A 1999000 61775000 61775000 2006 1 0 1 1 A 0 1 0 0 1 1 BB&T 10.000000000000 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1 UNDER THE BYLAWS OF THE ORGANIZATION, THE BOARD HAS DELEGATED AUTHORITY TO AN EXECUTIVE COMMITTEE COMPRISED OF THE ORGANIZATION'S CHAIRMAN, PRESIDENT, SECRETARY AND TREASURER. THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE ALL OF THE POWERS AND AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE ORGANIZATION EXCEPT FOR THOSE ACTIONS RESERVED SOLELY TO THE MEMBER OR THE DIRECTORS UNDER THE GENERAL LAWS OF THE STATE OF MARYLAND. FORM 990, PART VI, SECTION A, LINE 3 SEABROOK VILLAGE, INC. ENTERED INTO A MANAGEMENT AND MARKETING AGREEMENT ON APRIL 30, 2010 WITH ERICKSON LIVING MANAGEMENT, LLC ("ELM"). ELM IS A MARYLAND LIMITED LIABILITY COMPANY WHICH OPERATES AND MANAGES LARGE SCALE CONTINUING CARE RETIREMENT COMMUNITIES. THE MANAGEMENT AGREEMENT COMPLIES WITH REV. PROC. 97-13. THE JUNE 30, 2016 AMENDMENT TO THE MANAGEMENT AGREEMENT INCLUDED A DESCRIPTION OF CERTAIN SERVICES INCLUDED WITHIN THE SCOPE OF "IN-HOUSE LEGAL SERVICES." AN AMENDED AND RESTATED MANAGEMENT AND MARKETING AGREEMENT DATED SEPTEMBER 1, 2016 INCORPORATED ALL PREVIOUSLY ADOPTED AMENDMENTS INTO A SINGLE AGREEMENT, UPDATED CHANGES TO CERTAIN TERMS CONSISTENT WITH AMENDMENTS MADE IN JUNE 2016 TO THE ORGANIZATION'S BUDGET POLICY, REVISED AN EXHIBIT TO REFLECT THE ORGANIZATION'S CURRENT VISION/MISSION STATEMENT, AND ELIMINATED CERTAIN "DEADWOOD" REFERENCES. THE FOLLOWING OFFICERS ARE LISTED IN PART VII, AS NON-COMPENSATED OFFICERS OF THE FILING ORGANIZATION, JOHN HALL, JAMES WALTER, AND CHRIS RATHMANN. THEIR DUTIES ARE CONSIDERED PERFORMED PRO BONO. ARTHUR SPARKS, EXECUTIVE DIRECTOR (THROUGH 2/6/16), TODD DELANEY, EXECUTIVE DIRECTOR, NEAL FIORE, DIRECTOR OF FINANCE, PAULA DIGERNESS, ASSOCIATE EXECUTIVE DIRECTOR, AND JERRY MCDONALD, ASSOCIATE EXECUTIVE DIRECTOR (THROUGH 9/11/16), ARE LEASED EMPLOYEES FROM THE MANAGEMENT COMPANY. THE FILING ORGANIZATION REIMBURSES THE MANAGEMENT COMPANY FOR THEIR COMPENSATION WHICH IS REPORTED ON FORM 990, PART VII, SECTION A. FORM 990, PART VI, SECTION A, LINE 6 SEABROOK VILLAGE, INC.'S SOLE MEMBER IS NATIONAL SENIOR CAMPUSES, INC. ("NSC"). NSC IS A MARYLAND NON-STOCK CORPORATION. NSC IS A "SUPPORTING ORGANIZATION" WITH RESPECT TO SEABROOK VILLAGE, AS WELL AS CERTAIN OTHER ORGANIZATIONS SPECIFIED IN ITS GOVERNING DOCUMENTS. AS REQUIRED BY THE REGULATIONS RELATING TO "SUPPORTING ORGANIZATIONS," CERTAIN MEMBERS OF THE BOARD OF DIRECTORS OF NSC WILL ALSO BE MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS MAY NOMINATE A SLATE OF CANDIDATES FOR CONSIDERATION BY THE MEMBER, BUT THE MEMBER HAS SOLE DISCRETION TO ELECT DIRECTORS WHETHER OR NOT NOMINATED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN EXTRAORDINARY ACTIONS OF THE CORPORATION REQUIRE THE APPROVAL OF THE MEMBER UNDER APPLICABLE STATE LAW. UNDER THE ORGANIZATION'S BYLAWS, CERTAIN GOVERNANCE DECISIONS ARE MADE BY THE BOARD WITH THE CONSENT OF THE MEMBER AS SHARED POWERS AND CERTAIN GOVERNANCE DECISIONS ARE RESERVED TO THE MEMBER. SHARED POWERS INCLUDE AMENDMENTS TO ANY OF THE COMMUNITY DOCUMENTS (EXCEPT WHERE IT INVOLVES A RESERVED POWER), APPROVAL OF ALL CONTRACTS WITH OR PAYMENTS TO THE MEMBER OR OTHER RELATED ENTITIES (OTHER THAN GOVERNANCE COSTS OF THE MEMBER), AUTHORIZING THE FILING OF ANY BANKRUPTCY, CHANGES TO SHARED POWERS, A SIGNIFICANT EXPANSION OR NEW LINE OF BUSINESS JUST INVOLVING THE ORGANIZATION, AND SELECTION OF THE MANAGEMENT COMPANY. RESERVED POWERS OF THE MEMBER INCLUDE: APPROVAL OF POLICIES AFFECTING MORE THAN ONE COMMUNITY; SPONSORSHIP OF A NEW COMMUNITY; PAYMENT OF REASONABLE AMOUNTS TO COVER THE MEMBER'S OPERATING COSTS; THE EXECUTION OF JOINT PURCHASE CONTRACTS OR SIMILAR AGREEMENTS ALONG WITH AFFILIATE(S); THE DISPOSITION OR PLEDGE OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS (OTHER THAN A PLEDGE IN CONNECTION WITH AN ASSET OR FINANCING TRANSACTION); COMPENSATION OF OFFICERS, DIRECTORS AND ADVISORY COMMITTEE MEMBERS; AND APPROVAL OF CONTRACTS, AMENDMENTS, ETC. AFFECTING THE ORGANIZATION AND ONE OR MORE RELATED ENTITIES OR THE RESIDENTS OF THEIR COMMUNITIES. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD APPOINTS A COMMITTEE FROM AMONG ITS DIRECTORS AS WELL AS THE DIRECTORS FROM ONE OR MORE RELATED ENTITIES TO OVERSEE THE PREPARATION OF FORM 990. THE BOARD CHAIR HAS THE RESPONSIBILITY TO REVIEW FORM 990 PRIOR TO ITS FILING OR TO DESIGNATE ANOTHER BOARD MEMBER TO REVIEW THE FORM. THE FULL BOARD IS GIVEN THE OPPORTUNITY TO REVIEW THE FINAL VERSION OF FORM 990 BEFORE IT IS FILED AND ASK QUESTIONS OF THE COMMITTEE OR THE REVIEWER REGARDING THE FORM. THE BOARD CHAIR DESIGNATES AN OFFICER TO SIGN FORM 990. FORM 990, PART VI, SECTION B, LINE 12C SEABROOK VILLAGE, INC.'S CONFLICT OF INTEREST POLICY COVERS ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, EMPLOYEES AND VOLUNTEERS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER SEABROOK VILLAGE, INC.'S AFFAIRS, COMMITTEE MEMBERS, PROSPECTIVE DIRECTORS, AND SENIOR STAFF PROVIDING SERVICES TO THE ORGANIZATION UNDER A MANAGEMENT AGREEMENT. EACH COVERED PERSON COMPLETES A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY AND AS POTENTIAL CONFLICTS ARISE DURING THE YEAR. THESE STATEMENTS ARE REVIEWED BY THE BOARD CHAIR. IF THE CONFLICT INVOLVES A COVERED EMPLOYEE, THE CHAIR DETERMINES WHETHER A CONFLICT EXISTS AND, IF SO, HOW IT IS TO BE HANDLED, OR THE CHAIR MAY REFER THE MATTER TO THE BOARD OF DIRECTORS FOR CONSIDERATION. FOR ALL OTHER CONFLICTS, THE BOARD OF DIRECTORS OR A COMMITTEE OF DISINTERESTED DIRECTORS WILL DETERMINE WHETHER A CONFLICT ACTUALLY EXISTS. A COVERED PERSON MAY NOT PARTICIPATE IN ANY DISCUSSION OR DEBATE BY THE BOARD BUT MAY ANSWER QUESTIONS OR PROVIDE CLARIFYING INFORMATION UNLESS ANY BOARD MEMBER OBJECTS. FORM 990, PART VI, SECTION B, LINE 15 NSC HAS APPROVED A DIRECTORS' COMPENSATION POLICY WHICH ESTABLISHES THE PROCESS BY WHICH ALL DIRECTOR COMPENSATION IS DETERMINED. OFFICERS SERVE WITHOUT COMPENSATION. A REVIEW OF THE DIRECTORS' COMPENSATION IS CONDUCTED EACH FISCAL YEAR. COMPENSATION IS APPROACHED ON AN OVERALL BASIS AND THE TOTAL VALUE OF ALL FORMS OF COMPENSATION IS ESTABLISHED AND MONITORED. AN INDEPENDENT COMPENSATION CONSULTANT IS PERIODICALLY RETAINED TO PERFORM AN ANALYSIS OF SEABROOK VILLAGE, INC.'S COMPENSATION USING COMPARABLES OF BOTH FOR-PROFIT AND NON-PROFIT PEERS. A COMMITTEE OF THE NSC BOARD REVIEWS THE CONSULTANT'S REPORT AND MAKES A RECOMMENDATION TO NSC AS TO APPROPRIATE COMPENSATION OF DIRECTORS. THE FULL BOARD HAS ACCESS TO SEABROOK VILLAGE INC.'S CONSULTANT'S REPORT AND AN OPPORTUNITY TO QUESTION THE CONSULTANT ABOUT THE PROCESS, METRICS, AND COMPARABLES THAT WERE USED IN DETERMINING THE RECOMMENDED COMPENSATION. NSC THEN VOTES ON THE COMPENSATION RECOMMENDATIONS AND A CONTEMPORANEOUS RECORD IS MADE OF THE MEETING AND THE VOTE. THE CONSULTANT REVIEW WAS LAST UNDERTAKEN IN 2014 AND WAS ACTED UPON BY THE BOARD IN EARLY 2015. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE EXECUTIVE DIRECTOR'S OFFICE FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART XI, LINE 9: REVERSAL OF PRIOR AMORTIZATION -191,500. CHANGE IN BENEFICIAL INTEREST IN NATIONAL CCRC BUSINESS TRUST I 954,920. UNREALIZED LOSS ON INTEREST SWAP -321,881. TINTON FALLS CAMPUS LLC 3000 ESSEX ROAD TINTON FALLS NJ 07753 522027818 OWNER OF LAND AND BUILDINGS MD 0 269546524 SEABROOK VILLAGE INC ASHBY PONDS INC 21170 ASHBY PONDS BLVD ASHBURN VA 20147 205609803 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 BROOKSBY VILLAGE INC 100 BROOKSBY VILLAGE DRIVE PEABODY MA 01960 522126755 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 CEDAR CREST VILLAGE INC 1 CEDAR CREST VILLAGE DRIVE POMPTON PLAINS NJ 07444 522184915 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 EAGLE'S TRACE INC 14703 EAGLE VISTA DRIVE HOUSTON TX 77077 030498683 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 FOX RUN VILLAGE INC 41000 13 MILE ROAD NOVI MI 48377 522291271 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 ANN'S CHOICE INC 10000 ANNS CHOICE WAY WARMINSTER PA 18974 522095427 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 HIGHLAND SPRINGS INC 8000 FRANKFORD ROAD DALLAS TX 75252 510536892 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 LINDEN PONDS INC 300 LINDEN PONDS WAY HINGHAM MA 02043 141849849 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 MARIS GROVE INC 100 MARIS GROVE WAY GLEN MILLS PA 19342 550878964 CONTINUING CARE RETIREMENT COMMUNITY PA 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 NATIONAL SENIOR CAMPUSES INC 7440 SPRING VILLAGE DRIVE SPRINGFIELD VA 22150 204356247 SUPPORTING ORGANIZATION MD 501(C)(3) 11, III-FI N/A 0 NATIONAL SENIOR CAMPUSES FOUNDATION INC 7440 SPRING VILLAGE DRIVE SPRINGFIELD VA 22150 030611973 SUPPORTING ORGANIZATION MD 501(C)(3) 11, III-FI N/A 0 OAK CREST VILLAGE INC 8800 WALTHER BOULEVARD PARKVILLE MD 21234 521874053 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 RIDERWOOD VILLAGE INC 3110 GRACEFIELD ROAD SILVER SPRING MD 20904 522126753 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 TALLGRASS CREEK INC 13800 METCALF AVENUE OVERLAND PARK KS 66223 870765641 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 WIND CREST INC 3235 MILL VISTA ROAD HIGHLANDS RANCH CO 80129 510549976 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 GREENSPRING VILLAGE INC 7440 SPRING VILLAGE DRIVE SPRINGFIELD VA 22150 522095427 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 LANTERN HILL INC 535 MOUNTAIN AVENUE NEW PROVIDENCE NJ 07974 371742780 CONTINUING CARE RETIREMENT COMMUNITY MD 501(C)(3) LINE 10 NATIONAL SENIOR CAMPUSES INC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0