2014-02-14T14:25:33-06:00 2013-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2012-07-01 364335178 WASHINGTON AND JANE SMITH HOME WASH 7734747300 2320 WEST 113TH PLACE NO 1335 CHICAGO IL 60643 RAY MARNERIS 7734747350 2014-02-07 1 GREGORY S ADAMS P00095597 6305738600 2012 2015-11-30 17:44:51Z SMITH SENIOR LIVING KEVIN MCGEE 2320 WEST 113TH PLACE NO 1335 CHICAGO IL 60643 10491562 0 X WWW.SMITHSENIORLIVING.ORG X 1999 IL THE MISSION OF SMITH VILLAGE IS TO ENRICH THE LIVES OF SENIOR ADULTS. (SEE SCHEDULE O) THROUGH THE OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY OFFERING THE HIGHEST QUALITY OF SERVICES. 13 13 98 0 0 0 0 0 4984300 6197492 1814708 1576415 0 17 6799008 7773924 434403 462252 0 0 4233556 5459470 0 0 0 932527 1005754 5600486 6927476 1198522 846448 41848098 41171890 4183759 1928303 37664339 39243587 X THE MISSION OF SMITH SENIOR LIVING IS TO ENRICH THE LIVES OF SENIOR ADULTS THROUGH THE HIGHEST QUALITY OF SERVICES. THE ORGANIZATION'S CHARITABLE PURPOSE IS TO PROVIDE MANAGEMENT, PLANNING, FINANCIAL AND ADMINISTRATIVE SERVICES (SEE SCHEDULE O) EXCLUSIVELY TO ITS RELATED CCRC ORGANIZATIONAL AFFILIATES. 0 0 2528187 2802227 SMITH SENIOR LIVING PROVIDES MANAGEMENT, PLANNING, FINANCIAL AND ADMINISTRATIVE SERVICES EXCLUSIVELY TO ITS RELATED CONTINUING CARE RETIREMENT COMMUNITY ORGANIZATIONAL AFFILIATES. 3385795 3395265 SMITH SENIOR LIVING IS THE SOLE MEMBER OF SMITH CARES, LLC, A STAFFING HOLDING COMPANY. SMITH CARES PROVIDES PROFESSIONAL STAFF TO THE AFFILIATED COMPANIES OF SMITH CROSSING AND SMITH VILLAGE WHEN THE INDIVIDUALS ARE SHARED BETWEEN THE TWO AFFILIATE ORGANIZATIONS. 462252 462252 MONIES PROVIDED BY DONATION TO THE ORGANIZATION ARE A SHARING OF EARNINGS ON THE ORIGINAL ENDOWMENT CREATED BY EMILIE SMITH. THE BOARD HAS DESIGNATED THAT 4% OF THE VALUE OF THE ENDOWMENT BE CONTRIBUTED EACH YEAR TO SMITH VILLAGE FOR CHARITABLE CARE. 17 17 6376234 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 8 0 1 98 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X RAY MARNERIS 7734747350 2320 WEST 113TH PLACE CHICAGO IL 60643 ROBERT A BERGHOFF 3.00 1.00 X 0 0 0 GEORGE A PETRAITIS 3.00 1.00 X 0 0 0 ALLEN K FLAGLER 1.00 1.00 X 0 0 0 THOMAS L HOGAN 1.00 1.00 X 0 0 0 WILLIAM H HUNDING 3.00 3.00 X 0 0 0 STEVEN J MURPHY 2.00 2.00 X 0 0 0 KARYN PETTIGREW 1.00 1.00 X 0 0 0 KAY E THURN 2.00 1.00 X 0 0 0 ANDREW J ANELLO 3.00 3.00 X 0 0 0 THOMAS E CHOMICZ 3.00 2.00 X 0 0 0 HUGH J AHERN 2.00 1.00 X 0 0 0 JUDITH K LEWIS 1.00 1.00 X 0 0 0 ANNE Z SCHAIBLE 1.00 1.00 X 0 0 0 MICHAEL A FLYNN 37.50 X 182910 0 21272 RAYMOND J MARNERIS 37.50 24.00 X 132618 0 27668 KEVIN MCGEE 37.50 24.00 X 62138 77609 30269 ROBERT A BOEHM 37.50 X 139645 0 13337 517311 77609 92546 3 0 1 0 HUB INTERNATIONAL MIDWEST 15174 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 INSURANCE BROKER 326085 SHEILA KING PO BOX 10425 CHICAGO IL 60610 PUBLIC RELATIONS SERVICES 119687 WORLDWIDE SUPPLY ONE PARK DRIVE FRANKLIN NJ 07416 COMPUTER EQUIPMENT 113995 4 AGENCY FEE 623000 3395265 3395265 MANAGEMENT FEE 541610 2802227 2802227 6197492 786212 786212 3507841 2717638 790203 790203 790203 MISCELLANEOUS 623990 17 17 17 7773924 6197509 0 1576415 462252 462252 497861 497861 4082569 4082569 107744 107744 369029 369029 402267 402267 14316 14316 119742 119742 53309 53309 117964 105807 12157 132228 18063 114165 144752 44204 100548 93787 93787 103015 103015 33593 12326 21267 45838 45838 103537 103537 42784 6517 36267 TAXES AND FEES 889 889 6927476 6376234 551242 0 459379 255321 315 5065330 2745470 126128 184925 962162 641900 421764 320262 27447305 28130657 1258738 1231301 7069454 8303639 41848098 41171890 476641 587005 3707118 1341298 4183759 1928303 X 26158901 27163413 10638771 11213507 866667 866667 37664339 39243587 41848098 41171890 846448 732800 0 X X 0 1 X 1 0 X X X 0 0 0 WJS - SMITH VILLAGE 362167948 9 1 1 1 462252 WJS - SMITH CROSSING 364333423 9 1 1 1 0 2 462252 11505438 1104546 462252 67558 12080174 11903799 -85920 434403 121962 11505438 10274728 2092619 463548 11903799 9837732 870994 418398 15600 10274728 10661483 -418068 405683 9837732 0.07000 0.93000 0 0 462924 231462 231462 499238 410438 88800 320262 DUE FROM AFFILIATES 7500011 DEPOSITS 803628 8303639 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE EARNINGS ON THE ASSETS OF THE ENDOWMENT FUND HAVE BEEN DESIGNATED TO SUPPORT THE CHARITABLE CARE ACTIVITIES OF SMITH VILLAGE DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATIONS THAT MAKE UP SMITH SENIOR LIVING QUALIFY AS TAX-EXEMPT CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE INTERNAL REVENUE SERVICE (IRS). THE FEDERAL AND STATE TAX RETURNS OF THE ORGANIZATIONS 2010, 2011, AND 2012 FISCAL YEARS ARE SUBJECT TO EXAMINATION BY THE IRS AND STATE TAXING AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THE DATE THEY WERE FILED. 1 WASHINGTON AND JANE SMITH COMMUNITY-BEVERLY 2320 WEST 113TH PLACE CHICAGO IL 60643 362167948 501(C)(3) 462252 N/A N/A CHARITABLE CARE ACTIVITIES PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE GRANTED FUNDS ARE NOT RESTRICTED AS TO USE AND ARE FOR CHARITABLE CARE OPERATIONS. THE GRANT WAS MADE TO A RELATED TAX-EXEMPT ORGANIZATION AND MANAGEMENT ENSURES THE FUNDS ARE USED TO SUPPORT THE ORGANIZATION'S EXEMPT PURPOSE. X X X X 0 0 0 0 0 0 0 0 0 MICHAEL A FLYNN 140637 0 0 0 42273 0 4763 0 16509 0 204182 0 0 0 RAYMOND J MARNERIS 119176 0 0 0 13442 0 5658 0 22010 0 160286 0 0 0 KEVIN MCGEE 56008 68601 0 0 6130 9008 2452 2978 7742 17097 72332 97684 0 0 ROBERT A BOEHM 125199 0 0 0 14446 0 5128 0 8209 0 152982 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATIONS INTERNAL MANAGEMENT AND THE FINANCE COMMITTEE REVIEWS THE RETURN WITH ITS PAID TAX PREPARER. AFTER REVIEW, COPIES OF THE FULL FORM 990 ARE PRESENTED TO ALL TRUSTEES AND REVIEWED AT A BOARD MEETING PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL TRUSTEES AND KEY PERSONNEL ARE REQUIRED TO COMPLETE A DISCLOSURE FOR CONFLICTS OF INTEREST. THE DISCLOSURES ARE SUMMARIZED BY THE CFO AND REVIEWED BY THE GOVERNANCE COMMITTEE WHO DETERMINES IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS. IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS THE TRUSTEE IS REQUIRED TO RECUSE THEMSELVES FROM ANY VOTING, DELIBERATION, OR DECISION ON THE TRANSACTION AT THE BOARD LEVEL. FURTHERMORE, ALL VENDOR PAYMENT ACTIVITY IS REVIEWED BY THE CFO FOR VENDORS THAT MAY BE RELATED TO THE FILING ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF SSL EVALUATES AND ESTABLISHES COMPENSATION AND REVIEWS PROTOCOL FOR THE ORGANIZATION'S CEO AND CFO. ANNUAL COMPENSATION COMPARISONS TO INDUSTRY PROFESSIONALS ARE GATHERED AND REVIEWED ON AN ANNUAL BASIS. DECISIONS ARE DOCUMENTED IN THE COMPENSATION COMMITTEE MEETING MINUTES. THE LAST COMPENSATION REVIEW WAS COMPLETED IN 2012. THE CEO OF SSL DETERMINES THE ANNUAL COMPENSATION OF ALL OTHER OFFICERS, WITH THE EXCEPTION OF THE CFO, BY COMPARING THE COMPENSATION OF EACH OFFICER AND KEY EMPLOYEES TO PROFESSIONALS PERFORMING SIMILAR SERVICES IN SIMILAR INDUSTRIES ON AN ANNUAL BASIS. THE LAST COMPENSATION REVIEW WAS COMPLETED IN 2012. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. AUDIT COMMITTEE & FINANCIAL STATEMENT OVERSIGHT FORM 990, PAGE 12, PART XII, LINE 2C THIS PROCESS IS CONSISTENT WITH THE PRIOR YEAR. 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