FURP.ORG / PUBLIC DATA EXPLORER

SAINT ANNE HOME AND RETIRMENT COMMUNITY: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SAINT ANNE HOME AND RETIRMENT COMMUNITY (EIN 35-2024406)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-01
IRS object ID
201240619349301894
Schema version
2010v3.2
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)
Timestamp2012-03-01T13:00:19-06:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CROWE HORWATH LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13815 River Crossing ParkwayAddressLine1
Address Line2Suite 300AddressLine2
CityIndianapolisCity
StateINState
ZIP Code462400977ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN352024406EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SAINT ANNE HOME AND RETIREMENT COMMUNITYBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSAINNameControl
Phone2604845555Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11900 Randallia DriveAddressLine1
CityFort WayneCity
StateINState
ZIP Code46805ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY E HAVERSTICKName
TitleADMINISTRATORTitle
Date Signed2011-02-16DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3175698989Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1MARY HAVERSTICKBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11900 Randallia DriveAddressLine1
CityFort WayneCity
StateINState
ZIP Code46805ZIPCode
FieldValueIRS element (for citing)
Gross Receipts16122538GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.SAINTANNEHOME.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionIT IS THE MISSION OF SAINT ANNE HOME AND RETIREMENT COMMUNITY TO PROVIDE A SAFE, HEALTHY AND LOVING ENVIRONMENT IN WHICH SENIOR'S NEEDS CAN BE MET, FRIENDSHIPS CAN BE FORMED AND MEMORIES CAN BE SHAREDActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees366TotalNbrEmployees
Total Nbr Volunteers130TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year101105ContributionsGrantsPriorYear
Contributions Grants Current Year127477ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14275476ProgramServiceRevenuePriorYear
Program Service Revenue CY14914596ProgramServiceRevenueCY
Investment Income Prior Year58374InvestmentIncomePriorYear
Investment Income Current Year71960InvestmentIncomeCurrentYear
Other Revenue Prior Year248538OtherRevenuePriorYear
Other Revenue Current Year309304OtherRevenueCurrentYear
Total Revenue Prior Year14683493TotalRevenuePriorYear
Total Revenue Current Year15423337TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year3222GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1709GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9235328SalariesEtcPriorYear
Salaries Etc Current Year9598451SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4621666OtherExpensePriorYear
Other Expenses Current Year4953781OtherExpensesCurrentYear
Total Expenses Prior Year13860216TotalExpensesPriorYear
Total Expenses Current Year14553941TotalExpensesCurrentYear
Revenues Less Expenses Prior Year823277RevenuesLessExpensesPriorYear
Revenues Less Expenses CY869396RevenuesLessExpensesCY
Total Assets BOY13024790TotalAssetsBOY
Total Assets EOY12825145TotalAssetsEOY
Total Liabilities BOY5768020TotalLiabilitiesBOY
Total Liabilities EOY4554007TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7256770NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8271138NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionIT IS THE MISSION OF SAINT ANNE HOME AND RETIREMENT COMMUNITY (SAINT ANNE HOME) TO PROVIDE A SAFE, HEALTHY AND LOVING ENVIRONMENT IN WHICH SENIOR'S NEEDS CAN BE MET, FRIENDSHIPS CAN BE FORMED AND MEMORIES CAN BE SHARED. (CONTINUED IN SCHEDULE O)MissionDescription
Significant ChangefalseSignificantChange
Expense10941333Expense
Grants1709Grants
Revenue12001727Revenue
DescriptionNURSING, MEDICAL, AND ANCILLARY SERVICES - SAINT ANNE HOME AND RETIREMENT COMMUNITY (SAINT ANNE HOME) OPERATES A 165 BED NURSING FACILITY PROVIDING A FULL SPECTRUM OF QUALITY CARE INCLUDING PRIVATE REHABILITATION SUITES AND ALZHEIMER'S DEMENTIA CARE. EACH RESIDENT HAS AN INDIVIDUALIZED PROGRAM DESIGNED BY AN INTERDISCIPLINARY TEAM. A FEW OF THE MANY SERVICES PROVIDED INCLUDE: MEDICATION ADMINISTRATION AND MONITORING; ASSISTANCE WITH BATHING; TRANSPORTATION TO MEALS AND ACTIVITIES; AND ASSISTANCE WITH DRESSING. CERTIFIED NURSING ASSISTANTS AND LICENSED NURSES WORK AS A TEAM TO HELP EACH RESIDENT REACH AND MAINTAIN THEIR HIGHEST LEVEL OF FUNCTIONING. SERVICES WERE PROVIDED FOR 56,080 PATIENT DAYS WITH AN AVERAGE OCCUPANCY OF 93.12% DURING THE FISCAL YEAR ENDED JUNE 30, 2011. (CONTINUED IN SCHEDULE O)Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2148947Expense
Grants0Grants
Revenue2912869Revenue
DescriptionRESIDENTIAL SERVICES - SAINT ANNE HOME AND RETIREMENT COMMUNITY (SAINT ANNE HOME) OFFERS 97 INDEPENDENT AND RESIDENTIAL LIVING UNITS FOR PEOPLE WHO ARE ABLE TO CARE FOR THEMSELVES AND THEIR APARTMENTS. ACCORDING TO THE CRITERIA, RESIDENTS WHO BECOME UNABLE TO FUNCTION WILL BE EVALUATED FOR ASSISTED LIVING. SERVICES PROVIDED INCLUDE MEALS, ACTIVITIES AND RELIGIOUS SERVICES. SAINT ANNE RETIREMENT COMMUNITY RESIDENTIAL LIVING UNITS PROVIDED 35,718 PATIENT DAYS DURING THE YEAR ENDED JUNE 30, 2011.Description
FieldValueIRS element (for citing)
Total Program Service Expense13090280TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
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 RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
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 With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees366NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
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 Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MARY E HAVERSTICKBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2604845555TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11900 RANDALLIA DRIVEAddressLine1
CityFort WayneCity
StateINState
ZIP Code46805ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
MONSIGNOR JOHN SUELZER
CORPORATE OFFICER1XX000
MOST REVEREND KEVIN C RHOADES
CHAIRMAN/CORPORATE OFFICER1XX0195000
MARY HAVERSTICK
ADMINISTRATOR40X8758902846
MR DAN KOHNEN
VICE PRESIDENT/TREASURER/SECRETARY1XX000
MS NANCY O'BRIEN
DIRECTOR1X000
MR JOE RYAN
DIRECTOR1X0867520
MS CATHERINE WILCOX
DIRECTOR1X000
DR DIANE HOPEN
DIRECTOR1X000
MR TIM WAGNER
DIRECTOR/PARTIAL YEAR1X000
MR TIM SHIELDS
DIRECTOR1X000
MR ED WELLING
DIRECTOR1X000
MR MICHAEL DAHM
PRESIDENT1XX000
MR NICK CIOCCA
DIRECTOR1X000
MR MIKE FRIDLEY
DIRECTOR1X000
MR TOM DIXON
DIRECTOR1X000
MR JIM FITZPATRICK
CORPORATE OFFICER1XX000
SISTER CAROLE LANGHAUSER
DIRECTOR1X000
MR JERRY HENRY
DIRECTOR1X000
MR BOB NICHOLAS
DIRECTOR/PARTIAL YEAR1X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org87589TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs106252TotalReportableCompFrmRltdOrgs
Total Other Compensation2846TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SELECT REHABILITATIONBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 809056AddressLine1
CityCHICAGOCity
StateILState
ZIP Code606809056ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPHYSICAL/SPEECH/OCC THERAPYDescriptionOfServices
Compensation787084Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions127477AllOtherContributions
Total Contributions127477TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NURSING AND MEDICAL SERVICES94645399464539
ANCILLARY SERVICES29168002916800
RESIDENTIAL SERVICES25048112504811
ADULT DAY SERVICES2844628446

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue14914596TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column31505TotalRevenueColumn
Exclusion$31,505ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities739656Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities649862Securities
Other49339Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities89794Securities
Other-49339Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column40455TotalRevenueColumn
Exclusion$40,455ExclusionAmount

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 (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
DINING/VENDING SERVICES218734$218,734
TELEPHONE/LAUNDRY SERVICES37703$37,703
BEAUTY/BARBER SHOP32699$32,699

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column20168TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$20,168ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue309304TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15423337TotalRevenueColumn
Related Or Exempt Function Income14914596RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$381,264ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1709Total
Program Services1709ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total96014Total
Program Services96014ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total11099Total
Management And General11099ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7401427Total
Program Services6898158ProgramServices
Management And General503269ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total341918Total
Program Services318129ProgramServices
Management And General23789ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1204754Total
Program Services1121432ProgramServices
Management And General83322ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total543239Total
Program Services508724ProgramServices
Management And General34515ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total63280Total
Management And General63280ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total68895Total
Management And General68895ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total7387Total
Management And General7387ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1540334Total
Program Services1117245ProgramServices
Management And General423089ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total63117Total
Management And General63117ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1449831Total
Program Services1367939ProgramServices
Management And General81892ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total11460Total
Management And General11460ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total363124Total
Program Services319486ProgramServices
Management And General43638ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total13122Total
Management And General13122ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total118805Total
Program Services118805ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total596774Total
Program Services596774ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total35394Total
Program Services25569ProgramServices
Management And General9825ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVIDER TAXES503490503490
PROVISION FOR BAD DEBT5994359943
RESIDENT RELATIONS3686336863
DUES, FEES, & SUBSCRIPTIONS1958819588

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2374Total
Program Services0ProgramServices
Management And General2374ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14553941Total
Program Services13090280ProgramServices
Management And General1463661ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1300BOY
EOY1300EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1345597BOY
EOY1172901EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1249535BOY
EOY1827403EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY179911BOY
EOY182124EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY45908BOY
EOY62472EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis15344963LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8158752LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7489344BOY
EOY7186211EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1855473BOY
EOY2085533EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY857722BOY
EOY307201EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY13024790BOY
EOY12825145EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY980132BOY
EOY1116613EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY4320000BOY
EOY3090000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY20425BOY
EOY17738EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY447463BOY
EOY329656EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5768020BOY
EOY4554007EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7256770BOY
EOY8271138EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7256770BOY
EOY8271138EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13024790BOY
EOY12825145EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses869396ReconcilationRevenueExpenses
Reconcilation Other Changes144972ReconcilationOtherChanges
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 Years71561CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years49666CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years95152CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year101105CurrentTaxYearMinus1Year
Current Tax Year127477CurrentTaxYear
Total444961Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13181627CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years13946275CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14280838CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14275476CurrentTaxYearMinus1Year
Current Tax Year14914596CurrentTaxYear
Total70598812Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years232551CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years248444CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years241508CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year248538CurrentTaxYearMinus1Year
Current Tax Year309304CurrentTaxYear
Total1280345Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13485739CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14244385CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14617498CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14625119CurrentTaxYearMinus1Year
Current Tax Year15351377CurrentTaxYear
Total72324118Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total
FieldValueIRS element (for citing)
Public Support Total50972324118PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years87208CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years40203CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years35946CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year42290CurrentTaxYearMinus1Year
Current Tax Year31505CurrentTaxYear
Total237152Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years87208CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years40203CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years35946CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year42290CurrentTaxYearMinus1Year
Current Tax Year31505CurrentTaxYear
Total237152Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

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 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13572947CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14284588CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14653444CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14667409CurrentTaxYearMinus1Year
Current Tax Year15382882CurrentTaxYear
Total72561270Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99670PublicSupportPercentage509
Prior Year Support Percentage0.99585PriorYearSupportPercentage
Investment Income Percentage0.00330InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00381PriorYrInvestIncomePercentage
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)
Total Exmpt Function Expenditures0TotalExmptFunctionExpenditures
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$684OtherActivitiesAmount
Total Lobbying Expenditures IIB684TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Non Ded Lobby Political Total0NonDedLobbyPoliticalTotal

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDescription of other lobbying activitiesIdentifier
Return ReferenceSchedule C, Part II-B, Line 1iReturnReference
ExplanationTHE ORGANIZATION INDIRECTLY INFLUENCED LEGISLATION THOUGH ITS ANNUAL DUES PAID TO LEADINGAGE AND LEADINGAGE INDIANA. FOR THE YEAR ENDED JUNE 30, 2011, 5.3% OF LEADING AGE DUES AND 5.1% OF LEADINGAGE INDIANA DUES WERE USED FOR LOBBYING PURPOSES.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FStrueIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12184610OtherCostOrOtherBasis
Depreciation6500735Depreciation
Book Value5683875BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis203564OtherCostOrOtherBasis
Depreciation108606Depreciation
Book Value94958BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2904128OtherCostOrOtherBasis
Depreciation1549411Depreciation
Book Value1354717BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis52661OtherCostOrOtherBasis
Book Value52661BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7186211TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

FieldValueIRS element (for citing)
Book Value0BookValue

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value0BookValue

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionNORTHERN TRUST POOLED INVESTMENTSDescription
Book Value2085533BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities2085533TotalOfBookValueSecurities
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
SECURITY DEPOSITS$235,500
FAIR VALUE ADJUSTMENT ON INTEREST RATE SWAP$85,186
OTHER LIABILITIES$1,704
RESIDENTS COUNCIL FUNDS$3,910
ACCRUED INTEREST$3,356
FieldValueIRS element (for citing)
Total Of Amounts329656TotalOfAmounts
Total Revenue15423337TotalRevenue
Total Expenses14553941TotalExpenses
Excess Or Deficit For Year869396ExcessOrDeficitForYear
Net Unrealized GL On Investments118559NetUnrealizedGLOnInvestments
Other$26,413OtherAmount
Total Adjustments144972TotalAdjustments
Excess Or Deficit Per FS1014368ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt15576261TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments118559NetUnrealizedGainsInvestments
Other Revenues26413OtherRevenues
Revenue Not Rptd F990144972RevenueNotRptdF990
Revenue Subtotal15431289RevenueSubtotal
Investment Expenses Not Included7387InvestmentExpensesNotIncluded
Other Revenues Not Included-15339OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-7952RevenueNotRptdOnFinStmt
Total Revenue Per Form99015423337TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt14561893TotExpensesEtcAuditedFinclStmt
Other Expenses Included49339OtherExpensesIncluded
Expenses Not Rptd F99049339ExpensesNotRptdF990
Expenses Subtotal14512554ExpensesSubtotal
Investment Expenses Not Included27387InvestmentExpensesNotIncluded2
Other Expenses Not Included34000OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt41387ExpensesNotRptdOnFinStmt
Total Expenses Per Form99014553941TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Explanation of escrow agreementSchedule D, Part IV, Line 2bRESIDENTS ARE ENCOURAGED TO MAINTAIN ONLY A MINIMAL AMOUNT OF MONEY IN THEIR POSSESSION. AN ESCROW ACCOUNT MAY BE USED FOR THE RESIDENT TO ACCESS MONEY MONDAY THROUGH FRIDAY, DURING BUSINESS HOURS, WHEN NEEDED. RESIDENTS WHO USE THE ESCROW ACCOUNT ARE REQUIRED TO SIGN A STATEMENT INDICATING THAT IF HE/SHE DEPOSITS FUNDS INTO THE RESIDENT ESCROW ACCOUNT, THE FUNDS WILL BE MANAGED BY SAINT ANNE HOME, AND THAT THE POWER-OF-ATTORNEY, GUARDIAN, OR RESPONSIBLE PARTY MAY MAKE WITHDRAWALS ON BEHALF OF THE RESIDENT.
FIN 48 (ASC 740) footnoteSchedule D, Part X, Line 2THE ORGANIZATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. CURRENT ACCOUNTING STANDARDS REQUIRE THE ORGANIZATION TO DISCLOSE THE AMOUNT OF POTENTIAL BENEFIT OR OBLIGATION TO BE REALIZED AS A RESULT OF AN EXAMINATION PERFORMED BY A TAXING AUTHORITY. FOR THE YEARS ENDED JUNE 30, 2011 AND 2010, MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION DOES NOT HAVE ANY TAX POSITIONS THAT RESULT IN ANY UNCERTAINTIES REGARDING THE POSSIBLE IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE UNCERTAIN TAX POSITIONS ARE NOT EXPECTED TO CHANGE IN THE NEXT 12 MONTHS. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO THE UNRECOGNIZED TAX BENEFITS IN INTEREST AND INCOME TAXES, RESPECTIVELY. THE ORGANIZATION HAS NO AMOUNTS ACCRUED FOR INTEREST OR PENALTIES AS OF JUNE 30, 2011 AND 2010. THE ORGANIZATION HAS TAX RETURNS OPEN FOR FEDERAL AND STATE PURPOSES FOR 2007 AND AFTER.
Other changes in net assetsSchedule D, Part XI, Line 8UNREALIZED GAIN ON INTEREST RATE SWAP AGREEMENT - 26413;
Other revenues in audited financial statements not in form 990Schedule D, Part XII, Line 2dUNREALIZED GAIN ON INTEREST RATE SWAP AGREEMENT - 26413;
Other revenues in form 990 not in audited financial statementsSchedule D, Part XII, Line 4bLOSS ON DISPOSAL OF FIXED ASSETS - -49339; CONTRIBUTIONS ADJUSTMENT - 34000;
Other expenses in audited financial statements not in form 990Schedule D, Part XIII, Line 2dLOSS ON DISPOSAL OF FIXED ASSETS - 49339;
Other expenses in form 990 not in audited financial statementsSchedule D, Part XIII, Line 4bCONTRIBUTIONS ADJUSTMENT - 34000;

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ANNE NICHOLASBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipSPOUSE (BOB NICHOLAS) IS A BOARD MEMBERRelationship
Amount Of Transaction11081AmountOfTransaction
Description Of TransactionEMPLOYEE COMPENSATIONDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1(CONTINUED FROM PART III) SAINT ANNE HOME IS A NOT-FOR-PROFIT CHARITABLE CORPORATION ORGANIZED UNDER THE ROMAN CATHOLIC CHURCH, DIOCESE OF FORT WAYNE - SOUTH BEND TO PROVIDE NONSECTARIAN SERVICES TO MEET HUMAN NEEDS. SAINT ANNE HOME PROVIDES THE HIGHEST QUALITY CARE TO ALL THOSE ENTRUSTED TO US. THIS IS DONE IN A CHRISTIAN ATMOSPHERE WITH LOVE AND CONCERN FOR THE INDIVIDUAL, AND WHERE THE SPECIAL NEEDS OF EACH RESIDENT ARE RESPECTED AND MET. SINCE ITS OPENING, SAINT ANNE HOME HAS BECOME THE BENCHMARK FOR HIGH-QUALITY HEALTHCARE IN FORT WAYNE. STARTING AS A NURSING HOME, OVER THE YEARS, SAINT ANNE HOME HAS ADDED 103 APARTMENTS TO ITS CAMPUS AND 16 REHAB SUITES. CURRENTLY, WE HAVE THE ABILITY TO SERVE 165 NURSING HOME RESIDENTS AND 168 RESIDENTIAL CARE RESIDENTS. WHEN YOU WALK IN ANY ENTRANCE TO SAINT ANNE'S, A WARM FEELING OF HOME EMBRACES YOU. WE TREAT EACH OF OUR RESIDENTS AS FAMILY, AND WE WANT TO MEET THE NEEDS AND EXPECTATIONS OF EACH RESIDENT.
NURSING, MEDICAL, AND ANCILLARY SERVICESFORM 990, PART III, LINE 4A(CONTINUED FROM PART III) SAINT ANNE HOME ALSO PROVIDES ADULT DAY SERVICES FOR OLDER ADULTS WHO ARE UNABLE OR UNCOMFORTABLE STAYING HOME ALONE THROUGHOUT THE DAY. THESE PROGRAMS INCORPORATE A SOCIAL MODEL AND MEDICAL SUPPORT FOR THE ADULTS WE SERVE. THE ATMOSPHERE PROVIDES A SAFE, CARING ENVIRONMENT WHERE PARTICIPANTS CAN SOCIALIZE, PARTICIPATE IN THERAPEUTIC ACTIVITIES AND RECEIVE SUPPORT SERVICES AND HEALTH MONITORING. THESE PROGRAMS OFFER FAMILIES AND CAREGIVERS DAILY RESPITE FOR THE DEMANDS OF 24-HOUR CARE.
Classes of members or stockholdersForm 990, Part VI, Section A, Line 6THE ORGANIZATION HAS THREE MEMBERS, THE DIOCESAN BISHOP OF THE DIOCESE OF FORT WAYNE-SOUTH BEND, INC., AND TWO OTHER PERSONS DESIGNATED BY THE DIOCESAN BISHOP. THE THREE MEMBERS ARE EX-OFFICIO MEMBERS OF THE BOARD OF DIRECTORS; THESE EX-OFFICIO MEMBERS HAVE THE RIGHT TO VOTE AS DIRECTORS.
Members or stockholders electing members of governing bodyForm 990, Part VI, Section A, Line 7aTHE DIRECTORS (WHO ARE NOT ALSO MEMBERS OF THE ORGANIZATION) ARE ELECTED BY A MAJORITY VOTE OF THE MEMBERS AND SERVE AT THE SOLE DISCRETION OF THE MEMBERS. ANY DIRECTOR MAY BE REMOVED WITH OR WITHOUT CAUSE OR NOTICE BY A MAJORITY VOTE OF THE MEMBERS AT ANY TIME.
Decisions requiring approval by members or stockholdersForm 990, Part VI, Section A, Line 7bTHE ORGANIZATION'S MEMBERS HAVE THE FOLLOWING POWERS: APPROVAL BY MAJORITY VOTE OF THE BOARD OF DIRECTORS' PROPOSAL TO DISSOLVE THE ORGANIZATION; AMENDMENT OR REPEAL OF BYLAWS AND ADOPTION OF AMENDED BYLAWS; AUTHORIZATION OF ANY OFFICER, THE ADMINISTRATOR, OR OTHER CORPORATE AGENTS TO ENTER INTO CONTRACTS OR TO EXECUTE ANY CONTRACTS IN THE NAME OF AND ON BEHALF OF THE ORGANIZATION; AND CONSULTATION WITH THE BOARD OF DIRECTORS CONCERNING THE APPOINTMENT, RETENTION, AND TERMINATION OF THE ADMINISTRATOR.
Review of form 990 by governing bodyForm 990, Part VI, Section B, Line 11bA FINAL DRAFT OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS REVIEWED BY MANAGEMENT PRIOR TO FILING WITH THE IRS. A COPY OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS THEN PROVIDED TO EACH MEMBER OF THE GOVERNING BODY PRIOR TO ITS FILING WITH THE IRS.
Conflict of interest policyForm 990, Part VI, Section B, Line 12cANNUAL DISCLOSURE IS PROVIDED TO EACH BOARD MEMBER AND ADMINISTRATIVE STAFF. EACH PERSON COMPLETES AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. ONCE THE QUESTIONNAIRES ARE COMPLETED, THE ADMINISTRATIVE ASSISTANT REVIEWS THE RESPONSES AND DETERMINES WHETHER OR NOT THERE ARE ANY POTENTIAL CONFLICTS OF INTEREST. IF THERE IS A POTENTIAL CONFLICT OF INTEREST, THE PRESIDENT, TREASURER AND ADMINISTRATOR REVIEW THE CORRESPONDING ISSUE AND DETERMINE IF THERE IS AN ACTUAL CONFLICT OF INTEREST. IF AN ACTUAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, THAT PERSON IS EXCLUDED FROM ANY DISCUSSIONS CONCERNING THE CONFLICTING ISSUE AND IS NOT PERMITTED TO VOTE ON ANY DECISIONS REGARDING THE CONFLICTING ISSUE. ANY PURCHASES AND/OR BIDDING PROPOSALS ARE ALSO REVIEWED FOR ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO SUBMITTING BIDS OR MAKING PURCHASES. THE CONTROLLER ATTENDS THE BOARD MEETINGS AS A GUEST TO ENSURE THAT COMPLIANCE WITH THESE GUIDELINES IS FOLLOWED.
Process used to establish compensation of top management officialForm 990, Part VI, Section B, Line 15aANNUALLY, THE ADMINISTRATOR'S PERFORMANCE AND COMPENSATION ARE REVIEWED BY THE PRESIDENT AND VICE PRESIDENT OF THE BOARD OF DIRECTORS. DURING THE REVIEW PROCESS, THE EXECUTIVE COMMITTEE COMPLETES AN EVALUATION WITH INPUT FROM THE DIOCESE OF FORT WAYNE-SOUTH BEND DIRECTORS THAT SIT ON THE SAINT ANNE HOME AND RETIREMENT COMMUNITY BOARD. THE EXECUTIVE COMMITTEE LOOKS AT THE PAY STRUCTURE OF THE DIOCESE OF FORT WAYNE-SOUTH BEND, A SIMILAR ORGANIZATION, AND ALSO SPEAKS WITH OUR INDEPENDENT AUDITORS FOR INFORMATION REGARDING INDUSTRY TRENDS. THEY ALSO BASE THEIR FINAL DECISION ON THE RATE OF INCREASE SET BY THE BOARD OF DIRECTORS FOR SAINT ANNE HOME. A COPY OF THE ADMINISTRATOR'S REVIEW, ALONG WITH A LETTER FROM THE BOARD PRESIDENT, IS GIVEN TO HUMAN RESOURCES AND THE CONTROLLER AT THE DIOCESE. THE REVIEW PROCESS IS DOCUMENTED IN THE BOARD MEETING MINUTES AND WAS LAST COMPLETED DURING 2011.
Public DisclosureForm 990, Part VI, Section C, Line 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERSFORM 990, PART VI, SECTION B, LINE 15BTHE ORGANIZATION DOES NOT HAVE ANY OTHER COMPENSATED OFFICERS; THEREFORE, THIS QUESTION HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS.
Average hours worked per week for related organizationForm 990, Part VII, Section A, Column BMONSIGNOR JOHN SUELZER - DEVOTES APPROXIMATELY FIVE HOURS PER WEEK TO THE DIOCESE OF FORT WAYNE-SOUTH BEND, A RELATED TAX-EXEMPT ORGANIZATION. MOST REVEREND KEVIN C. RHOADES - DEVOTES APPROXIMATELY FIVE HOURS PER WEEK TO THE DIOCESE OF FORT WAYNE-SOUTH BEND, A RELATED TAX-EXEMPT ORGANIZATION. MR. JOE RYAN - DEVOTES APPROXIMATELY 40 HOURS PER WEEK TO THE DIOCESE OF FORT WAYNE-SOUTH BEND, A RELATED TAX-EXEMPT ORGANIZATION. MR. JIM FITZPATRICK - DEVOTES APPROXIMATELY FIVE HOURS PER WEEK TO THE DIOCESE OF FORT WAYNE-SOUTH BEND, A RELATED TAX-EXEMPT ORGANIZATION.
Other changes in net assets or fund balancesForm 990, Part XI, Line 5NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 118559; UNREALIZED GAIN ON INTEREST RATE SWAP AGREEMENT - 26413;

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1DIOCESE OF FORT WAYNE-SOUTH BENDBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 390AddressLine1
CityFORT WAYNECity
StateINState
ZIP Code46801ZIPCode
FieldValueIRS element (for citing)
EIN350876373EIN
Primary ActivitiesRELIGIOUSPrimaryActivities
Legal Domicile StateINLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status1PublicCharityStatus

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 OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
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 OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg