TY 2015 Form 990 Schedule O

efile Public Visual Render ObjectId: 201603209349308670 - Submission: 2016-11-15 TIN: 42-0819620

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

FRIENDSHIP HOME ASSOCIATION

Employer identification number

42-0819620

Return Reference	Explanation
FORM 990, PAGE 6, PART VI, LINE 3	THE ORGANIZATION HAS A MANAGEMENT CONTRACT WITH RURAL HEALTH DEVELOPMENT (RHD) FOR A ONE-YEAR PERIOD WITH AUTOMATIC RENEWAL TO MANAGE THE FACILITY. RHD WILL PROVIDE AN ADMINISTRATOR AT THE FACILITY ON A FULL-TIME BASIS PLUS VARIOUS RESOURCES IN THE AREA OF LONG-TERM HEALTH CARE OPERATIONS. THE MANAGEMENT FEE IS BASED ON A FLAT MONTHLY FEE SUBJECT TO A 3% LIVING INCREASE EACH ANNIVERSARY DATE. MONTHLY FEES WERE 11,344 AT DECEMBER 31, 2015. THE MANAGEMENT COMPANY IS ALSO COMPENSATED FOR EXPENSES NOT TO EXCEED 500 PER MONTH. THE MANAGEMENT FEE PLUS EXPENSES IS INCLUDED IN ADMINISTRATIVE AND NURSING EXPENSE AREAS. THE AMOUNT OF MANAGEMENT FEES PLUS EXPENSES INCURRED FOR THE YEAR ENDED DECEMBER 31, 2015 WAS 130,334.
FORM 990, PAGE 6, PART VI, LINE 6	MEMBERSHIP IN THE CORPORATION IS OPEN TO ALL UPON PAYMENT OF A 25.00 LIFE-MEMBERSHIP FEE. MEMBERS ARE EXEMPT FROM ANY AND ALL LIABILITY FOR DEBTS AND OBLIGATIONS OF THE CORPORATION. THE FACILITIES OF THE INSTITUTE ESTABLISHED BY THE CORPORATION ARE AVAILABLE TO ALL PERSONS, WHETHER MEMBERS OR NON-MEMBERS. NO PERSON BY REASON OF HIS MEMBERSHIP IN THE CORPORATION, OR OTHERWISE, MAY BE ENTITLED TO ANY DIVIDENDS OR EARNINGS OF THE CORPORATION, NOR BE ENTITLED TO ANY SPECIAL CONSIDERATION OF SERVICE.
FORM 990, PAGE 6, PART VI, LINE 7A	MEMBERSHIP IN THE CORPORATION ENTITLES THE HOLDER TO VOTE UPON ELECTION OF THE MEMBERS OF THE BOARD OF DIRECTORS AS WELL AS AT OTHER SPECIAL MEETINGS. ANNUAL MEETINGS ARE HELD FOR ALL MEMBERS OF THE CORPORATION. THE MANAGEMENT OF THE CORPORATION SHALL BE SOLELY IN THE HANDS OF THE BOARD OF DIRECTORS, ALL OF WHOM MUST BE MEMBERS OF THE CORPORATION.
FORM 990, PAGE 6, PART VI, LINE 7B	IN ADDITION TO VOTING ANNUALLY FOR THE BOARD MEMBERS, MEMBERS ALSO VOTE DURING SPECIAL MEETINGS SUCH AS THOSE NECESSARY TO MAKE CHANGES TO THE BY-LAWS OR ARTICLES OF INCORPORATION.
FORM 990, PAGE 6, PART VI, LINE 11B	EACH MEMBER OF THE BOARD OF DIRECTOS WAS E-MAILED A COPY OF THE DRAFT 990 AND WAS ASKED TO REVIEW AND COMMENT TO THE FINANCE/INVESTMENT COMMITTEE. THE FORM WAS ALSO REVIEWED AND DISCUSSED AT A BOARD MEETING.
FORM 990, PAGE 6, PART VI, LINE 12C	MEMBERS ARE REQUIRED TO SIGN AND DISCLOSE CONFLICTS ANNUALLY. THE BOARD WILL TAKE APPROPRIATE ACTION IF CONFLICTS ARE NOT DISCLOSED.
FORM 990, PAGE 6, PART VI, LINE 19	COPIES OF THE 990 AND AUDITED FINANCIAL STATEMENTS ARE AVAIABLE AT THE BUSINESS OFFICE UPON REQUEST.

Return Reference

Explanation

FORM 990, PAGE 6, PART VI, LINE 3

THE ORGANIZATION HAS A MANAGEMENT CONTRACT WITH RURAL HEALTH DEVELOPMENT (RHD) FOR A ONE-YEAR PERIOD WITH AUTOMATIC RENEWAL TO MANAGE THE FACILITY. RHD WILL PROVIDE AN ADMINISTRATOR AT THE FACILITY ON A FULL-TIME BASIS PLUS VARIOUS RESOURCES IN THE AREA OF LONG-TERM HEALTH CARE OPERATIONS. THE MANAGEMENT FEE IS BASED ON A FLAT MONTHLY FEE SUBJECT TO A 3% LIVING INCREASE EACH ANNIVERSARY DATE. MONTHLY FEES WERE 11,344 AT DECEMBER 31, 2015. THE MANAGEMENT COMPANY IS ALSO COMPENSATED FOR EXPENSES NOT TO EXCEED 500 PER MONTH. THE MANAGEMENT FEE PLUS EXPENSES IS INCLUDED IN ADMINISTRATIVE AND NURSING EXPENSE AREAS. THE AMOUNT OF MANAGEMENT FEES PLUS EXPENSES INCURRED FOR THE YEAR ENDED DECEMBER 31, 2015 WAS 130,334.

FORM 990, PAGE 6, PART VI, LINE 6

MEMBERSHIP IN THE CORPORATION IS OPEN TO ALL UPON PAYMENT OF A 25.00 LIFE-MEMBERSHIP FEE. MEMBERS ARE EXEMPT FROM ANY AND ALL LIABILITY FOR DEBTS AND OBLIGATIONS OF THE CORPORATION. THE FACILITIES OF THE INSTITUTE ESTABLISHED BY THE CORPORATION ARE AVAILABLE TO ALL PERSONS, WHETHER MEMBERS OR NON-MEMBERS. NO PERSON BY REASON OF HIS MEMBERSHIP IN THE CORPORATION, OR OTHERWISE, MAY BE ENTITLED TO ANY DIVIDENDS OR EARNINGS OF THE CORPORATION, NOR BE ENTITLED TO ANY SPECIAL CONSIDERATION OF SERVICE.

FORM 990, PAGE 6, PART VI, LINE 7A

MEMBERSHIP IN THE CORPORATION ENTITLES THE HOLDER TO VOTE UPON ELECTION OF THE MEMBERS OF THE BOARD OF DIRECTORS AS WELL AS AT OTHER SPECIAL MEETINGS. ANNUAL MEETINGS ARE HELD FOR ALL MEMBERS OF THE CORPORATION. THE MANAGEMENT OF THE CORPORATION SHALL BE SOLELY IN THE HANDS OF THE BOARD OF DIRECTORS, ALL OF WHOM MUST BE MEMBERS OF THE CORPORATION.

FORM 990, PAGE 6, PART VI, LINE 7B

IN ADDITION TO VOTING ANNUALLY FOR THE BOARD MEMBERS, MEMBERS ALSO VOTE DURING SPECIAL MEETINGS SUCH AS THOSE NECESSARY TO MAKE CHANGES TO THE BY-LAWS OR ARTICLES OF INCORPORATION.

FORM 990, PAGE 6, PART VI, LINE 11B

EACH MEMBER OF THE BOARD OF DIRECTOS WAS E-MAILED A COPY OF THE DRAFT 990 AND WAS ASKED TO REVIEW AND COMMENT TO THE FINANCE/INVESTMENT COMMITTEE. THE FORM WAS ALSO REVIEWED AND DISCUSSED AT A BOARD MEETING.

FORM 990, PAGE 6, PART VI, LINE 12C

MEMBERS ARE REQUIRED TO SIGN AND DISCLOSE CONFLICTS ANNUALLY. THE BOARD WILL TAKE APPROPRIATE ACTION IF CONFLICTS ARE NOT DISCLOSED.

FORM 990, PAGE 6, PART VI, LINE 19

COPIES OF THE 990 AND AUDITED FINANCIAL STATEMENTS ARE AVAIABLE AT THE BUSINESS OFFICE UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

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