TY 2016 Form 990 Schedule O

efile Public Visual Render ObjectId: 201800459349301010 - Submission: 2018-02-14 TIN: 04-2853296

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

2016

Open to Public
Inspection

Name of the organization

SYMMES LIFE CARE INC
D/B/A BROOKHAVEN AT LEXINGTON

Employer identification number

04-2853296

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 1	THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT OF THE CORPORATION, AND THE FOUR ELECTED OFFICERS OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL POSSESS AND MAY EXERCISE ALL OF THE POWERS OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE CORPORATION AND THE DIRECTION OF ITS AFFAIRS BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY LIMITATIONS IMPOSED ON THE EXECUTIVE COMMITTEE BY LAW, THE ARTICLES OF ORGANIZATION, THESE BYLAWS, OR BY THE BOARD OF TRUSTEES. THE BOARD SHALL HAVE THE POWER TO RESCIND ANY VOTE OR ACTION OF THE EXECUTIVE COMMITTEE, BUT NO SUCH RESCISSION SHALL HAVE RETROACTIVE EFFECT OR INVALIDATE ACTION ALREADY TAKEN IN RELIANCE ON SUCH VOTE OR ACTION. THE EXECUTIVE COMMITTEE SHALL MEET AS OFTEN AS MAY BE NECESSARY TO MEET ITS RESPONSIBILITIES, MEETINGS TO BE CALLED BY THE CHAIR OR THE PRESIDENT OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B	A DRAFT OF THE 990 WAS REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO BEING SUBMITTED TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	THE POLICY & PROCEDURE ON CONFLICTS OF INTEREST AND DISCLOSURE OF CERTAIN INTERESTS COVERS ALL TRUSTEES. ALL NEW TRUSTEES ARE REQUIRED TO REVIEW THIS POLICY AND PROCEDURE AND ACKNOWLEDGE IN WRITING THAT THEY HAVE DONE SO. ANNUALLY, ALL TRUSTEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE A DISCLOSURE FORM IDENTIFYING ANY SITUATION HE/SHE BELIEVES COULD GIVE RISE TO A CONFLICT. THE BOARD CHAIR WILL BE INFORMED OF ALL DISCLOSED POTENTIAL CONFLICTS. PRIOR TO ANY BOARD/COMMITTEE ACTION ON A CONTRACT OR TRANSACTION INVOLVING A CONFLICT OF INTEREST, A TRUSTEE HAVING A CONFLICT OF INTEREST SHALL DISCLOSE ALL FACTS MATERIAL TO THE CONFLICT TO THE BOARD CHAIR WHO SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. TRUSTEES WITH A CONFLICT OF INTEREST WILL NOT PARTICIPATE IN OR BE PERMITTED TO HEAR THE BOARD/COMMITTEE'S DISCUSSION OF THE MATTER EXCEPT TO DISCLOSE MATERIAL FACTS AND TO RESPOND TO QUESTIONS; IF A VOTE IS INVOLVED, THE TRUSTEE SHALL NOT VOTE AND SHALL NOT BE PRESENT IN THE ROOM WHEN THE VOTE IS TAKEN. RESPONSIBLE PERSONS WHO ARE NOT MEMBERS OF THE BOARD OR WHO HAVE A CONFLICT OF INTEREST WITH RESPECT TO A CONTRACT OR TRANSACTION THAT IS NOT THE SUBJECT OF BOARD/COMMITTEE ACTION, SHALL DISCLOSE ANY CONFLICT OF INTEREST TO THE CHAIR. THE RESPONSIBLE PERSON SHALL REFRAIN FROM ANY ACTION THAT MAY AFFECT THE ORGANIZATION'S PARTICIPATION IN SUCH CONTRACT OR TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15	AN EXTERNAL COMPENSATION CONSULTANT CONDUCTED A WAGE AND BENEFITS SURVEY FOR THE CEO/PRESIDENT ROLE IN 2016 ON BEHALF OF BROOKHAVEN'S EXECUTIVE COMPENSATION COMMITTEE. THE SURVEY FINDINGS WERE REPORTED TO BROOKHAVEN'S EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO COMPLETED A SELF-EVALUATION OF HIS PERFORMANCE WHICH WAS PROVIDED TO MEMBERS OF THE BOARD OF TRUSTEES ALONG WITH THE ANNUAL PERFORMANCE EVALUATION FORM WHICH THEY WERE ASKED TO COMPLETE. COMPLETED PERFORMANCE EVALUATIONS WERE RETURNED TO THE CHAIR OF THE EXECUTIVE COMPENSATION COMMITTEE. THE RESULTS OF THE WAGE AND BENEFITS SURVEY AND PERFORMANCE EVALUATION WERE SUMMARIZED AND DISCUSSED WITH THE EXECUTIVE COMPENSATION COMMITTEE WHO VOTED TO RECOMMEND THE ANNUAL PAY ADJUSTMENT FOR THE PRESIDENT/CEO.THE FULL BOARD OF TRUSTEES VOTED TO ACCEPT THE RECOMMENDATION. AN EXTERNAL COMPENSATION CONSULTANT CONDUCTED A WAGE AND BENEFITS SURVEY IN 2016. THE SURVEY FINDINGS WERE REPORTED TO THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO COMPLETED A PERFORMANCE EVALUATION FOR THE EVP/COO AND SVP/CCO. THE PRESIDENT/CEO SHARED THE RESULTS OF THE PERFORMANCE EVALUATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AND RECOMMENDED PAY ADJUSTMENTS FOR THESE POSITIONS BASED ON THE PERFORMANCE EVALUATION AND WAGE AND SALARY SURVEY DATA.
FORM 990, PART VI, SECTION C, LINE 19	AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN A PUBLIC ROOM. RESIDENTS RECEIVE A COPY YEARLY. AUDITED FINANCIAL STATEMENTS ARE UPLOADED TO THE EMMA WEBSITE FOR THE PUBLIC.

Return Reference

Explanation

FORM 990, PART VI, SECTION A, LINE 1

THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT OF THE CORPORATION, AND THE FOUR ELECTED OFFICERS OF THE CORPORATION. THE EXECUTIVE COMMITTEE SHALL POSSESS AND MAY EXERCISE ALL OF THE POWERS OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE CORPORATION AND THE DIRECTION OF ITS AFFAIRS BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY LIMITATIONS IMPOSED ON THE EXECUTIVE COMMITTEE BY LAW, THE ARTICLES OF ORGANIZATION, THESE BYLAWS, OR BY THE BOARD OF TRUSTEES. THE BOARD SHALL HAVE THE POWER TO RESCIND ANY VOTE OR ACTION OF THE EXECUTIVE COMMITTEE, BUT NO SUCH RESCISSION SHALL HAVE RETROACTIVE EFFECT OR INVALIDATE ACTION ALREADY TAKEN IN RELIANCE ON SUCH VOTE OR ACTION. THE EXECUTIVE COMMITTEE SHALL MEET AS OFTEN AS MAY BE NECESSARY TO MEET ITS RESPONSIBILITIES, MEETINGS TO BE CALLED BY THE CHAIR OR THE PRESIDENT OF THE CORPORATION.

FORM 990, PART VI, SECTION B, LINE 11B

A DRAFT OF THE 990 WAS REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO BEING SUBMITTED TO THE INTERNAL REVENUE SERVICE.

FORM 990, PART VI, SECTION B, LINE 12C

THE POLICY & PROCEDURE ON CONFLICTS OF INTEREST AND DISCLOSURE OF CERTAIN INTERESTS COVERS ALL TRUSTEES. ALL NEW TRUSTEES ARE REQUIRED TO REVIEW THIS POLICY AND PROCEDURE AND ACKNOWLEDGE IN WRITING THAT THEY HAVE DONE SO. ANNUALLY, ALL TRUSTEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE A DISCLOSURE FORM IDENTIFYING ANY SITUATION HE/SHE BELIEVES COULD GIVE RISE TO A CONFLICT. THE BOARD CHAIR WILL BE INFORMED OF ALL DISCLOSED POTENTIAL CONFLICTS. PRIOR TO ANY BOARD/COMMITTEE ACTION ON A CONTRACT OR TRANSACTION INVOLVING A CONFLICT OF INTEREST, A TRUSTEE HAVING A CONFLICT OF INTEREST SHALL DISCLOSE ALL FACTS MATERIAL TO THE CONFLICT TO THE BOARD CHAIR WHO SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. TRUSTEES WITH A CONFLICT OF INTEREST WILL NOT PARTICIPATE IN OR BE PERMITTED TO HEAR THE BOARD/COMMITTEE'S DISCUSSION OF THE MATTER EXCEPT TO DISCLOSE MATERIAL FACTS AND TO RESPOND TO QUESTIONS; IF A VOTE IS INVOLVED, THE TRUSTEE SHALL NOT VOTE AND SHALL NOT BE PRESENT IN THE ROOM WHEN THE VOTE IS TAKEN. RESPONSIBLE PERSONS WHO ARE NOT MEMBERS OF THE BOARD OR WHO HAVE A CONFLICT OF INTEREST WITH RESPECT TO A CONTRACT OR TRANSACTION THAT IS NOT THE SUBJECT OF BOARD/COMMITTEE ACTION, SHALL DISCLOSE ANY CONFLICT OF INTEREST TO THE CHAIR. THE RESPONSIBLE PERSON SHALL REFRAIN FROM ANY ACTION THAT MAY AFFECT THE ORGANIZATION'S PARTICIPATION IN SUCH CONTRACT OR TRANSACTION.

FORM 990, PART VI, SECTION B, LINE 15

AN EXTERNAL COMPENSATION CONSULTANT CONDUCTED A WAGE AND BENEFITS SURVEY FOR THE CEO/PRESIDENT ROLE IN 2016 ON BEHALF OF BROOKHAVEN'S EXECUTIVE COMPENSATION COMMITTEE. THE SURVEY FINDINGS WERE REPORTED TO BROOKHAVEN'S EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO COMPLETED A SELF-EVALUATION OF HIS PERFORMANCE WHICH WAS PROVIDED TO MEMBERS OF THE BOARD OF TRUSTEES ALONG WITH THE ANNUAL PERFORMANCE EVALUATION FORM WHICH THEY WERE ASKED TO COMPLETE. COMPLETED PERFORMANCE EVALUATIONS WERE RETURNED TO THE CHAIR OF THE EXECUTIVE COMPENSATION COMMITTEE. THE RESULTS OF THE WAGE AND BENEFITS SURVEY AND PERFORMANCE EVALUATION WERE SUMMARIZED AND DISCUSSED WITH THE EXECUTIVE COMPENSATION COMMITTEE WHO VOTED TO RECOMMEND THE ANNUAL PAY ADJUSTMENT FOR THE PRESIDENT/CEO.THE FULL BOARD OF TRUSTEES VOTED TO ACCEPT THE RECOMMENDATION. AN EXTERNAL COMPENSATION CONSULTANT CONDUCTED A WAGE AND BENEFITS SURVEY IN 2016. THE SURVEY FINDINGS WERE REPORTED TO THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO COMPLETED A PERFORMANCE EVALUATION FOR THE EVP/COO AND SVP/CCO. THE PRESIDENT/CEO SHARED THE RESULTS OF THE PERFORMANCE EVALUATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AND RECOMMENDED PAY ADJUSTMENTS FOR THESE POSITIONS BASED ON THE PERFORMANCE EVALUATION AND WAGE AND SALARY SURVEY DATA.

FORM 990, PART VI, SECTION C, LINE 19

AUDITED FINANCIAL STATEMENTS ARE MAINTAINED IN A PUBLIC ROOM. RESIDENTS RECEIVE A COPY YEARLY. AUDITED FINANCIAL STATEMENTS ARE UPLOADED TO THE EMMA WEBSITE FOR THE PUBLIC.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2016

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