Form 990 Oepartment of the Treasury Ir.ternal Revenue Service

Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung

benefit trust or private foundation)

� The organization may have to use a copy of this return to satisfy state reporting requirements.

A For the 2012 calendar year or tax year beginning , and ending

OMB No. 1545-0047

2012 Open to Public

Inspection

B Check if C Name of organization D Employer identification number applicable:

DAddress change KENDAL AT ITHACA INC .

DNarne change Doing Business As 5 2 - 1 7 8 7 4 8 7

D,nitia: return Number and street (or P.O. box if mail is not delivered to street address) E Telephone number

DTermin-ated 2 2 3 0 NORTH TRIPHAMMER ROAD I Room/suite

6 0 7 - 2 6 6 - 5 3 0 0 DAmended return City, town, or post office, state, and ZIP code G Groas receipts $ 3 7 , 6 6 4 3 4 0 . DAPPIIca- ITHACA NY 148 5 0 H(a) Is this a group retum lion

pending F Name and address of principal officer:DANIEL GOVERNANTI for affiliates? DYes 00 No

SAME AS C ABOVE , H(b) Are all affiliates included? DYes D No

I Tax-exempt status: 501{Q){Ql D 5011c) ( )<IiII (insert no.) D 4947(al(1) or D 527 1 H 'No," attach a list. (see instructions) J Website: � WWW • KAI • KENDAL . ORG I H(cl Group exemption number � K Form of omanization: [XJ Corporation [ f Trust [ J Association D Other� I L Year of formation: 1 9 9 21 M State of leaal domicile: NY I Part II Summary

GI 1 Briefly describe the organization's mission or most significant activities: TO PROVIDE A MUTUALLY SUPPORTIVE u ENVIRONMENT FOR RESIDENTSl AND CONTRIBUTE TO THE ITHACA COMMUNITY . c III D if the organization discontinued its operations or disposed of more than 25% of its net assets. c 2 Check this box � ...

� 3 Number of voting members of the governing body (Part VI, line 1 a) ................................................ ............ 3 1 9 '"' 4 Number of independent voting members of the goveming body (Part VI, line 1 b) .......................................... 4 19 oil

3 1 5 1/1 5 Total number of individuals employed in calendar year 2012 (Part V, line 2a) 5 GI ................................................ :;:I 6 Total number of volunteers (estimate if necessary) .............................. ......................................................... 6 2 2 .> � 7 a Total unrelated business revenue from Part VIII, column (C), line 12 .......... .................................................. 7a O .

b Net unrelated business taxable income from Form 990-T line 34 .................................................................. 7b o . Prior Year Current Year

GI 8 Contributions and grants (Part VIII, line 1 h) ................................................ .......... ..... 1 0 8 , 9 1 6 . 6 0 , 8 1 2 . :::I 9 Program service revenue (Part VIII, line 2g) 1 6 , 6 6 0 , 2 3 0 . 1 7 0 4 2 7 9 7 . c: ......... .......... ............. . ..............................

� 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) ......... .. . ........................... 1 8 77 , 3 4 1 . 1 5 0 4 5 9 3 . a::

Other revenue (Part VIII, column (A), lines 5, 6d, Be, 9c, 1Oc, and 11e) 1 2 7 5 3 7 . 6 3 6 3 . 1 1 . ......... ..............

12 Total revenue - add lines 8 throuah 11 (must�ual Part VIII column (A), line 12) ......... 1 8 7 7 4 , 0 2 4 . 1 8 6 1 4 5 6 5 . 13 Grants and similar amounts paid (Part iX, column (A), lines 1-3) .. ......... ......... ............. 4 3 , 6 0 0 . 4 9 2 0 0 . 14 Benefits paid to or for members (Part IX, column (A), line 4) ...................... ................. O. O.

1/1 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) ......... 9 1 4 4,5 4 5 . 9 1 0 1 0 1 3 . GI O. O. 1/1 16a Professional fund raising fees (Part IX, column (A), line 11e) .......................................... c GI b Total fund raising expenses (Part IX, column (0), line 25) � o . 8 17 Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) ....................................... 7 9 2 1 , 8 3 1 . 7 , 6 8 4 , 9 9 3 .

18 Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) ..................... 1 7 1 0 9 9 7 6 . 1 6 8 3 5 2 0 6 . 19 Revenue less expenses. Subtract line 18 from line 12 .................................. .............. 1 6 6 4 , 0 4 8 . 1 7 7 9 , 3 5 9 .

�'" Beginning of Current Year End of Year 0'" u j!3<=

Total assets (Part X, line 16) 6 5 1 0 5 , 9 4 9 . 6 5 9 2 9 , 1 5 8 . .".g 20 "'''' ........... . . . . . . .................................... ...............................

� 21 Total liabilities (Part X, line 26) ............................ ...... . . . . ............ . ................ . ............. 5 8 5 0 5 , 0 4 5 . 5 7 1 13 7 1 3 . ",<= � 22 Net assets or fund balances. Subtract line 21 from line 20 ..... , ....... . ............................ 6 6 0 0J9 0 4 . 8 8 1 5 4 4 5 . L Part II J Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is

Sign

Here

Paid

CFO

PrintlType preparer's name Preparer's signature

ERNADETTE O'TOOLE CPA ERNADETTE O'TOOLE Preparer Firm's name CLIFTONLARSONALLEN LLP

knowled e.

PTIN

Use Only Firm's address� 6 1 0 WEST GERMANTOWN PIKE I SUITE 4 0 0 PLYMOUTH MEETING PA 1 9 4 6 2 Phone no. 2 1 5 - 6 4 3 - 3 9 0 0

May the IRS discuss this return with the preparer shown above? (see instructions) ...................... . . . . . . . . . . . . . . . ... ............... ....... [XJ Yes D No

232001 12-1Q-12 LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 990 (2012) SEE SCHEDULE 0 FOR ORGANIZATION MISSION STATEMENT CONTINUATION

Check if Schedule 0 contains a response to any question in this Part iii

1 Briefly describe the organization's mission:

5 2-1 7 8 7 4 8 7 Pa e 2

PLEASE REFER TO SCHEDULE 0 FOR KENDAL AT ITHACA'S PRIMARY MISSION .

2 Did the organization undertake any significant program services during the year which were not listed on

the prior Form 990 or 990·EZ? ......... . ............................. ... ................................ .... . . . .. . . . . . . . . . . . ......................... .. . . ............ DYes [Xl No

If 'Yes," describe these new services on Schedule O.

3 Did the organization cease conducting, or make significant changes in how it conducts, any program services?. . . . . . . . . . . . . . . . . DYes [X] No

If "Yes," describe these changes on Schedule O.

4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501 (c)(3) and 501 (c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4a (Code: )(eXpenS86 $ 1 4 , 2 7 4 , 5 7 9 . Including gra�ts of $ . 4 9 , 2 0 o . ) (Revenue $ 1 7 , 0 4 2 , 7 9 7 . ) CONTINUING CARE RETIREMENT COMMUNITY: KENDAL AT ITHACA CONSI STS OF 2 1 2 INDEPENDENT LIVING UNITS , A COMMUNITY CENTER, AND A 7 1- BED HEALTH CENTER COMPOSED OF 3 6 ADULT HOME BEDS AND 3 5 NURSING HOME BEDS . KENDAL AT ITHACA IS COMMITTED TO FOSTERING WELL-BEING, SECURITY , AND FULFILLMENT IN LATER YEARS FOR THOSE IT SERVES AND FOR OLDER PEOPLE IN THE BROADER COMMUNITY .

4b (Code: ___ ) (expenses $ __ _____ _ _

4c (Code: ___ ) (expenses $ ________ _

4d Other program services (Describe in Schedule 0.) (expenses $ including grants of $

including grants 01$ _________ ) (Revenue $ ________ _

Including grantsof$ _________ ) (Revenue $ _ _ ___ _ _ _ _

) (Revenue$

4e Total program service expenses � 1 4 , 2 7 4 , 5 7 9 .

232002 12-10·12

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2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC .

Form 990 (2012)

9 1 9 41 1

Form 990 (2012>- KENDAL AT ITHACA I INC . 5 2 - 1 7 8 7 4 8 7 Paae3 I Part IV I Checklist of Required Schedules

1 Is the organization described in section 50 1 (c)(3) or 4947 (a) ( 1) (other than a private foundation)? If 'Yes, ' complete Schedule A ............................................... ............................................................................................. .

2 Is the organization required to complete Schedule B, Schedule of Contributo� ................................................................. .

3 Did the organization engage i n di rect or indirect political campaign activities on behalf of or in opposition to candidates for public office? If " Yes, " complete Schedule C, Part I ........................................................................................................... .

4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501 (h) election in effect during the tax year? If ·Yes, ' complete Schedule C, Part II .................................................................................................. .

5 Is the organization a section 50 1 (c)(4), 50 1 (c)(5), or 50 1 (c)(6) organization that receives membership dues, assessments, or similar amounts as defined i n Revenue Procedure 98·19? If 'Yes, " complete Schedule C, Part 11/ .•..••.••.••••..•..•..•.••. • • . . . . . . . . . .•••

6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts i n such funds or accounts? If " Yes, " complete Schedule D, Part I

7 Did the organization receive or hold a conservation easement, i ncluding easements to preserve open space, the e nvironment, historic land areas, or historic structures? If "Yes, " complete Schedule D, Part 1/ . . . . . . . . . .......•.......•....•..... . ......

8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If " Yes, " complete

Schedule D, Part III ........................................................................................................................................................... .

9 Did the organization report an amount i n Part X, line 21, for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If 'Yes, ' complete Schedule D, Part IV ............................................................................................................................. .

10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi·endowments? If " Yes, " complete Schedule D, Part V ....................................................................... .

11 If the organization 's answer to any of the following questions is "Yes,' then complete Schedule 0, Parts VI, VII, VIII, IX,or X as applicable .

a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If 'Yes,' complete Schedule D, Part VI . . . . ....................................... . . . . ................................................................ ..................................... ................ ......... .

b Did the organization report an amount for investments -other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If 'Yes, " complete Schedule D, Part VII .......................................................................... .

c Did the organization report an amount for investments -program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If 'Yes, • complete Schedule D, Part VIII .......................................................................... .

d Did the organization report an amount for other assets in Part X, li ne 1 5 that is 5% or more of its total assets reported in Part X, li ne 16? If " Yes, " complete Schedufe D, Part IX ........... ............................................................................................. .

e Did the organization report an amount for other liabilities in Part X, line 25? If " Yes, " complete Schedule D, Part X ................. .

f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization'S liability for uncertain tax positions under FIN 48 (ASC 74O)? If 'Yes, ' complete Schedule D, Part X ........... .

12a Did the organization obtain separate, independent audited financial statements for the tax year? If " Yes, " compfete Schedule D, Parts XI and XI/ . . . . _ . ........................ .............................. . . . . . . . . . . . .................. ............................... . . .. .. ............. ..

b Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes,' and ifthe organization answered " No· to line 12a, then completing Schedule D, Parts XI and XI/ is optional .............. .

13 Is the organization a school described i n section 170 (b)( 1)(A)QO? If 'Yes, ' complete Schedule E ........................................ ..

14a Did the organization maintain an office, employees, or agents outside of the United States? ....................... ....................... . .

b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If 'Yes, " complete Schedule F, Parts I and IV ....................................................................................................... ..

15 Did the o rganization report on Part IX, column (A), l i ne 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If 'Yes, " compfete Schedule F, Parts" and IV .................................................. .

16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If " Yes, • complete Schedule F, Parts III and IV .............................................................. .

17 Did the organization report a total of more than $15,000 of expenses for profesSional fund raising services on Part IX, column (A), lines 6 and 1 1e? If 'Yes,' complete Schedule G, Part I ...................................................................................... .

18 Did the organization report more than $15,000 total of fund raising event gross income and contributions on Part V III, lines 1 c and Sa? If "Yes, " complete Schedule G, Part" ............................................................................................................. ..

19 Did the organization report more than $15,000 of gross income from gaming activities on Part VI II, line 9a? ff ·Yes, "

complete Schedule G, Part III ............................................................................................................................................ .

20a Did the organization operate one or more hospital facilities? If 'Yes, ' complete Schedule H .............................................. ..

b If "Yes· to line 20a did the oraanization attach a CODV of its audited financial statements to this retum? . . ........... ............ .. ..

232003 12-10-12

0 7 4 5 1 1 0 7 1 3 1 8 4 4 9 1 9 4 1 3

2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC .

I

Yes No

1 X

2 X

3 X

I 4 I X

5 X

6 X

7 X

8 X

f t

9 X

10 X

118 X

11b X

11c X

11d X 11e X

11f X

128 X

12b X 13 X

14a X

, ,

14b X

15 X

16 X

17 1 X

! 18 I X

19 X 20a I X 20b ; Form 990 (20 12)

9 1 9 41_1

Form 990�2012) KENDAL AT ITHACA INC. 5 2 -17 8 7 4 8 7 Paae4 l Part IV I Checklist of Required Schedules (continued)

21 Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If "Yes, ' complete Schedule I, Parts I and /I ..................................................... .

22 Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX,

column (A), line 2? If " Yes, " complete Schedule I, Parts I and 11/ ........................................................................................ ..

23 Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes, ' complete

Schedu/eJ .................. ................................... ............. ......... ............................................ .................... ............................ .

24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If "Yes," answer lines 24b through 24d and complete Schedule K. If 'No ', go to line 25 ..................................................................................................................................... ..

b Did the organization invest any proceeds of tax·exempt bonds beyond a temporary period exception? ................................ .

c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? ..................................................................................................................................................... .

d Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? ............................... ..

25a Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If ' Yes, " complete Schedule L, Part I ......................................................................... ..

b Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990·EZ? If "Yes, " complete Schedule L, Part I ........................................................................................................................................................... .

26 Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization's tax year? If "Yes, " complete Schedule L, Part /I ................................ .

27 Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member

of any of these persons? If " Yes, " complete Schedule L, Part 11/ ........................................................................................ ..

28 Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV

instructions for applicable filing thresholds, conditions, and exceptions): a A current or former officer, director, trustee, or key employee? If 'Yes, ' complete Schedule L, Part IV ............................... ..

b A family member of a current or former officer, director, trustee, or key employee? If " Yes, • complete Schedule L, Part IV ..... .

c An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer,

director, trustee, or direct or indirect owner? If • Yes, " complete Schedule L, Part IV .............................................................. .

29 Did the organization receive more than $25,000 in non-cash contributions? If " Yes, ' complete Schedule M ......................... ..

30 Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation

contributions? If "Yes, • complete Schedule M .................................................................................................................... . 31 Did the organization liquidate, terminate, or dissolve and cease operations?

If " Yes, " complete Schedule N, Part I ............................................................................................................................... ..

32 Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If 'Yes, " complete

Schedule N, Part /I ........................................................................................................................................................... .

33 Did the organization own 100% of an entity disregarded as separate from the organization under Regulations

sections 301.7701·2 and 301.7701·3? If "Yes,· complete Schedule R, Part I ....................................................................... .

34 Was the organization related to any tax-exempt or taxable entity? If "Yes, • complete Schedule R, Part /I, 11/, or IV, and Part V, line 1 .................................................................................................................................................................... .

35a Did the organization have a controlled entity within the meaning of section 512(b)(13)? .................................................... ..

b If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13}? If 'Yes, • complete Schedule R, Part V, line 2 ....................................................... ..

36 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non·charitable related organization?

If "Yes, " complete Schedule R, Part V, line 2 ....................................................................................................................... .

37 Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If " Yes, • complete Schedule R, Part VI ....................... .

38 Did the organization complete Schedule 0 and provide explanations in Schedule 0 for Part VI, lines 11 b and 19? Note. All Form 990 filers are reauired to comolete Schedule 0 ..... ..................... .............................. .. .......... .............. .

232004 �2-10-12

0 7 4 5 1 1 0 7 1 3 1 8 44 9 1 9 41 4

2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC .

Yes No

21 X

22 X

23 X

24a X

24b X I

240 X

24d X I

25a X

25b X

26 X

27 X

28a X

28b X

28c X 29 X

30 X

31 X

32 X

,

33 X

34 X 35a X

I 35b

36 X

37 X

38 X Form 990 (2012)

9 1 9 4 1_1

Form 990 201 KENDAL AT ITHACA INC. 5 2-1 7 8 7 4 8 7 Pa e5 Statements Regarding Other IRS Filings and Tax Compliance Check if Schedule 0 contains a response to any question in this Part V ...................................................................................... . D

Yes No 1a Enter the number reported in Box 3 of Form 1096. Enter.()· if not applicable .. .... ... .............. .... ..... . 11--'1:.::a:....+-I ____ --=6:....:5"'"

b Enter the number of Forms W·2G included in line 1 a. Enter ·0· if not applicable ...... ...... .......... .... .... I 1b I 0 ��----------�

c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming

2a ��:rb�����!����� :o��:;e:��:;:��· ��.��;�.�.�:.������;�� ���� .��.�. ��

.����������:

.....

j ..... ..

·r··· ...................... .

filed for the calendar year ending with or within the year covered by this return . . . . . . . . . ........... .... ...... I 2a I 3 1 5 b If at least one is reported on line 2a, did the organization file all required federal employment tax returns? ............................. .

Note. If the sum of lines 1 a and 2a is greater than 250, 'you may be required to e-file (see instructions) 3a Did the organization have unrelated business gross income of $1,000 or more during the year? ......................................... .

b If "Yes," has it filed a Form 990·T for this year? If "No, ' provide an explanation in Schedule 0 ............................................ .

4a At. any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? .................... .

b If "Yes," enter the name of the foreign country:" ________________________ _ See instructions for filing requirements for Form TD F 90·22.1, Report of Foreign Bank and Financial Accounts.

I

1c

i I 2b X

3a X 3b

4a X

5a Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ................................... . 5a ' X b Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction? ......................... . c If 'Yes,' to line 5a or 5b, did the organization file Form 8886·T? ......................................................................................... .

6a Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ....................................................................... .

b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?

7 Organizations that may receive deductible contributions under section 170(c).

5b x 5c : 6a x

6b

7a a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? I-'-""---If----l--=X� b If "Yes," did the organization notify the donor of the value of the goods or services provided? ............................................ .

c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required

d ��·�::.�;d���::h�������·��·���·�;·��·�;��·�·����·���·��� ...

::::::::::::::: .. :::::

.. ::::::::::::::.:::::::::::··r·��··r··························

e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? .................... .

f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? .......................... .

g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? .. .

h If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? 8 Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting

organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?

9 Sponsoring organizations maintaining donor advised funds.

a Did the organization make any taxable distributions under section 4966? ............................................................................. .

b Did the organization make a distribution to a donor, donor advisor, or related person? ........................................................ .

I 10 Section 501(c}(7) organizations. Enter:

a Initiation fees and capital contributions included on Part VIII, line 12 . . . . .. . . ....... ......................... .. ... 11-11..:..:

00�

ba"+�-------j

b Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities .................. . .

I 11 Section 501(c)(12) organizations. Enter:

: �:�:==:=�d�a:�� d� O;���:���::�;� IL..:"'-:'-'::....L..I ______ -!

7b

7c

7e 7f 7a 7h

8

9a 9b

12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? : 12a b If "Yes,' enter the amount of tax·exempt interest received or accrued during the year ... .......... ..... IL1.!! 2b=..Li· ______ -j 13 Section 501(c)(29) qualified nonprofit health insurance issuers.

X

x X

a Is the organization licensed to issue qualified health plans in more than one state? . . . . . . . . . . . . . . .. . . . . . . .. ............. .................... . . . . . . J-1..:..:3a=-, r----t __ Note. See the instructions for additional information the organization must report on Schedule o. 1

b Enter the amount of reserves the organization is required to maintain by the states in which the 1 r

organization is licensed to issue qualified health plans ... ......................... ...... ....... ... ...... ..... ..... ...... 13b I i c Enter the amount of reserves on hand .. . .. ........ . . . ............. . . . . . . . . . . . . . . . ............................... ..... . .. . ...... IL1..:..: 3c�L t ______ +-_+_+ __ 14a Did the organization receive any payments for indoor tanning services during the tax year? .. ..... ............... .... .......... ......... . . . 14a I i X

b If "Yes" has it filed a Form 720 to report these.Dayrnents? If 'No • provide an eXJ2lanation in Schedule 0 . ........ ................ 14b i

232005 12·10·12

0 7 4 5 1 1 0 7 1 3 1 8 44 9 1 9 4 1 5

2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA, INC.

Form 990 (2012)

9 1 9 41_1

Form 990 2012 KENDAL AT ITHACA INC . 5 2 - 1 7 8 7 4 8 7 Pa e 6 �---' Governance, Management, and Disclosure For each "Yes' response to lines 2 through 7b below, and for a 'No' response

to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule 0 contains a response to any question in this Part VI ... . ................. "".................................................... ...... 00 Section A. Governing Bod� and Manaaement

Yes No 1a Enter the number of voting members of the goveming body at the end of the tax year . ...... ........... 1----'-1"'a-+-____ --..:1:..: 9:!1

If there are material differences in voting rights among members of the governing body, or if the governing

body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

b Enterthe number of voting members included in line 1a, above, who are independent ........... ....... L....!1=b -l.. _____ =1 "'9'-j 2 Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other

officer, director, trustee, or key employee? ....................................................................................................................... .

3 Did the organization delegate control over management duties customarily performed by or under the direct supervision

of officers, directors, or trustees, or key employees to a management company or other person? ............................ '" .......... .

4 Did the organization make any significant changes to its goveming documents since the prior Form 990 was filed? .............. .

5 Did the organization become aware during the year of a significant diversion of the organization's assets? .......................... .

6 Did the organization have members or stockholders? ........................................................................................................ .

7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or

more members of the goveming body? ............................................................................................................................. .

b Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or

persons other than the governing body? .......................................................................................................................... .

8 Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

2

3

4

5

6

7a

7b

a The goveming body? .......................................... ..... . . . . . . . . . ................................................................... ............................. . 18a

b Each committee with authority to act on behalf of the governing body? ............................................................................. .

9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the

organization's mailina address? If 'Yes • orovide the names and addresses in Schedule 0 ................................................ .

Section B, Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

10a Did the organization have local chapters, branches, or affiliates? ..................... , .............................. ..................................... .

b If 'Yes,' did the organization have written policies and procedures goveming the activities of such chapters, affiliates,

and branches to ensure their operations are consistent with the organization's exempt purposes? ...................................... .

11 a Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?

b Describe In Schedule 0 the process, if any, used by the organization to review this Form 990.

12a Did the organization have a written conflict of interest policy? If "No," go to line 13 ........................................................... .

b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ................. .

c Did the organization regularly and consistently monitor and enforce compliance with the policy? If 'Yes, • describe

in Schedule 0 how this was done ...................................................................................................................................... .

13 Did the organization have a written whistleblower policy? .................................................................................................. .

14 Did the organization have a written document retention and destruction policy? ................................................................. .

15 Did the process for determining compensation of the follOwing persons include a review and approval by independent

persons, comparability data, and contemporaneous SUbstantiation of the deliberation and decision?

a The organization's CEO, Executive Director, or top management official ............................................................................. .

b Other officers or key employees of the organization ........................................................................................................... .

If "Yes" to line 1Sa or 1Sb, describe the process in Schedule 0 (see instructions).

16a Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a

taxable entity during the year? ......................................................................................................................................... .

b If 'Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation

in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's

exemct status with rescect to such arranaements? .... . Section C. Disclosure

8b

9

10a

10b

11a

12a

12b

12c

13

14

!

15a

15b

i

16a

16b

X

X X

I X X

X

X

X X

X

Yes No X

X

X X

X X X

X X

X

17 Ust the states with which a copy of this Form 990 is required to be filed �"'NY'-=-___________________ __ _

18 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990T (Section S01 (c)(3)s only) available

for public inspection. Indicate how you made these available. Check all that apply.

00 Own website [X] Another's website [XJ Upon request D Other (explain in Schedule 0) 19 Describe in Schedule 0 whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial

statements available to the public during the tax year.

20 State the name, physical address, and telephone number of the person who possesses the books and records of the organization: � ___ _

ANN E . WALL, CHIEF FINANCIAL OFFICER - 6 0 7 - 2 6 6 - 530 0 2 230 NORTH TRIPHAMMER ROAD. ITHACA. NY 1 4 8 5 0 232068

12-10-12

0 7 4 5 1 1 0 7 131 8 4 4 9 1 9 41 6

2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC .

Form 990 (2012)

9 1 9 41 1

Form 990 20 12 KENDAL AT ITHACA INC . 5 2 - 1 7 8 7 4 8 7 Pa e 7 '-'---''-'--''---' Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated

Employees, and Independent Contractors Check if Schedule 0 contains a response to any question in this Part VI I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D

Section A. Officers. Directors. Trustees. Key Employees. and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.

• List al ! of the organization 's current of ficers, directors , trustees (whether individuals or organizations), regardless of amount of compensation . E nter -0- i r. columns (D), (E), and (F) if no compensation was paid .

• List all of the organization 's current key employees, if any . See instructions for definition of "key employee ." • Listthe organization's five current highest compensated employees (other than an officer, director, trustee, or key employee) who received reportable

compensation (Box 5 of Form W-2 and/or Box 7 of Form 1 099-MISC) of more than $100,000 from the organization and any related organizations_

• List al l of the organization 's former officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations .

• List all of the organization 's former directors or trustees that received, i n the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations . List persons i n the following order : individual trustees or directors ; i nstitutional trustees ; officers ; key employees ; highest compensated employees ; and fo rmer such persons . D Check this box if neither the organization nor any related organization compensated any cur rent officer di rector, or trustee .

(A) (8) (C) (D) (E) I (F)

Name and Title Average Position Reportable Reportable i Estimated (do not check more than one I

hours per box. unless person Is both an compensation compensation I amount of week officer and a dlrector/trustee) f rom from related other

(list any � I the organizations i compensation

( 1 ) MARTHA ARMSTRONG

BOARD MEMBER

( 2 ) JAMES A . BROWN

BOARD MEMBER

( 3 ) DAVID CALL

BOARD MEMBER

( 4 ) JANET L . CORSON-RIKERT

BOARD MEMBER

( 5 ) HAL CRAFT

BOARD VICE CHAIR

( 6 ) HENRIK DULLEA

BOARD MEMBER

( 7 ) SHIRLEY DURFEE

BOARD MEMBER

( 8 ) BETSY EAST

BOARD MEMBER

( 9 ) GERALD A . KINCHY

BOARD CHAIR

( 1 0 ) JOHN KROUT

BOARD MEMBER

( 1 1 ) DAVID MCNIFF

BOARD TREASURER

( 12 ) SUSAN NOHELTY

BOARD MEMBER

( 1 3 ) MARY OPPERMAN

BOARD MEMBER

( 14 ) HANNAH RICHTER

BOARD MEMBER

( 15 ) TANYA SA��ERS

BOARD SECRETARY

( 16 ) ROGER SIBLEY

BOARD MEMBER

( 17 ) CAROL SISLER

BOARD MEMBER

232007 12-10-12

0 7 4 5 1 1 0 7 131 8 4 4 9 1 9 4 1

hours for related

organizat ions below line) 2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

2 . 0 0

:; .; � I = = .., .., � � � ! �

X X X X

! X X X X X X

I x l

I X i X X

i X 2 . 0 0 i

I X 2 . 0 0

X

tI

X

X

X

X

= organization ryJ-2/1099-MISC) ! ryJ-2/1099-MISC)

� S-g. ! 8 �

1;; >- � -=� 11;- .5!'E ". :>:: � ti!

o . o .

o . o .

o . o .

o . o .

o . o .

o . o .

o . o .

o . o .

o . O.

o . o .

o . o .

o . o . f

o . O . I o . o .

! i I I o . o .

o . o .

o . O.

7 2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC .

from the organization and related

organizations

o .

o .

o .

o .

o .

o .

o .

o .

o .

o .

o .

o .

o .

o .

o .

o .

o . Form 990 (20 1 2)

9 1 9 4 1_1

Form 990 (2012) KENDAL AT ITHACA INC . 5 2 - 1 7 8 7 4 8 7 Page S i Part VII I Section A. Officers Directors Trustees Key Employees and Highest Compensated Employees (continued)

(A) (8) ! (C) (D) i (E)

Name and title Average II Position Reportable ,i Reportable (do not check more than one hours per bo�, unless person is both an compensation compensation

week officer an d a directorltrustee) f rom from related Oist a ny t the o rganizations hours fo r 'D ... organization (W·2/1099·MISC) re lated j I

u ,t (W·2/1099·MISC)

( 18 ) DONALD STEWART

BOARD MEMBER

( 19 } MACK TRAVIS

BOARD MEMBER

( 2 0 ) BRYAN WARREN

BOARD MEMBER

( 21 ) WILLIAM WHITE

BOARD VICE CHAIR

( 2 2 ) DANIEL GOVERNANTI

EXECUTIVE DIRECTOR

( 2 3 ) ANN E. WALL

CHIEF FINANCIAL OFFICER

( 24 ) SHARI HUTCHISON

HEALTH SERVICES ADMINISTRATOR

!o rganizations " :g j � Q i below gj � � "! � -

f � B - - E line) � � � i �� �

2 . 0 0

1 b Sub-total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � c Total from continuation sheets to Part VII, Section A . . . . . . . . . . . . . . . . . . . . . . . . � d Total (add lines 1b and 1c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . �

34 8, 38 4 . o .

3 4 8 , 38 4 . 2 Tota l number of individua ls Oncluding but not limited to those listed above) who rece ived more than $100,000 of reportable

compensation f rom the o rganization � 3 Did the o rganization list any former office r, director, or t rustee , key employee, o r highest compensated employee on

o .

o .

o .

o .

o .

o .

O .

o . o . o .

li ne 1 a 7 If 'Yes, " complete Schedule J for such individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 For any individual listed on line 1 a, is the sum of repo rtable compensation and othe r compensat ion from the organization

and re lated o rganizations greate r than $150,0007 If "Yes, " complete Schedule J for such individual ....................................... 5 Did any pe rson listed on line 1a receive or accrue compensation from any unrelated organization or i ndividual for services

rendered to the oraanization7 If 'Yes • comolete Schedule J for such oerson ......................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 8. Independent Contractors

,

(F)

Estimated amount of

other compensation

from the organization and related

organizations

o .

o .

o .

o .

23 0 03 .

2 4 , 0 6 9 .

2 1 , 0 9 7 .

6 8 1 6 9 . o .

6 8 1 6 9 .

3 Yes No

3 X

4 X

5 i X

1 Comp lete this table fo r your five highest compensated independent contracto rs that received more than $100,000 of compensation from th . f R . f h i d d" h . h' h . . , t e o rganlza Io n. aport compensation o r t e ca en ar year en IngWit o r Wit In t e o rganization s ax year.

(A) (8) Name and business address Descript ion of services

PERKINS EASTMAN ARCHITECTS , PC i 1 1 5 FIFTH AVENUE, NEW YORK, NY 1 0 0 03 ARCHITECTS OMNICARE OF SYRACUSE , D/B/A PHARMACY SOLUTI P . O . BOX 7 4 039 1 , CINCINNAT I , OH 4 5 2 7 4 - 03 9 1 PHARMACY B&B FLOORING SALE AND 2 2 1 7 DRYDEN ROAD DRYDEN, NY 130 53 INSTALLATION OF A&S BLAKCTOP PAVING , LLC , 2 4 9 POLARD HILL ROAD . JOHNSON CITYL NY 137 9 0 �SPHALT PAVING JOHN J . PAUSLEY , INC , 5 139 JACKSONVILLE

CARP

ROAD TRUMANSBURG. NY 1 4 8 8 6 G�'"ERAL CONTRACTING 2 Total number of independent cont racto rs Oncluding but not limited to those listed above) who received more than

$100,000 of compensation f rom the organization � 232008 12-10-12

5

8 0 7 45 1 1 0 7 131 8 4 4 9 1 9 4 1 2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC .

(C) Compensation

4 6 0 , 4 6 6 .

2 73 , 4 4 2 .

1 5 6 9 1 0 .

1 4 4 , 8 9 7 .

1 1 5 31 9 .

Form 990 (2012)

9 1 9 4 1_1

Fo rm 990 (2012) KENDAL AT ITHACA « INC . i Part VIII Statement of Revenue 5 2 - 1 7 8 7 4 8 7 Page 9

Check if Schedule 0 contains a response to any question in this Part V ii i . . . . . . . . . . . . . . . . . . . . . . _ - - - _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D

II II I 1 a Federated campaigns . . . . . .. . . . . . . . . . . . 1a 1:::: 1:::: 1'II :::lI b Membership dues 1b "' 0 . . . . . . . . . . . . . . . . . . . . . . . .

�� . c Fundraising events . . . . . . . . .. ... . . . . . . . . . . . 1c ! ... a� d Related o rganizations .. .. . .. . . . . . .. . . . . 1d ui E e Government grants (contr ibutions) 1e au; 1 All other contribUtions, gifts, grants, and I .- ... .. ., :::J ,c similar amounts not included above 11 60 I ..a .. . .. . . . 812 I liO 9 Noncash contributions included In lines 1a-1f: $ 1:::: '0 0 1::::

h Tota l. Add lines 1a-1f ........ . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . � 0 111 Busi ness Code

., 2 a RESIDENT CARE FEES 623990 u 'e: GI b ENTRY FEES EARNED 623990 � E C HEALTH CENTER FEES 623990 E � d MEDICARE AND MEDICAID PAYMENTS 623990 I'll " � 623990 0 e PER DIEM RESIDENT FEES ... Q. f All other program service revenue . ......... .. . ..

a Total. Add lines 2a-21 .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � 3

4

5

6 a b c d

7 a

b

c d

., 8 a :::lI I:::: � ., a: ... ., 8 b

c

9 a

b C

10 a ,

b c

11 a b C

d e

12 232009 12-10-12

I nvestment income Oncluding dividends , interest, and other similar amounts) ............... ............................ .. ...... � I ncome from investment of tax -exempt bond proceeds � Royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �

(i) Real (in Personal Gross rents . _ _ . . . . _ _ . . . . . .. . . . . .

Less : rental expenses ....... .. Rental i ncome o r (loss) . . . . .. Net rental income or Qoss) . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � Gross amo unt from sales of Ji} Securities 00 Other assets other than inventory 19 699 226 . 300 Less : cost or other basis and sales expenses . . . . . . . . . 19 047 985 1 790 Gain o r (loss) . . . . . . . . . . . . . . . . . . .. . 651 241 . -1 490 Net gain or Qoss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � Gross income f rom fund raising events (not inc luding $ of contributions repo rted on line 1c). See Part IV, line 18 a !

. . . . .. . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .

Less : di rect expenses ... .... ..... . .. ... ... ... ... ... b Net i ncome or Qoss) f rom f und raisi ng events . . . . . . . . . . . . . . . � ' Gross i ncome from gaming activities . See J Part IV, line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Less : direct expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . b i Net income or ( loss) from gami ng activiti es . . . . . . . . . . . . . . . . . . � Gross sales of i nvento ry, less retums and al lowances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a

Less : cost of goods sold . . .. . . . . . . . . . . . . . . . . . . . . b Net income or (loss) from sales of i nventorv . . . . . . . . . . . . . .. . .. �

Miscellaneous Revenue Business Code CAFETERIA 623000 OTHER 623000 LOSS ON EXTINGUISHMENT OF DEBT 623000 All other revenue . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .. . .. . . . . .

Total. Add lines 1 1a-11d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � Total revenue. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �

(A) (8) (C) Total revenue Related o r Unrelated

exempt function business revenue revenue

! , I

! I

60 812 I I 11 105 278 . 11 105 278

3 577 127 . 3 577 127 2 156 654 2 156 654

203 700 . 203 700 38 . 38

".7 042 797 !

854 842

649 751 .

I ! I I

i

103 647 I 60 227 . i

-157 511 .

6 363 18 614 565 17 042 797

9 0 7 4 5 1 1 0 7 1 3 1 8 4 4 9 1 9 4 1 2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC .

�D) Revenu excl�ded

from tax un er se�tions 512, 5 3 0r 514

! I !

854 842

I

649 751

I !

103 647 ! 60 227 I -157 511

0 1 510.956 Form 990 (2012)

9 1 9 41_1

5 2 - 1 7 8 7 4 8 7 Pa e 1 0

Section 501 (c)(3) and 501 (c)(4) organizations must compfete all columns. All other organizations must complete column (A). Check if Schedule 0 contains a response to any question in this Part IX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D

Do not include amounts reported on lines Gb, (A) (8) (C) ! JD} Total expenses Program service Management and Fun raising 7b, 8b, 9b, and 10b of Part VII/. expenses general expenses e�er.ses

1 Grants and other assistance to governments and f organizations in the United States. See Part IV, line 21

2 Grants and other assistance to individuals in f the United States. See Part IV, line 22 . . . . . . . . . 4 9 2 0 0 . 4 9 . 2 0 0 . 3 Grants and other assistance to governments, I

organizations, and individuals outside the United States. See Part IV, lines 15 and 1 6 .. .

4 Benefits paid to or for members . . . . . . . . . . . . . . . . . . . . . 5 Compensation of current officers, directors,

trustees, and key employees . . . . . . . . . . . . . . . . . . . . . . . . 2 9 4 4 2 7 . 2 9 4 , 4 2 7 . 6 Compensation not included above, to disqualified I persons (as defined under section 4958(f)(1» and I

persons described in section 4958(c)(3)(8) . . . . . . . . . i 7 Other salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 6 , 44 9 3 8 5 . 5 , 6 2 0 , 7 6 3 . 8 2 8 6 2 2 . 8 Pension plan accruals and contributions (include

section 401(k) and 403(b) employer contributions) 5 5 4 6 8 5 . 4 8 6 , 5 3 1 . 6 8 1 5 4 . 9 Other employee benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 , 3 2 2 , 7 9 0 . 1 , 1 6 0 . 2 57 . 1 6 2 , 5 3 3 .

10 Payroll taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 7 9 , 7 2 6 . 4 2 4 , 0 1 6 . 5 5 , 7 1 0 . 1 1 Fees for services (non-employees):

a Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 4 3 , 4 2 6 . 5 4 3 . 4 2 6 . b Legal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 4 , 7 5 5 . 2 4 , 7 5 5 . c Accounting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 3 , 8 9 1 . 5 3 . 8 9 1 . d Lobbying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e Professional fundraising services. See Part IV, line 17

f Investment management fees . . . . . . . . . . . . . . . . . . . . . . . .

g Other. (If line 1 1 g amount exceeds 10% of line 25,

column (A) amount, list line 1 1 g expenses on Sch 0.) 3 4 0 , 5 4 7 . 2 4 9 , 7 2 1 . 9 0 , 8 2 6 . 12 Advertising and promotion . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 8 , 5 3 6 . 6 8 . 5 3 6 . 13 Office expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 7 9 , 4 4 9 . 1 6 9 1 4 1 . 1 1 0 , 3 0 8 . 14 Information technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 , 6 9 0 . 1 1 1L6 9 0 . 15 Royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 , 8 5 1 , 5 8 1 . 1 7 7 5 , 8 0 7 . 7 5 . 7 7 4 . 17 Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 6 , 9 1 5 . 3 5 4 0 9 . 2 1 , 5 0 6 . 18 Payments of travel or entertainment expenses

for any federal, state, or local public officials

19 Conferences, conventions, and meetings . . . . . . 1 7 L 1 8 2 . 1 4 1 5 4 . 3 , 0 2 8 . 20 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 6 8 , 6 4 2 . 6 1 5 1 5 1 . 5 3 , 4 9 1 . 21 Payments to affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22 Depreciation, depletion, and amortization . . . . . . 2 , 0 9 2 , 2 8 1 . 1 9 2 4 , 8 9 9 . 1 6 7 , 3 8 2 . 23 Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 4 5 7 9 . 8 4 . 5 7 9 . 24 Other expenses. Itemize expenses not covered

above. (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule 0.) . . . . . .

a FOOD SERVICES 8 7 0 . 3 0 7 . 8 7 0 , 3 0 7 . b MEDICAL EXPENSE 4 0 8 , 9 8 3 . 4 0 8 , 9 8 3 . c MI SC . EXPENSE 2 1 2 , 2 2 9 . 1 7 5 , 8 1 3 . 3 6 , 4 1 6 . d

e All other expenses

25 Total functional expenses. Add lines 1 throuah 24e 1 6 8 3 5 , 2 0 6 . 1 4 , 2 7 4 . 5 7 9 . 2 , 5 6 0 6 2 7 . O . 26 Joint costs. Complete this line only if the organization

reported in column (8) joint costs from a combined I educational campaign and fundraising solicitation. I Check here � D if followina SOP 98·2 rASC Q58-720)

232010 12-10-12 Form 990 (2012) 1 0

0 7 4 5 1 1 0 7 1 3 1 8 4 4 9 1 9 4 1 2 0 1 2 . 0 4 0 4 0 KE��AL AT ITHACA , INC . 9 1 9 4 1_1

Form 990 (2012) KENDAL AT ITHACA, INC . I Part X I Balance Sheet

5 2 - 1 7 8 7 4 8 7 Page 1 1

j

1/1 III � :s 1"11 :::i

1/1 III () r::: 1"11 i& m 'C r::: :::I

u.. 6 1/1 ti 1/1 � ti z

Check if Schedule 0 contains a response to any Question in this Part X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D

1 Cash - non-interest-bearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 Savings and temporary cash investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3 Pledges and grants receivable, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 Accounts receivable, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 Loans and other receivables from current and former officers, directors,

trustees, key employees, and highest compensated employees. Complete Part II of Schedule L

6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1», persons described in section 4958(c)(3)(8), and contributing

employers and sponsoring organizations of section 501 (c)(9) voluntary employees' beneficiary organizations (see instr). Complete Part II of Sch L . . . . . .

7 Notes and loans receivable, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8 Inventories for sale or use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9 Prepaid expenses and deferred charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D . . . . . . . . . 10a 5 9 0 5 7 , 4 0 0 •

! l I I I !

(A) (8) Beginning of year End of year

6 3 3 . 1 6 3 3 . 2 , 6 9 1 5 3 3 . 2 3 , 1 2 0 6 6 4 .

3

1 , 6 42 0 2 1 . 4 1 , 2 9 8 1 7 3 .

5

6

7

9 5 7 7 0 . 8 7 3 , 4 2 2 . 1 , 0 7 2 7 0 1 . 9 1 , 3 8 7 0 4 2 .

b Less: accumulated depreciation . . . . . . . . . . . . . . . . . . '-1=Ob=-.L._2=8...L....::6:....:6:....:2=-L-.:...,7=5-=0:....:.+--=3=1..L,-=3'-=3:....:5=--<-4=-=-7-=3:....:.+-'-1o=c�---=3:....:0:.....,L..;3=-=..9-=4CL,-=6:....::5:...;0=--=-. Investments - public!y traded securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 6 , 7 2 1 1 6 4 . 1 1 2 7 , 4 5 8 , 0 9 8 . 1 1

12

13

14

15

16

17

18

19 20

21

22

23 24

25

26

27

28 29

30 31

32 33 34

Investments - other securities. See Part IV, line 1 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Investments - program·related. See Part IV, line 1 1 . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . 13

Intangible assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Other assets. See Part IV, line 1 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 , 5 4 6 , 6 5 4 . 15

Total assets. Add lines 1 throuah 1 5 (must eaual line 34) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 5 , 1 0 5 , 9 4 9 . 16

Accounts payable and accrued expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2 7 , 4 1 5 . 17

Grants payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Deferred revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tax-exempt bond liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Escrow or custodial account liability. Complete Part IV of Schedule D . . ... . .. . .. .

Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons.

Complete Part II of Schedule L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Secured mortgages and notes payable to unrelated third parties . . . . . . . . . . . . . . . . . .

Unsecured notes and loans payable to unrelated third parties . . . . . . . . . . . . . . . . . . . . . . . .

Other liabi!ities Qncluding federal income tax, payables to related third

parties, and other liabilities not included on lines 1 7-24). Complete Part X of Schedule D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total liabilities. Add lines 1 7 throuah 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Organizations that follow SFAS 1 17 (ASC 958), check here � [XJ and

complete lines 27 through 29, and lines 33 and 34. Unrestricted net assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . , . . . . . . . . .

Temporarily restricted net assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Permanently restricted net assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Organizations that do not follow SFAS 1 17 (ASC 958), check here � [J and complete lines 30 through 34. Capital stock or trust principai, or curre!1t funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Paid-in or capital surplus, or land, building, or equipment fund . . . . . . . . . . . . . . . . . . . . . . . .

Retained earnings, endowment, accumulated income, or other funds . . . . . . . . . . . .

Total net assets or fund balances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Tota! liabilities and net assets/fund balances . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36 , 4 1 2 , 5 9 4 . 19

1, 6 3 4 , 8 0 0 . 21

22 23

24

8 5 6 , 6 0 4 . 25

5 8 5 0 5 , 0 45 . 26

5 , 4 4 2 , 2 1 0 . 27

1 1 5 8 , 6 9 4 . 28 29

30 31

32 6 , 6 0 0 , 9 0 4 . 33 1

6 5 1 0 5 , 9 4 9 . 34

2 , 1 9 6 , 47 6 . 6 5 9 2 9 1 5 8 .

6 8 2 , 9 3 8 .

3 7 , 3 8 9 , 0 0 5 . 1 7 , 7 1 3 , 8 1 4 .

9 3 0 , 447 .

3 9 7 , 5 0 9 . 5 7 1 1 3 7 1 3 .

7 , 6 0 3 , 0 7 5 . 1 , 2 1 2 , 3 7 0 .

8 , 8 1 5 , 4 45 . 6 5 , 9 2 9 , 1 5 8 .

Form 990 (2012)

232011 12-10-12

1 1 0 7 4 5 1 1 0 7 1 3 1 8 4 4 9 1 9 4 1 2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC . 9 1 9 41_1

KENDAL AT ITHACA INC . 5 2 - 1 7 8 7 4 8 7 Pa e 12

Check if Schedule 0 contains a response to any question in this Part XI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . [XJ 1 Total revenue (must equal Part VIII, column (A), line 12)

2 Total expenses (must equal Part IX, column (A), line 25) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3 Revenue less expenses. Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4 Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A» . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5 Net unrealized gains Oosses) on investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 Donated services and use of facilities

1 1 8 6 1 4 , 5 6 5 . 2 1 6 8 3 5 , 2 0 6 . 3 1 7 7 9 , 3 5 9 . 4 6 6 0 0 9 0 4 . 5 3 7 7 , 6 5 2 . 6

7 Investment expe!1ses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f-7'--+-________ _

8 Prior period adjustmems . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . ..... . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1--'8�t-____ =--_=--:-::-_

9 Other changes in net assets or fund balances (explain in Schedule 0) . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-'9"---f--___ ---=5:....7:.....L...:5;..;:3:....0:::....::.,. 10 Net assets or fund balances at end of year. Combine lines 3 through 9 (must equai Part X, line 33,

column (B» . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I Part XIII Financial Statements and Reporting 10 ! 8 , 8 1 5 4 4 5 .

Check if Schedule 0 contains a response 0 any question in this Part XII . . . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .

1 Accounting method used to prepare the Form 990: D Cash [XJ Accrual D Other

If the organization changed its method of accounting from a prior year or checked "Other,' explain in Schedule O.

Yes No

2a Were the organization's financial statemems compiled or reviewed by an independent accountant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a X If 'Yes,' check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:

D Separate basis D Consolidated basis D Both consolidated and separate basis

b Were the organization's financial statements audited by an independent accountant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b X If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both: [XJ Separate basis D Consolidated basis D Both consolidated and separate basis

c If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statemems and selection of an independent accountant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c X If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit

Act and OMB Circular A-133? . . . . . ... . . ... . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . .. . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . 3a X b If ·Yes,· did the organization undergo the required audit or audits? If the organization did not undergo the required audit

or audits eXDlain whv in Schedule 0 and describe anv stees taken to underao such audits . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3b

232012 12-10-12

0 7 4 5 1 1 0 7 1 3 1 8 4 4 9 1 9 4 1 1 2

2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC .

Form 990 (2012)

9 1 9 4 1_1

SCHEDULE A (Form 990 or 99O-EZ)

Department of the Treasury !ntemal Revenue Service

Public Charity Status and Public Support Complete if the organization is a section 501(c}(3) organization or a section

4947(a)(1) nonexempt charitable trust.

� Attach to Form 990 or Form 990-EZ. � See separate instructions.

OMB No. 1545-0047

2012 Open to Public

Inspection

Name of the organization Employer identification number

KENDAL AT ITHACA INC . I 5 2 - 1 7 8 7 4 8 7 Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 1 1 , check only one box.)

1 0 A church, convention of churches, or association of churches described in section 17O(b}(1)(A)(i).

2 0 A school described in section 170(b}(1}(A)(ii). (Attach Schedule E.)

3 0 A hospital or a cooperative hospital service organization described in section 170(b}(1}(A)(iii).

4 D A medical research organization operated in conjunction with a hospital described in section 17O(b}(1}(A)(iii). Enter the hospital's name, city, and state: _______________________________________ _

5 0 An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

6 D 7 0 a D g OO

section 170(b}(1)(A)(iv). (Complete Part 1 1 .) A federal, state, or local government or governmental unit described in section 170(b)(1)(A}(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1}(A}(vi). (Complete Part 1 1 .) A community trust described in section 170(b)(1)(A)(vi). (Complete Part I I .) An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions · subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment

Income and unrelated business taxable income Oess section 51 1 tax) from businesses acquired by the organization after June 30, 1975.

See section 509(a)(2). (Complete Part i lL) 10 0 An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

1 1 0 An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that

describes the type of supporting organization and complete lines 1 1 e through 1 1 h. a 0 Type I b D Type I I c D Type III . Functionally integrated d 0 Type III . Non·functionally integrated

e 0 By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than

foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

f If the organization received a written determination from the IRS that it is a Type I, Type II, or Type I I I

supporting organization, check this box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D 9 Since August 1 7, 2006, has the organization accepted any gift or contribution from any of the following persons?

(/) A person who directly or indirectly controls, either alone or together with persons described in (i� and Oi� below, Yes No

the governing body of the supported organization? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(ii) A family member of a person described in (0 above? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1/1) A 35% controlled entity of a person described in (0 or M above? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...,1:....:1",",-,,"-LJ.._.....J.... __

h Provide the following information about the supported organization(s).

(I) Name of supported ! organization I

I

Total

(i i) EIN I (i ii) Type of organization (described on lines 1-9

I above or IRC section , (see instructions»

I 1 i

iv) Is the organization n col. (i) listed in your governing document?

Yes No ,

I

LHA For Paperwork Reduction Act Notice. see the Instructions for

Form 990 or 990-EZ.

232021 12-04·12

1 3

(v) Did you notify the (vi) Is the (vii) Amount of monetary organization in col. organization in col. (i) organized in the support (i) of your support? U.S.?

Yes No Yes No

:

I I

I

Schedule A (Form 990 or 990-EZ) 2012

0 7 4 5 1 1 0 7 1 3 1 8 4 4 9 1 9 41 2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC . 9 1 9 41_1

Schedule A Form 990 or 990· 2012 Part II Support Schedule for Organizations Described in Sections 170(b){1)(A)(iv) and 170(b)(1){A){vi)

Pa e 2

(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III . If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support Calendar year (or fiscal year beginning in) � (a) 2008 (b) 2009 (c) 2010 (d) 201 1 (el 2012 (f) Total

1 Gifts, grants, contributions, and membership fees received. (Do not include any 'unusual grants.") . . . . . .

2 Tax revenues levied for the organ· ization's benefit and either paid to or expended on its behalf . . . . . . . . . . . .

3 The value of services or facilities t fumished by a governmental unit to the organization without charge . . .

4 Total. Add lines 1 through 3 . . . . . . . . . 5 The portion of total contributions

by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the I I amount shown on line 11 , column (I) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I

6 Public SUDDOrt. Subtract line 5 from line 4. Section B. Total Support Calendar year (or fiscal year beginning in) � (al 2008 (b) 2009 (c) 2010 (d) 201 1 (e) 2012 (f) Total

7 Amounts from line 4 . . . . . . . . . . . . . . . . . . . . . 8 Gross income from interest,

dividends, payments received on securities loans, rents, royalties

and income from similar sources . . .

9 Net income from unrelated business activities, whether or not the

business is regularly carried on . . .

10 Other income. Do not include gain I

or loss from the sale of capital i assets (Explain in Part IV.) . . . . . . . . . . . .

1 1 Total support. Add lines 7 through 10

12 Gross receipts from related activities, etc. (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ! 12 1 13 First five years. If the Form 990 Is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3)

organization. check this box and stOD here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . � D Section C. Computation of Public Support Percentage 14 Public support percentage for 2012 Olne 6, column (f) divided by line 1 1 , column (f» . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . %

15 Public support percentage from 201 1 Schedule A, Part I I, line 1 4 . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . %

16a 33 1/3% support test - 2012. If the organization did not check the box on line 13, and line 1 4 is 33 1/3% or more, check this box and

stop here. The organization qualifies as a publicly supported organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � [J b 33 1/3% support test - 2011. If the organization did not check a box on line 1 3 or 16a, and line 1 5 is 33 1/3% or more, check this box

and stop here. The organization qualifies as a publicly supported organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � D 17a 10% -facts-and-circumstances test - 2012. If the organization did not check a box on line 13, 1 6a, or 16b, and line 14 is 10% or more,

and if the organization meets the 'facts·and·circumstances" test, check this box and stop here. Explain in Part IV how the organization meets the "facts·and-circumstances' test. The organization qualifies as a publicly supported organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . � D

b 10% -facts-and-circumstances test - 201 1. If the organization did not check a box on line 13, 1 6a, 1 6b, or 1 7a, and line 1 5 is 10% or more, and if the organization meets the 'facts·and-circumstances" test, check this box and stop here. Explain in Part IV how the organization meets the "facts·and-circumstances' test. The organization qualifies as a publicly supported organization . . . . . . . . . . . . . . . . . . . . . . . . � D

18 Private foundation. If the organization did not check a box on line 1 3, 16a, 16b, 1 7a, or 1 7b, check this box and see instructions . . . . . .... � D

232022 12·04·12

0 7 4 5 1 1 0 7 1 3 1 8 4 4 9 1 9 41

Schedule A (Form 990 or 990-EZ) 2012

1 4 2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC . 9 1 9 4 1_1

I Schedule A Form 990 or 990- 2012 KENDAL AT I THACA INC . 5 2 - 1 7 8 7 4 8 7 Pa e 3 Part II I I Support Schedule for Organizations Described in Section 509(a)(2)

(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part IL If the organization fails to qualify under the tests listed below, please complete Part IL)

Section A. Public Support Calendar year (or fiscal year beginning in) � (a) 2008 ! (b) 2009

1 Gifts, grants, contributions, and I membership fees received. (Do not

!

include any "unusual grants.") . . . . . . 1 7 6 8 2 1 . i 2 0 6 , 3 7 9 . 2 Gross receipts from admissions, I merchandise sold or services per- l

formed, or facilities furnished in I any activity that is related to the i organization's tax-exempt purpose 15 7 6 7 2 8 7.1 16 142 9 5 4

3 Gross receipts from activities that i I

are not an unrelated trade or bus- I iness under section 513 . . . . . . . . . . . . . . .

4 Tax revenues levied for the organ-ization's benefit and either paid to or expended on its behalf . . . . . . . . . . . .

5 The value of services or facilities furnished by a governmental unit to i the organization without charge I

. . .

6 Totai. Add lines 1 through 5 . . . . . . . . . 15 9 4 4 108.1 16 349 3 3 3

7a Amounts included on lines 1 , 2 , and 3 received from disqualified persons

b Amounts Included on lines 2 and 3 received

from other than disqualified persons that

exceed the greater of $5,000 or 1% of the

amount on line 13 for the year . . . . . . . . . . . . _ . . . . .

c Add lines 7a and 7b . . . . . . . . . . . . . . . . . . . . .

8 Public support (Subtract line 7cfrom line 6.) Section B. Total Support Calendar year (or fiscal year beginning in) � (a) 2008 (b) 2009

9 Amounts from line 6 . . . . . . . . . . . . . . . . . . . . . 15 944 1 0 8 . 16 349 3 3 3 .

10a Gross income from interest, dividends, payments received on securities loans, rents, royalties

7 7 0 7 0 5 . 6 7 3 , 8 0 6 . and income from similar sources . . . b Unrelated business taxable income

(less section 511 taxes) from businesses

acquired after June 30, 1975 . . . . . . . . . . . .

c Add lines 10a and 1 0b . . . . . . . . . . . . . . . . . . 7 7 0 7 0 5 . 6 7 3 , 8 0 6 . 1 1 Net income from unrelated business

activities not included in line 1 0b, whether or not the business is regularly carried on . . . . . . . . . . . . . . . . . . . . .

12 Other income. Do not include gain or loss from the sale of capital 1 3 6 0 9 7 . 1 2 0 , 7 4 8 . assets (Explain in Part IV.) . . . . . . . . . . . .

13 Total support. (Add lines g, 10c, 1 1 , and 12.) 16 8 5 0 910 . 17 143 B 8 7 .

(c) 2010 (d) 201 1 ! (e) 2012 (tl Total

I 5 0 , 0 3 8 . 1 0 8 9 1 6 .f 6 0 , 8 1 2 . 6 0 2 , 9 6 6 .

I I

16 1 0 6 9 7 1 1 6 6 6 0 2 3 0 17 0 4 2 7 9 7 . 81 7 2 0 2 3 9 .

I 16 1 5 7 0 0 9 . 16 7 6 9 146 . 17 103 6 0 9 8 2 3 2 3 205

9 8 3 3 8 6 . 1 5 5 1 0 8 2.1 2 5 3 4 4 6 8

2 7 5 0 2 6 1 2 7 5 0 2 6 1

9 8 3 3 8 6 . 4 3 0 1 3 4 3 5 2 8 4 7 2 9

7 7 0 3 B 4 7 6

(c) 2010 (d) 201 1 (e) 2012 (f) Total

16 1 5 7 0 0 9 1 6 7 6 9 146 . 17 1 0 3 609 . 8 2 3 2 3 205 •

7 4 5 , 5 8 8 . 8 2 7 5 0 4 . 8 5 4 , 8 4 2 . 3 8 7 2 445 •

7 4 5 , 5 8 8 . 8 2 7 , 5 0 4 . 8 5 4 , 8 4 2 . 3 8 7 2 445 •

1 3 3 , 9 6 9 .1 1 2 7 , 5 3 7 . 1 6 3 . 8 7 4 . 6 8 2 . 2 2 5 . 17 0 3 6 5 6 6 . 17 7 2 4 18 7 . 18 122 3 2 5 . 86 8 7 7 8 7 5

14 First fi ve years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3) organization,

check this box and stop here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � D Section C. Computation of Public Support Percenta e 15 Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f» . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . 8 8 . 6 7 % 16 Public su ort ercenta e from 201 1 Schedule Part I I I line 15 . . . . . . . . .. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . 9 3 . 4 5 % Section D. Computation of Investment Income Percenta e 17 Investment income percentage for 2012 Oine 1 0c, columr. (f) divided by line 1 3, column (f» . . . . . . . . . . . . . . . . . . . . . . . . 4 . 46 % 18 Investment income percentage from 201 1 Schedule A, Part II I , line 1 7 . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . l 18 4 • 6 8 % 19a 33 1/3% support tests - 2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% , and line 1 7 is not

more than 33 1/3% , check this box and stop here. The organization qualifies as a publicly supported organization . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . � [XJ b 33 1/3% support tests - 201 1. If the organization did not check a box on line 14 or line 1 9a, and line 1 6 is more than 33 113% , and

line 1 8 is not more than 33 1/3% , check this box and stop here. The organization qualifies as a publicly supported organization . . . . . . . . . . . . � D 20 Private foundation. If the organization did not check a box on line 14, 19a, or 1 9b, check this box and see instructions . . . . . . . . . . . . . . . . . . . . . . . . � D

232023 12-04-12 Schedule A (Form 990 or 990-EZ) 2012

1 5 0 7 4 5 1 1 0 7 1 3 1 8 44 9 1 9 4 1 2 0 1 2 . 0 4 0 4 0 KENDAL AT ITHACA , INC . 9 1 9 4 1_1