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        <FormAndLineReferenceDesc>Pt III Ln 12</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
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      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>A complete copy of Form 990 was provided to the CFO prior</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>to filing. The CFO will forward the Form 990 to each member</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>of the Board of Directors who will discuss it with each</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>member and answer any questions.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The conflict of interest policy is discussed with new</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>board members at the start of their term.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>The board of directors and key employees are required to</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>sign the conflict of interest policy and disclose any</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>conflicts at the beginning of every Board Meeting and</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>on an annual basis. Board members are prohibited from</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>voting or exerting personal influence related to any issue</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>that presents a conflict of interest.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>increases in the industry in general and compensation at</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>similar facilities.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>Community LTC, Inc. participates in a state and national</ExplanationTxt>
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      <SupplementalInformationDetail>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>salaries and wages.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Other officers and key employees compensation is proposed</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 15b</FormAndLineReferenceDesc>
        <ExplanationTxt>by the CEO for Board of Directors approval as part of</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>available to the public upon request.</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Community LTC, Inc. does file the Form 990 tax return,</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Medicaid and Medicare Cost Reports with the appropriate</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>agencies on an annual basis. The Form 990 tax return is</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>available upon request and/or available on a delayed</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>basis on GuideStar.com. The Medicaid and Medicare</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Pt VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Cost Reports are available via Freedom of Information</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Request filed with the applicable agencies.</ExplanationTxt>
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        <ExplanationTxt>Betty Crum 6897 N 200 East Alexandria IN 46001</ExplanationTxt>
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        <ExplanationTxt>John Longnecker 940 Meridian Street Anderson IN 46016</ExplanationTxt>
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        <ExplanationTxt>Brandon Aiman 14726 N 300 W Summitville IN 46070</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>John Harris 217 Somerville Rd. Anderson IN XXX-XX-XXXX</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Mary Jo Lee P.O. Box 1302 Anderson IN 46015</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Dr. Kelly Chambers 9739 W. 400 N. Noblesville IN 46060</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Elizabeth Tharp 1515 N. Madison Ave. Anderson IN 46011</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>Kerry Robinson 4012 Northwood Lane Anderson IN 46012</ExplanationTxt>
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      <SupplementalInformationDetail>
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        <ExplanationTxt>LeVeda Standifer PO Box 2749 Anderson IN 46018</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Tina Baker 312 Church Drive Anderson IN 46016</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Dr. Steven Gatewood 1474 W 26th Sheridian IN 46069</ExplanationTxt>
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</Return>
