2025-03-12T18:10:17-05:00 2024-10-31 370818432 KEMPER CPA GROUP LLP 3031 W MARCH LANE STE 133 S STOCKTON CA 95219 990 2023-11-01 941546850 BETHANY HOME SOCIETY OF SAN JOAQUIN CO BETH 2095994221 930 W MAIN STREET RIPON CA 95366 TOM VERMEULEN TREASURER 2095994221 2025-03-07 1 1 SUE CIPPONERI P01263381 2094732001 2025-03-07 2023 2025-03-06 01:10:19Z TOM VERMEULEN 930 W MAIN STREET RIPON CA 95366 17851674 0 X WWW.BETHANYRIPON.ORG X 1963 CA BETHANY HOME SOCIETY OPERATES A SKILLED NURSING FACILITY, ASSISTED LIVING FACILITY, MEMORY CARE FACILITY, ADULT DAY SERVICES PROGRAM, IN-HOME CARE SERVICES AND INDEPENDENT LIVING APARTMENTS. FEE STRUCTURE IS BASED ON RECOVERING COSTS, DEBT RETIREMENT & EXPANSION OF SERVICESWITH NO PROFIT BUILT IN. 11 11 294 55 0 0 0 0 14369777 17560949 274791 274499 -106124 5126 14538444 17840574 0 0 0 0 8819385 10001421 0 0 0 5466114 7824951 14285499 17826372 252945 14202 78906525 81322960 55357133 57322049 23549392 24000911 X BETHANY HOME SOCIETY OPERATES A SKILLED NURSING FACILITY, ASSISTED LIVING FACILITY, MEMORY CARE FACILITY, ADULT DAY SERVICES PROGRAM, IN-HOME CARE SERVICES AND INDEPENDENT LIVING APARTMENTS. FEE STRUCTURE IS BASED ON RECOVERING COSTS, DEBT RETIREMENT & EXPANSION OF SERVICES WITH NO PROFIT BUILT IN. 0 0 14779177 17560949 BETHANY HOME SOCIETY OPERATES A SKILLED NURSING FACILITY, ASSISTED LIVING FACILITY, MEMORY CARE FACILITY, ADULT DAY SERVICES PROGRAM, IN-HOME CARE SERVICES AND INDEPENDENT LIVING APARTMENTS. FEE STRUCTURE IS BASED ON RECOVERING COSTS, DEBT RETIREMENT & EXPANSION OF SERVICESWITH NO PROFIT BUILT IN. 14779177 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 56 0 1 294 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X THE ORGANIZATION 2095994221 930 W MAIN STREET RIPON CA 95366 JEFF MILLER PRESIDENT 1.00 X X 0 0 0 JEFF VAN GRONINGEN VICE PRESIDENT 1.00 X X 0 0 0 TOM VERMEULEN TREASURER 1.00 X X 0 0 0 CAROL SLAGER SECRETARY 1.00 X 0 0 0 JUDY VANDER PLAATS DIRECTOR 1.00 X 0 0 0 CLAIRE OSBORN DIRECTOR 1.00 X 0 0 0 JOAN WEAVER DIRECTOR 1.00 X 0 0 0 ADRIAN VAN HOUTEN DIRECTOR 1.00 X 0 0 0 BILL MULDER DIRECTOR 1.00 X 0 0 0 RON VAN ESSEN DIRECTOR 1.00 X 0 0 0 JOHN VAN TILL DIRECTOR 1.00 X 0 0 0 CINDY SCHEUBLEIN EXECUTIVE DIRECTOR 40.00 X 141667 0 0 VIJAY SHARMA ACCOUNTING DIRECTOR 40.00 X 100907 0 0 SUSAN MARTINS SKILLED NURSING ADMINISTRATOR 40.00 X 124548 0 0 367122 0 0 3 0 0 0 SODEXO AMERICA LLC 9801 WASHINGTON BLVD GAITHERSBURG MD 20878 FOOD SERVICES 648730 KAISER PERMANENETE PO BOX 741562 LOS ANGELES CA 90074 HEALTH INSURANCE 631222 ABSOLUTE PROCUREMENT LLC 564 N HUMBOLDT STREET PORTLAND OR 97217 PROJECT MANAGEMENT 523382 DEPARTMENT OF HEALTH CARE SERVIVES PO BOX 997415 SACRAMENTO CA 95899 SNF QUALITY ASSURANCE FEE 467221 NATIONWIDE MUTUAL INSURANCE COMPANY 1 NATIONWIDE PLAZA COLUMBUS OH 43215 PROPERTY INSURANCE 445735 5 SKILLED NURSING & RESIDENTIAL CAR 623000 17560949 17560949 17560949 274499 274499 16226 11100 5126 5126 5126 17840574 17560949 0 279625 227307 227307 8224415 7890411 334004 909905 849936 59969 639794 595310 44484 567003 543041 23962 78328 52000 26328 1428055 1306758 121297 LAWSUIT SETTLEMENT 2000000 2000000 PLANT OPERATIONS AND MA 977810 948754 29056 ADMINISTRATION 836747 726573 110174 DIETARY SERVICES 671122 632284 38838 1265886 1234110 31776 17826372 14779177 3047195 0 1539249 2671923 250244 252541 781561 1653986 43330 43482 267906 304757 35013819 19659374 16127763 15354445 49552292 34985389 10344180 26056437 78906525 81322960 1964799 4167624 447119 363586 52845215 52509884 100000 280955 55357133 57322049 X 23549392 24000911 23549392 24000911 78906525 81322960 14202 437317 0 X 0 1 X 1 0 X 136107 37694 20 0 173821 15535081 13369368 13360651 14369777 17560949 74195826 -57607 -43809 -103932 -106124 5126 -306346 15613581 13363253 13256739 14263653 17566075 74063301 0 0 0 74063301 174167 212513 274292 327540 988512 174167 212513 274292 327540 988512 15787748 13575766 13256739 14537945 17893615 75051813 0.98680 0.98880 0.01320 0.01120 X 2991581 2991581 30977353 18958396 12018957 1044885 700978 343907 15354445 CONSTRUCTION IN PROGRESS 25942194 RIGHT OF USE ASSET, OPERATING LEASE 114243 26056437 TENANT DEPOSIT PAYABLE 165712 OTHER CURRENT LIABILITIES 1000 OPERATING LEASE LIABILITY 114243 280955 18288991 437317 11100 448417 17840574 0 17840574 17837472 11100 11100 17826372 0 17826372 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE NETTED AGAINST INCOME 11,100. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED AGAINST INCOME 11,100. A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048VG69 2023-01-31 54952977 TO CONSTRUCT 82 APARTMENT HOMES WITH DINING VENUES, FITNESS, AND ACTIVITIES. 0 0 0 A 62903760 1779123 712067 1094060 2964158 28028693 3118459 25207201 1 0 0 1 A 0 0 0 0 0 0 1 A 0 1 1 0 0 0 0 0 1 A 1 COLUMN A: PART I (F) - THE BONDS WERE ISSUED FOR THE PURPOSE OF MAKING A LOAN TO THE BORROWER TO FINANCE AND REFINANCE THE COSTS OF EXPANSION, IMPROVEMENT, FURNISHING AND EQUIPPING OF FACILITIES IN CONNECTION WITH THE PROVISION OF SENIOR RESIDENCY, CARE AND SERVICES AND TO REFINANCE THE TAXABLE LOAN ORIGINALLY ISSUED ON MARCH 29, 2017. COLUMN A: PART II, LINE 3 - THE TOTAL PROCEEDS SHOWN IN PART II, LINE 3 DIFFERS FROM THE ISSUE PRICE SHOWN IN PART I, (E) DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS. COLUMN A: PART III, LINE 7 - AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE SECURITY OR PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY OR PAYMENT TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE REPORTED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. COLUMN A: PART IV, LINE 2(B) - THE REFUNDING PORTION OF THE BOND ISSUE HAS MET THE SIX MONTH EXCEPTION. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP IN THE BETHANY HOME SOCIETY IS AVAILABLE TO ANYONE WHO UNDERSTANDS AND AGREES WITH THE MISSION STATEMENT ADOPTED BY THE BOARD OF DIRECTORS. ALL MEMBERSHIPS MUST BE APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MEMBERSHIP IN THE BETHANY HOME SOCIETY IS AVAILABLE TO ANYONE WHO UNDERSTANDS AND AGREES WITH THE MISSION STATEMENT ADOPTED BY THE BOARD OF DIRECTORS. ALL MEMBERSHIPS MUST BE APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S BOARD MEMBERS ARE NOTIFIED OF THE AVAILABILITY OF THE DRAFT COPY, EITHER IN ELECTRONIC FORMAT OR ON PAPER, OF THE TAX EXEMPT FILING PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE ORGANIZATION REQUIRES BOARD MEMBERS TO SIGN A STATEMENT DISCLOSING ANY CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE DIRECTOR MAKES ASSIGNMENT OF SALARY FOR STAFF AND THE BOARD USES COMPARATIVE SALARY REPORTS TO DETERMINE THE EXECUTIVE DIRECTOR'S SALARY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVIALABLE TO THE PUBLIC UPON REQUEST BETHANY HOME SOCIETY FOUNDATION INC 930 W MAIN STREET RIPON CA 95366 911787884 RAISE FUNDS FOR THE BENEFIT OF BETHANY HOME SOCIETY. CA 501(C)(3) LINE 7 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 BETHANY HOME SOCIETY FOUNDATION INC O COST BETHANY HOME SOCIETY FOUNDATION INC Q COST BETHANY HOME SOCIETY FOUNDATION INC C COST