2023-03-13T20:34:59-05:00 2022-04-30 390859910 BAKER TILLY US LLP 777 E WISCONSIN AVENUE 32ND FLOOR MILWAUKEE WI 53202 990 2021-05-01 381299215 EVANGELICAL HOMES OF MICHIGAN EVAN 7342952220 400 WEST RUSSELL ST SALINE MI 48176 THOMAS HOSINSKI PRESIDENT/CEO 7342952220 2023-03-13 1 THOMAS HOSINSKI XXX-XX-XXXX TROY MARINE CPA P00187863 4147775500 2023-03-13 0 AAL1 IAL1 2021 2023-04-26 12:10:37Z EHM SENIOR SOLUTIONS THOMAS HOSINSKI 400 WEST RUSSELL ST SALINE MI 48176 31616143 0 X WWW.EHMSS.ORG X 1879 MI NURSING HOME CARE FOR THE ELDERLY AND INFIRM, AND SPIRITUAL, VOCATIONAL, AND SOCIAL PROGRAMS. 12 12 543 11 0 0 4940182 4369305 27447278 26229986 266522 48416 2669306 240902 35323288 30888609 0 0 0 0 15297426 17738860 0 0 0 19504239 14479593 34801665 32218453 521623 -1329844 60615647 59302012 52773032 51780479 7842615 7521533 X IT IS THE MISSION OF THE EVANGELICAL HOMES OF MICHIGAN, A HEALTH AND HUMAN SERVICE MINISTRY RELATED TO THE UNITED CHURCH OF CHRIST, TO PROVIDE HEALTH AND HOUSING SERVICES TO PERSONS WHO ARE ELDERLY IN A MANNER WHICH RESPECTS THEIR RIGHTS, DIGNITY AND WORTH AS CHILDREN OF GOD AND TO RENDER THOSE SERVICES WITH COMPASSION AND PATIENCE IN ACCORDANCE WITH THE HIGHEST PROFESSIONAL AND ETHICAL STANDARDS. 0 0 19883556 17560160 NURSING HOME CARE FOR THE ELDERLY AND INFIRM PROVIDED 48,001 PATIENT DAYS. REHABILITATION SERVICES PROVIDED 14,003 PATIENT DAYS THAT ASSISTED SENIORS TO RETURN TO THEIR COMMUNITY. ALSO, THE ORGANIZATION PROVIDES SPIRITUAL, VOCATIONAL AND SOCIAL PROGRAMS. 9118443 8520395 HOUSING SUPPORT PROGRAMS FOR INDEPENDENT AND ASSISTED LIVING SENIORS PROVIDING 38,537 PATIENT DAYS. PROGRAMS PROVIDE A FOCUS ON SPIRITUAL, VOCATIONAL AND SOCIAL NEEDS OF SENIORS IN THE COMMUNITY. 249929 135443 OUTPATIENT REHABILITATION SERVICES PROVIDED 1,472 PATIENT ENCOUNTERS THAT ASSISTED SENIORS AND OTHER COMMUNITY MEMBERS TO RETURN TO THEIR COMMUNITY. 29251928 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 76 0 543 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X THOMAS HOSINSKI 7342952220 400 WEST RUSSELL ST SALINE MI 48176 HAKIM BERRY BOARD CHAIR (TERM. 07/2021) 0.10 0.50 X X 0 0 0 REV JAMES CURENTON BOARD CHAIR (EFF. 07/2021) 0.10 0.40 X X 0 0 0 REV LINDA ANDERSON VICE CHAIR 0.10 0.10 X X 0 0 0 JAMES POLSON TREASURER 0.10 0.50 X X 0 0 0 ROBERT LIVINGSTON SECRETARY (TERM. 07/2021) 0.10 0.40 X X 0 0 0 REV CHARITY OMARTUIAN SECRETARY (EFF. 07/2021) 0.10 0.00 X X 0 0 0 BONNIE MEEK-MILLER DIRECTOR (TERM. 03/2022) 0.10 0.00 X 0 0 0 REV DR ED BRAY DIRECTOR 0.10 0.00 X 0 0 0 REV DR GEOFFREY DRUTCHAS DIRECTOR 0.10 0.00 X 0 0 0 REV DR HERMAN HALLER DIRECTOR 0.10 0.00 X 0 0 0 ANGELA JAMISON DIRECTOR 0.10 0.00 X 0 0 0 REV CASE VAN KEMPEN DIRECTOR 0.10 0.00 X 0 0 0 DR PAUL T VON OEYEN DIRECTOR 0.10 0.00 X 0 0 0 EARL ROEHM DIRECTOR 0.10 0.00 X 0 0 0 PATRICK SPERTI DIRECTOR 0.10 0.00 X 0 0 0 THOMAS HOSINSKI PRESIDENT AND CEO 38.30 1.70 X 252138 0 9659 JULIE WIEWIORA CFO (EFF. 08/2021) 38.00 2.00 X 125075 0 9752 JEFF EWALD CFO (TERM. 06/2021) 38.00 2.00 X 53770 0 4217 JULIA WELLINGS COO 40.00 0.00 X 164801 0 8340 TRACEY MOFFETT EXECUTIVE DIRECTOR 0.40 39.60 X 124598 0 20268 BARBARA SMITH EXECUTIVE DIRECTOR 40.00 0.00 X 122607 0 1556 842989 0 53792 5 0 1 0 MORRISON MANAGEMENT SPECIALISTS 5801 PEACHTREE DUNWOOD RD ATLANTA GA 30204 DIETARY & PLANT OPERATIONS 2128200 AEGIS THERAPIES PO BOX 936653 ATLANTA GA 31193 THERAPY SERVICES 1471354 ATC HEALTHCARE SERVICES LLC 75 REMITTANCE DRIVE DEPT 6773 CHICAGO IL 606756773 CONTRACTED LABOR - NURSING 725088 LEADERSTAT LTD 1322 B MANNING PKWY POWELL OH 43065 CONTRACTED LABOR - NURSING 676143 ONECARE LTC 1945 HEIDE DR TROY MI 48084 PHARMACY 537054 13 257738 4111567 4369305 NURSING 623000 12164984 12164984 IND. & ASSISTED LIVING 623000 7977920 7977920 THERAPIES 623990 5553522 5553522 PHARMACY REVENUE 623990 508420 508420 MANAGEMENT FEE 900099 25140 25140 26229986 172919 172919 124518 0 124518 124518 124518 603031 727534 -124503 -124503 -124503 MEALS & VENDING 900099 103154 103154 BARBER & BEAUTY 900099 27218 27218 OTHER OPERATING REV. 900099 -13988 -13988 116384 30888609 26215998 0 303306 454611 431880 22731 15206884 14446540 760344 1056805 908852 147953 1020560 877682 142878 66645 35322 31323 62513 33132 29381 1382634 732796 649838 67394 35045 32349 809794 785500 24294 39604 20990 18614 938463 685078 253385 9382 8819 563 1918166 1476988 441178 1934632 1857247 77385 500380 485369 15011 LABORATORY, X-RAY, AND 2629797 2629797 PROVIDER TAX 1252696 1252696 FOOD AND DIETARY 1162127 1162127 MISCELLANEOUS 661537 496153 165384 1043829 889915 153914 32218453 29251928 2966525 0 1183531 419985 5794 5142653 2605506 3780586 19718 0 1127127 1280549 61928051 33560227 29330469 28367824 12710258 12124939 3217946 0 10415298 8185476 60615647 59302012 11424928 14828098 15497 0 33825000 34427764 5088847 1255074 2418760 1269543 52773032 51780479 X 7842615 6945862 575671 7842615 7521533 60615647 59302012 X -1329844 -1734617 2207419 535961 X 0 1 X 1 0 X 464786 2697394 854050 4940182 4369305 13325717 48537916 37698289 32769413 29958483 26215998 175180099 49002702 40395683 33623463 34898665 30585303 188505816 0 0 0 188505816 292047 315509 365696 316596 297437 1587285 292047 315509 365696 316596 297437 1587285 811831 743665 306377 126899 130372 2119144 50106580 41454857 34295536 35342160 31013112 192212245 0.98070 0.98060 0.00830 0.00710 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2017 AMOUNT: $ 811,831. 2018 AMOUNT: $ 743,665. 2019 AMOUNT: $ 306,377. 2020 AMOUNT: $ 126,899. 2021 AMOUNT: $ 130,372. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2394495 -180589 118937 23383 2071586 2157489 365220 113180 15034 2394495 2156892 30000 -15517 13886 2157489 2124169 5000 68723 41000 2156892 2076761 15023 99385 67000 2124169 0.65290 0.34710 0 0 693324 693324 37612835 20512124 17100711 4712687 2970539 1742148 9988325 8606626 1381699 8920880 1470938 7449942 28367824 INTERCOMPANY RECEIVABLES 7219751 RESIDENT DEPOSITS 965725 8185476 RESIDENT DEPOSITS HELD IN TRUST 1269543 1269543 PART V, LINE 4: FOR RESIDENT AND STAFF EDUCATIONAL PURPOSES REGARDING CARE RELATED TO AGING ADULTS WITH AN EMPHASIS ON MEMORY LOSS. X X 1 0 0 0 0 0 0 0 0 THOMAS HOSINSKI PRESIDENT AND CEO 252138 0 0 0 0 0 2598 0 7061 0 261797 0 0 0 JULIA WELLINGS COO 164551 0 250 0 0 0 1710 0 6630 0 173141 0 0 0 PART I, LINE 3 THE CEO'S COMPENSATION AT TIME OF PROMOTION WAS BASED ON MARKET COMPARABLE DATA FROM A CONSULTING COMPANY. A SUB-COMMITTEE OF THE BOARD OF DIRECTORS WITH A BACKGROUND IN HUMAN RESOURCES USED THIS DATA TO ASSIST THE GOVERNING BODY IN THE DETERMINATION OF COMPENSATION. THE PROCESS WAS CONDUCTED IN 2020. PART I, LINE 4A JEFF EWALD : $13,751 SEVERENCE. A MICHIGAN STRATEGIC FUND 521417332 594698KV3 2013-02-07 24081694 REFUNDING OF MSF SERIES 2008 BONDS AND NEW MONEY COMPONENT 0 0 0 B THE ECONOMIC DEVELOPMENT CORPORATION OF THE CITY OF SALINE (MICHIGAN) 382491353 795208AE7 2013-02-07 10545184 REFUNDING OF EDC SERIES 1997 BONDS 0 0 0 A 385000 24081694 1687988 17231428 478200 4674079 10000 2013 1 0 0 1 B 170000 10545184 740638 9592658 211889 1 0 1 1 A 0 0 0 0 1 0 1 B 0 0 0 0 1 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE EXECUTIVES AND THE BOARD OF DIRECTORS PRIOR TO FILING. THE 990 IS SENT ELECTRONICALLY TO THE BOARD OF DIRECTORS PRIOR TO THE BOARD MEETING FOR REVIEW AND THEN DISCUSSED AT THE MEETING, IF NECESSARY. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS GO THROUGH AN ORIENTATION PROCESS TO ADVISE THEM ON FIDUCIARY RESPONSIBILITIES AND COMPLIANCE ISSUES. ANNUALLY, A CONFLICT OF INTEREST QUESTIONNAIRE IS COMPLETED BY THE BOARD. FURTHER, THE BOARD GOES THROUGH EMPLOYEE ORIENTATION AND PERIODIC TRAINING REGARDING THE "CORPORATE COMPLIANCE" POLICY. ALL FORMS ARE REVIEWED BY THE COMPLIANCE OFFICE AND ANY CONFLICTS ARE IDENTIFIED AND RESOLVED. THE RESOLUTION OF AN INDEPENDENCE ISSUE CAN RANGE FROM REMOVAL FROM VOTING TO TERMINATION OF THE RELATIONSHIP DEPENDING UPON FACTS AND CIRCUMSTANCES. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION AT TIME OF PROMOTION WAS BASED ON MARKET COMPARABLE DATA FROM A CONSULTING COMPANY. A SUB-COMMITTEE OF THE BOARD OF DIRECTORS WITH A BACKGROUND IN HUMAN RESOURCES USED THIS DATA TO ASSIST THE GOVERNING BODY IN THE DETERMINATION OF COMPENSATION. THE PROCESS WAS CONDUCTED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION RELATED CHANGE 535,961. FORM 990, PART XI, LINE 8: THE PRIOR PERIOD ADJUSTMENT OF $2,207,419 REPRESENTS THE EMPLOYEE RETENTION CREDIT RECEIVABLE FOR APPLICABLE QUARTERS IN FISCAL YEAR ENDED APRIL 30, 2021. SHARED CARE SERVICES 400 WEST RUSSELL ST SALINE MI 48176 260711417 HOME CARE MI 501(C)(3) LINE 10 EVANGELICAL HOMES OF MICHIGAN 1 SHARED SERVICES HOME HEALTH CARE CORPORATION 400 WEST RUSSELL ST SALINE MI 48176 261365915 HOME CARE MI 501(C)(3) LINE 10 EVANGELICAL HOMES OF MICHIGAN 1 LIFE CHOICE SOLUTIONS INC 400 WEST RUSSELL ST SALINE MI 48176 272605153 HOME AND COMMUNITY BASE SERVICE MI 501(C)(3) LINE 10 EVANGELICAL HOMES OF MICHIGAN 1 LIFECHOICES INC 400 WEST RUSSELL ST SALINE MI 48176 272605174 HOME AND COMMUNITY BASE SERVICE MI 501(C)(3) LINE 10 EVANGELICAL HOMES OF MICHIGAN 1 EVANGELICAL HOMES OF MICHIGAN FOUNDATION 400 WEST RUSSELL ST SALINE MI 48176 814001272 COLLECT AND DISTRIBUTE CHARITABLE CONTRIBUTIONS MI 501(C)(3) LINE 7 EVANGELICAL HOMES OF MICHIGAN 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 LIFECHOICES INC S 915300 ACTUAL AMOUNT LIFECHOICES INC P 1323229 ACTUAL AMOUNT SHARED CARE SERVICES S 1033026 ACTUAL AMOUNT SHARED CARE SERVICES P 1028633 ACTUAL AMOUNT SHARED SERVICES HOME HEALTH CARE S 1372000 ACTUAL AMOUNT SHARED SERVICES HOME HEALTH CARE P 1182092 ACTUAL AMOUNT LIFE CHOICE SOLUTIONS S 41974 ACTUAL AMOUNT LIFE CHOICE SOLUTIONS P 38301 ACTUAL AMOUNT EVANGELICAL HOMES OF MICHIGAN FOUNDATION C 257738 CASH