2023-04-27T14:24:46-05:00 2022-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2021-07-01 231606038 CALVARY FELLOWSHIP HOMES INC CALV 7173930711 502 ELIZABETH DRIVE LANCASTER PA 17601 DALE WEAVER PRESIDENT/CEO 7173930711 2023-04-25 1 DALE WEAVER XXX-XX-XXXX KERRI N BOGDA CPA P00760402 7177404863 2023-04-25 X 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DALE WEAVER 502 ELIZABETH DRIVE LANCASTER PA 17601 15947792 0 X WWW.CALVARYHOMES.ORG X 1961 PA OPERATE A CONTINUING CARE RETIREMENT COMMUNITY & PROVIDE HOUSING, HEALTH CARE & RELATED SVCS. 14 12 300 148 0 0 2579929 910320 12612393 13480765 125016 -66717 346457 330734 15663795 14655102 418631 373679 0 0 8748699 8916889 0 0 84567 6584436 6624102 15751766 15914670 -87971 -1259568 36194065 34704131 28059225 28417893 8134840 6286238 X TO SERVE SENIOR ADULTS, ENRICHING THEIR LIVES IN A MANNER THAT GLORIFIES OUR LORD JESUS CHRIST AND MAXIMIZES THEIR QUALITY OF LIFE. WE OPERATE A CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES HOUSING, PERSONAL CARE, AND HEALTH CARE. 0 0 13458160 373679 13480765 THE ORGANIZATION OPERATES A CONTINUING CARE RETIREMENT COMMUNITY PROVIDING HOUSING, HEALTH CARE AND OTHER RELATED SERVICES TO SENIOR ADULTS THROUGH THE OPERATION OF A SKILLED NURSING FACILITY THAT IS CERTIFIED BY MEDICARE AND MEDICAID, A PERSONAL CARE FACILITY WHICH INCLUDES A SECURED DEMENTIA UNIT AND INDEPENDENT LIVING APARTMENTS AND COTTAGES. FOR THE YEAR ENDING 6/30/22, THERE WERE 15,762 NURSING DAYS WITH 96% OCCUPANCY AND 12,725 PERSONAL CARE DAYS WITH 79% OCCUPANCY. THE ORGANIZATION ALSO PROVIDED CARE TO RESIDENTS WHO MET CERTAIN CRITERIA AT AMOUNTS LESS THAN ESTABLISHED RATES. CHARGES FOREGONE FOR SERVICES RENDERED AND SUPPLIES FURNISHED UNDER THE BENEVOLENT CARE POLICY AMOUNTED TO $362,000 IN FISCAL YEAR 2022. DURING FISCAL YEAR 2022, 61% OF OUR RESIDENTS IN OUR NURSING CENTER WERE RECEIVING ASSISTANCE THROUGH THE MEDICAL ASSISTANCE PROGRAM WHICH RESULTS IN A DEFICIT OF OVER $2,306,000 BETWEEN OUR COSTS AND WHAT WE RECEIVE IN REIMBURSEMENT.WE PROVIDE MANY OPPORTUNITIES FOR RESIDENTS TO ENJOY EVENTS AND ACTIVITIES THROUGHOUT OUR CAMPUS AND OFF CAMPUS. THIS INCLUDES ENTERTAINMENT, CRAFTS, PAINTING CLASSES, EXERCISE AND BALANCE CLASSES, SEWING AND QUILT MAKING, BOOK CLUBS, BIBLE STUDIES, DEVOTIONS, CHURCH SERVICES, AND PRAYER MEETINGS. THERE ARE TRIPS TO SEE PLAYS, SIGHTSEEING TRIPS AND OTHER LOCAL EVENTS. 13458160 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 14 0 300 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 14 12 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 PA X VINCENT REIGLE VP OF FINANCE CFO 7178248817 502 ELIZABETH DR LANCASTER PA 17601 CLIFFORD K HURTER PRESIDENT & CEO 40.00 0.00 X X 206939 0 24471 DAVID STOTT DIRECTOR OF OPERATIONS 40.00 0.00 X X 109233 0 24979 RAY LANAS CHAIRMAN 1.00 0.00 X X 0 0 0 JEFF DAHL VICE CHAIRMAN 1.00 0.00 X X 0 0 0 PENNY CLAWSON SECRETARY 1.00 0.00 X X 0 0 0 JIM MARTIN TREASURER 1.00 0.00 X X 0 0 0 JON SENSENIG DIRECTOR 1.00 0.00 X 0 0 0 JOHN ZESWITZ DIRECTOR 1.00 0.00 X 0 0 0 NANCY JAMES DIRECTOR 1.00 0.00 X 0 0 0 REV ROBERT REID DIRECTOR 1.00 0.00 X 0 0 0 REV HENRY HEIJERMANS DIRECTOR 1.00 0.00 X 0 0 0 JONATHAN YODER DIRECTOR 1.00 0.00 X 0 0 0 SHELDON MYER DIRECTOR 1.00 0.00 X 0 0 0 ANDREW WOOLLEY DIRECTOR 1.00 0.00 X 0 0 0 DAVE HOSTETTER DIRECTOR (UNTIL 10/2021) 1.00 0.00 X 0 0 0 TIM JAMES DIRECTOR (UNTIL 01/2022) 1.00 0.00 X 0 0 0 DALE WEAVER PRESIDENT & CEO (AS OF 10/2022) 40.00 0.00 X X 0 0 0 ERIC BENDER VP OF FINANCE/CFO 40.00 0.00 X 114245 0 16543 DANIELLE MARTIN VP OF HEALTH SERVICES 40.00 0.00 X 119973 0 20199 550390 0 86192 4 0 1 0 EG STOLTZFUS 474 MT SIDNEY RD LANCASTER PA 17602 RENOVATION SERVICES 258640 FLAGSHIP REHABILITATION 157 BALTIMORE ST SUITE 200 CUMBERLAND MD 21502 THERAPY SERVICES 250498 RANCK INC 2541 MARIETTA AVE LANCASTER PA 17601 RENOVATION SERVICES 190919 FLOORING CONCEPTS INC 201 CAROL DRIVE WASHINGTON BORO PA 17582 FLOORING 142180 INTELYCARE INC 1250 HANCOCK ST SUITE 501N QUINCY MA 02169 NURSING AGENCY 118841 6 23262 289156 597902 910320 NET RESIDENT SERVICE REVENUE 623000 11856432 11856432 AMORTIZATION OF ADVANCE FEES 623000 1624333 1624333 13480765 57684 57684 1142787 1250 1062565 205873 80222 -204623 -124401 -124401 28414 23262 18369 10045 10045 12696 5883 6813 6813 CABLE TV INCOME 900099 117447 117447 TELEPHONE INCOME 900099 51279 51279 CAFE REVENUE 722210 47496 47496 97654 97654 313876 14655102 13480765 0 264017 8300 8300 365379 365379 373651 310983 62668 6676374 5501330 1100446 74598 118582 97887 20000 695 1212244 1031589 178135 2520 536038 450342 79990 5706 16640 16640 65772 65772 1377 1377 30714 30714 664715 664715 107372 107372 398729 47370 350311 1048 1130991 1130991 79020 67133 11887 80543 44644 35899 424612 424612 2252821 2252821 135892 135892 DIETARY SUPPLIES 618307 618307 MEDICAL SUPPLIES 284143 284143 PA BED ASSESSMENT 77607 77607 SUPPORT STAFF 52542 52542 202305 105072 97233 15914670 13458160 2371943 84567 102407 178876 592372 42345 468422 712410 160929 150802 61786901 31367677 31160545 30419224 3590585 3084242 118805 116232 36194065 34704131 1496540 1788527 14199387 14213184 18805 16232 11997532 12099566 346961 300384 28059225 28417893 X 8134840 6286238 8134840 6286238 36194065 34704131 X -1259568 -648115 59081 X 0 1 X 1 0 X 466580 1019790 646704 2579929 894702 5607705 12048645 11773219 12234878 12612393 13480765 62149900 12515225 12793009 12881582 15192322 14375467 67757605 56587 42340 56079 35040 12500 202546 0 56587 42340 56079 35040 12500 202546 67555059 95659 99592 79908 53021 57684 385864 95659 99592 79908 53021 57684 385864 111741 347103 402616 359468 370604 1591532 12722625 13239704 13364106 15604811 14803755 69735001 0.96870 0.96930 0.00550 0.00740 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: ANNUITIES - 2018 AMOUNT: $ 35,053. 2019 AMOUNT: $ 40,649. BARBER BEAUTY INCOME - 2018 AMOUNT: $ 30,635. 2019 AMOUNT: $ 23,037. 2020 AMOUNT: $ 19,574. 2021 AMOUNT: $ 29,567. CABLE TV INCOME - 2018 AMOUNT: $ 90,083. 2019 AMOUNT: $ 98,950. 2020 AMOUNT: $ 109,670. 2021 AMOUNT: $ 117,447. CAFE REVENUE - 2017 AMOUNT: $ 55,142. 2018 AMOUNT: $ 83,957. 2019 AMOUNT: $ 78,048. 2020 AMOUNT: $ 36,482. 2021 AMOUNT: $ 47,496. CARE LTD CAPTIVE DIVIDEND - 2020 AMOUNT: $ 17,230. 2021 AMOUNT: $ 24,203. DISCOUNTS - 2017 AMOUNT: $ 1,004. 2018 AMOUNT: $ 1,251. 2019 AMOUNT: $ 1,510. 2020 AMOUNT: $ 24,016. 2021 AMOUNT: $ 96. GIFT SHOP - 2018 AMOUNT: $ 8,211. 2019 AMOUNT: $ 13,453. 2020 AMOUNT: $ 11,007. 2021 AMOUNT: $ 12,696. GUEST MEALS - 2017 AMOUNT: $ 55,595. 2018 AMOUNT: $ 51,891. 2019 AMOUNT: $ 49,079. 2020 AMOUNT: $ 31,841. 2021 AMOUNT: $ 33,956. HIGHMARK IMPLEMENTATION CREDIT - 2020 AMOUNT: $ 10,000. MISCELLANEOUS REVENUE - 2018 AMOUNT: $ 1,531. 2019 AMOUNT: $ 47,389. 2020 AMOUNT: $ 36,967. 2021 AMOUNT: $ 9,832. NON-CHARITABLE FUNDRAISING RECEIPTS - 2018 AMOUNT: $ 8,337. 2019 AMOUNT: $ 8,337. 2020 AMOUNT: $ 3,189. 2021 AMOUNT: $ 44,032. REBATES - 2020 AMOUNT: $ 10,356. TELEPHONE INCOME - 2018 AMOUNT: $ 36,154. 2019 AMOUNT: $ 42,164. 2020 AMOUNT: $ 49,136. 2021 AMOUNT: $ 51,279. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1377 1377 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO LEADINGAGE PA, AN ORGANIZATION WHICH ADVOCATES FOR SENIOR CITIZENS. A PORTION OF DUES PAID ARE ALLOCATED TO LOBBYING EXPENSES. 0 1 X 1495003 1495003 46067115 20761602 25305513 1512310 1245322 266988 12712473 9360753 3351720 30419224 REFUNDABLE FEES AND DEPOSITS 27475 SPLIT-INTEREST OBLIGATIONS 272909 300384 13635146 -648115 -396093 -1044208 14679354 -24252 -24252 14655102 15483748 -34829 -34829 15518577 396093 396093 15914670 PART IV, LINE 2B: THE GENERAL RESIDENT FUND EXISTS FOR RESIDENTS TO MAINTAIN SMALL AMOUNTS OF SPENDING CASH WITH THE FACILITY. THE FACILITY MAINTAINS THESE FUNDS IN A CUMULATIVE CHECKING ACCOUNT. WHEN RESIDENTS ASK TO WITHDRAW MONEY FROM THEIR SPENDING ACCOUNT, A CHECK IS WRITTEN AND CASHED. THE FUNDS ARE THEN PROVIDED TO THE RESIDENT. THE FUNDS ARE HELD IN INTEREST-BEARING CHECKING ACCOUNTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RESIDENT ASSISTANCE AND SUBSIDIES -365,379. INVESTMENT FEES -30,714. PART XI, LINE 4B - OTHER ADJUSTMENTS: GIFT SHOP SUPPLIES -5,883. FUNDRAISING EVENT EXPENSES -18,369. PART XII, LINE 2D - OTHER ADJUSTMENTS: GIFT SHOP SUPPLIES 5,883. FUNDRAISING EVENT EXPENSES 18,369. CHANGE IN VALUE OF ANNUITIES -59,081. PART XII, LINE 4B - OTHER ADJUSTMENTS: RESIDENT ASSISTANCE AND SUBSIDIES 365,379. INVESTMENT FEES 30,714. GOLF TOURNAMENT 33793 23262 10531 0 1932 3731 4469 0 399 SPRING FLING 17883 0 17883 0 0 0 7838 0 0 51676 23262 28414 1932 3731 12307 399 18369 10045 1 ASSISTANCE TOWARD ROOM & BOARD EXPENSES FOR RESIDENTS IN FINANCIAL NEED. 18 365379 PART I, LINE 2: THE ORGANIZATION PROVIDES ASSISTANCE TO RESIDENTS WITH A FINANCIAL NEED WHO COMPLETE AN APPLICATION WITH THE PRESIDENT/CEO. APPLICATIONS FOR ASSISTANCE ARE PRESENTED TO THE FINANCE COMMITTEE AND BOARD FOR THEIR APPROVAL. UPON BOARD APPROVAL, FUNDS ARE TRANSFERRED FROM THE HOME'S BENEVOLENT FUND TO COVER THE RESIDENT'S FEES. CONTRIBUTIONS TO OTHER ORGANIZATIONS ARE ONLY PROVIDED TO KNOWN NON-PROFITS. THE ORGANIZATION SUPPORTS LOCAL CHARITIES AND DOES NOT MONITOR THE FUNDS AFTER THEY ARE DISBURSED. NO GRANTS WERE GIVEN IN EXCESS OF $5K DURING FY22. X X 0 0 0 0 0 0 0 0 0 CLIFFORD K HURTER PRESIDENT & CEO 203229 0 0 0 3710 0 2547 0 21924 0 231410 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 NANCY JAMES AND TIM JAMES HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP IN THE ORGANIZATION IS UPON INVITATION BY THE BOARD OF DIRECTORS AND SHALL CONSIST OF NOT LESS THAN TWENTY FIVE MEMBERS. MEMBERS MUST MEET THE FOLLOWING REQUIREMENTS: 1)MEMBERS SHALL BE TWENTY-ONE YEARS OF AGE OR OLDER; 2)MEMBERS SHALL SUBSCRIBE ANNUALLY IN WRITING TO THE STATEMENT OF FAITH SET FORTH IN THE ORGANIZATION'S BYLAWS AND SHALL HAVE A VITAL INTEREST IN THE SPIRITUAL AND PHYSICAL WELFARE OF ELDERLY PEOPLE. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE CORPORATION ELECT ALL MEMBERS OF THE BOARD. ADDITIONALLY THE PRESIDENT/CEO IS DESIGNATED BY HIS TITLE TO BE A BOARD MEMBER - HE IS NOT ELECTED TO THE BOARD BY THE CORPORATION MEMBERS. THE DIRECTOR OF OPERATIONS IS ASSIGNED, BY THE PRESIDENT, TO BE ON THE BOARD AS WELL. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ARE SITUATIONS WHERE THE CORPORATION MEMBERS HAVE VOTING AUTHORITY OVER BOARD DECISIONS: FROM THE BY-LAWS, ANY CHANGE TO ARTICLE II (SPIRITUAL BASIS/STATEMENT OF FAITH) PROPOSED BY THE BOARD OF DIRECTORS MUST BE APPROVED BY A UNANIMOUS VOTE OF THE CORPORATION MEMBERS. FROM THE BY-LAWS (TOP OF PAGE 8 FROM ARTICLE 6 SECTION 6.11) NO RESOLUTION APPROVING THE MERGER, CONSOLIDATION, LIQUIDATION OR DISSOLUTION OF THE CORPORATION NOR ANY ACTION THAT WOULD RESULT IN THE SALE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION SHALL BE VALID UNLESS FIRST APPROVED BY THE AFFIRMATIVE VOTE OF TWO-THIRDS (2/3) OF (A) ALL MEMBERS OF THE BOARD AND (B) THE CORPORATE MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 8B NONE OF THE COMMITTEES CAN ACT WITHOUT BOARD APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED IN DETAIL BY THE PRESIDENT/CEO, THE VP OF FINANCE/CFO AND THE TREASURER OF THE BOARD. A COPY WAS ALSO PROVIDED TO ALL BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS COMPLETE THE CONFLICT OF INTEREST POLICY STATEMENT ANNUALLY. THE PRESIDENT/CEO MONITORS THE PROCESS AND REVIEWS ANY IDENTIFIED CONFLICTS. COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IS REVIEWED PRIOR TO THE ORGANIZATION ENTERING INTO ANY SIGNIFICANT TRANSACTIONS. THE POLICY MENTIONS FAMILY AND BUSINESS RELATIONSHIPS. ANY BOARD MEMBER WITH A POTENTIAL CONFLICT IS REQUESTED TO ABSTAIN FROM VOTING ON MATTERS RELATED TO THEIR CONFLICT. IF THE CONFLICT IS DETERMINED TO BE SIGNIFICANT, THE BOARD MEMBER IS ASKED TO RESIGN FROM THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE ANNUAL INCREASE FOR THE PRESIDENT/CEO AND DIRECTOR OF OPERATIONS IS BASED STRICTLY ON THE BOARD OF DIRECTORS' DECISION AND IS INFLUENCED BY A NUMBER OF FACTORS INCLUDING MERIT, COST OF LIVING/INFLATION ISSUES AND WAGES PAID FOR COMPARABLE POSITIONS WITHIN THE INDUSTRY TO ENSURE COMPENSATION DOES NOT EXCEED FAIR MARKET VALUE. COUNTY WAGE SURVEYS ARE USED AS GUIDANCE. THE PROCESS AND DETERMINATION IS DOCUMENTED IN THE BOARD OF DIRECTORS' MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF ANNUITIES 59,081.