2023-05-18T17:55:41-07:00 2022-09-30 452838168 Templin Healthcare Accounting Services LLP PO Box 326 Plainfield IL 60544 990 2021-10-01 363867476 TABOR HILLS HEALTH CARE FACILITY INC TABO 6307786677 1347 Crystal Avenue Naperville IL 60563 Anthony Harvat Chief Executive Officer 6307786677 2023-05-19 0 Larry Templin P01696703 6303612868 2023-05-19 0 11 0 AAL2 2021 2023-04-26 12:10:37Z Anthony Harvat 1347 Crystal Avenue Naperville IL 60563 13531931 0 X www.taborhills.org X 1992 IL Tabor Hills provides an extensive range of services and programs which enhances the well-being of residents living in our community. Tabor Hills' priority is meeting the needs of its residents using resources in a fiscally responsible manner, insuring the financial stability of the corporation. 12 10 175 12 0 0 1750239 248934 12055008 13282997 0 0 4445 0 13809692 13531931 0 0 0 0 8900811 13329412 0 0 0 5183441 6959155 14084252 20288567 -274560 -6756636 16011372 15353311 4328370 4452658 11683002 10900653 Tabor Hills is committed to offering quality senior care by seeking to provide a safe and comfortable environment focused on dignity and self-determination. 0 0 19154665 0 13282997 Tabor Hills provides long-term skilled nursing care to its residents, inpatient and outpatient rehabilitation services, and offers outside activity and support to our seniors who prefer to live at home through our Senior Day Services program. Tabor provided care to 287 short-term rehabilitation residents enrolled in Medicare/Insurance programs during fiscal year 2022. Short-term rehabilitation accounts for 15% of Tabor Hills total patient days, with 85% dedicated to long-term care. Total days care for fiscal year 2022: 41,900 (Medicare Days 4,340, Private Insurance Days 1,740, Public Aid Days 13,610) 0 0 0 19154665 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 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 0 0 0 1 154 0 1 175 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X Nicholas Peczkowski 6307786677 1347 Crystal Avenue Naperville IL 60563 Emelinda Lantin Registered Nurse 40 0 X 189331 0 12185 Rima Bentulan Registered Nurse 40 0 X 167652 0 9755 Frances Salinas Former Chief Executive Officer 40 1 X X X X 154513 0 16771 Anthony Harvat Chief Executive Officer 40 1 X X X 157108 0 6738 Rosalie Mendoza Registered Nurse 40 0 X 156146 0 6246 John Lawler Director of Environmental Services 40 0 X 144682 0 15814 Evelyn Mamparo Registered Nurse 40 0 X 132832 0 5313 Robert Peiler Vice President 1.5 1 X X 12975 0 0 Gloria Pindiak President 1.5 1 X X 0 0 0 Lynda Filipello Secretary 1.5 1 X X 0 0 0 Rena Strahorn Treasurer 1.5 1 X X 0 0 0 John Bozett Director 1.5 1 X 0 0 0 Judy Mayer Director 1.5 1 X 0 0 0 Angeline Bultas Director 1.5 1 X 0 0 0 Frank Michalek Director 1.5 1 X 0 0 0 Dee McHale Director 1.5 1 X 0 0 0 Jim Kopriva Director 1.5 1 X 0 0 0 Aaron Troy Director 1.5 1 X 0 0 0 1115239 0 72822 20 1 1 0 Nurses on Calls Inc 1475 Basswood Dr Bolingbrook IL 60490 Nursing Services 1180048 Total Nurses Network 7026 W North Ave 2W Chicago IL 60707 Nursing Services 383477 Reliable Nursing Healthcare Services LLC 7343 Tennessee Dr Apt 212 Willowbrook IL 60527 Nursing Services 306370 Grapetree Medical Staffing 2501 Boji Bend Dr Suite 100 Milford IA 51351 Nursing Services 183564 Mckesson Medical-Surgical 9954 Mayland Dr Suite 5176A Henrico VA 23233 Pharmacy/Nursing Supplies 149685 6 0 0 0 0 248934 0 0 248934 Resident Care 623311 13282997 13282997 0 0 0 0 0 0 13282997 0 0 0 0 0 0 13531931 13282997 0 0 X 0 0 0 0 0 0 0 0 187034 0 187034 0 0 0 0 0 7748530 7322936 425594 0 4040203 4040203 0 0 760306 760306 0 0 593339 593339 0 0 0 0 0 0 46791 0 46791 0 84603 0 84603 0 0 0 0 0 0 0 0 0 0 0 3031635 2943319 88316 0 30388 0 30388 0 31172 0 31172 0 161124 0 161124 0 0 0 0 0 355886 303148 52738 0 10219 10219 0 0 0 0 0 6265 6265 0 0 70228 70228 0 0 0 0 0 0 791660 791660 0 0 417505 417505 0 0 Healthcare Supplies and Services 535333 535333 0 0 Resident Food and Dietary Supplies 507118 507118 0 0 Maintenance and Repairs 398908 398908 0 0 Assessment Fees/Provider Tax 286544 286544 0 0 193776 177853 15923 0 20288567 19154665 1133902 0 0 0 0 0 0 0 1682150 1677160 0 0 0 0 0 0 0 0 130523 163901 28513339 15391628 13657012 13121711 0 0 0 0 541687 390539 16011372 15353311 946459 1163961 0 0 0 0 2619776 2398296 0 0 0 0 0 0 0 0 762135 890401 4328370 4452658 X 11683002 10900653 0 0 11683002 10900653 16011372 15353311 X -6756636 0 0 0 12215 5962072 X 0 1 X 0 0 X 0 0 641353 1750239 248934 2640526 12186791 11976682 13004561 12055008 13282997 62506039 4213 337 4977 4445 0 13972 0 0 0 0 0 0 0 0 0 0 0 0 12191004 11977019 13650891 13809692 13531931 65160537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65160537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12191004 11977019 13650891 13809692 13531931 65160537 1 1 0 0 X 0 574693 574693 0 21295656 9587861 11707795 0 0 0 0 0 2498303 2101189 397114 0 4144687 3702578 442109 13121711 0 Resident Credit Balances 890401 890401 X 13531931 0 0 0 0 0 13531931 0 0 0 13531931 20288567 0 0 0 0 0 20288567 0 0 0 20288567 Schedule D, Part X, Line 2 Tabor Hills is classified by the Internal Revenue Service (IRS) as an organization exempt from income tax under Section 501(c)(3) of the Internal Revenue Code and is similarly classified by the Illinois Department of Revenue. Tabor Hills files a Form 990 (Return of Organization Exempt from Income Tax) annually. When the return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Unrelated business income (UBI) is reported on Form 990-T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. As of September 30, 2022 and 2021, there were no unrecognized tax benefits identified and recorded as liabilities. Form 990 filed by Tabor Hills is subject to examination by the IRS up to three years from the extended due date of each return. Form 990 filed by Tabor Hills is no longer subject to examination for the years ended September 30, 2018 and prior. X X X 0 0 0 0 0 0 0 0 0 Anthony Harvat Chief Executive Officer 157108 0 0 0 0 0 0 0 6738 0 163846 0 0 0 Frances Salinas Former Chief Executive Officer 154513 0 0 0 0 0 0 0 16771 0 171284 0 0 0 Emelinda Lantin Registered Nurse 189331 0 0 0 0 0 0 0 12185 0 201516 0 150303 0 Rima Bentulan Registered Nurse 167652 0 0 0 0 0 0 0 9755 0 177407 0 161788 0 Rosalie Mendoza Registered Nurse 156146 0 0 0 0 0 0 0 6246 0 162392 0 0 0 John Lawler Director of Environmental Services 144682 0 0 0 0 0 0 0 15814 0 160496 0 0 0 Evelyn Mamparo Registered Nurse 132833 0 0 0 0 0 0 0 5313 0 138146 0 0 0 A Illinois Finance Authority Series 2021 861091967 2021-03-31 2443100 Payment of existing 2017 bonds 0 0 0 A 109393 0 2443100 0 0 0 2443100 2032 0 0 0 1 A 0 0 0 0 1 0 1 A 0 1 0 0 0 0 0 0 1 A 1 Schedule K, Part I, Column e-03/31/2021 2,443,100 Illinois Finance Authority Series 2021 The total issue price of the tax-exempt bonds reported on Form 8038 was $11,000,000. The difference is reported on the Form 990 for Bohemian Home for the Aged EIN 36-2181959. Form 990, Part VI, Section A, Line 6 The sole corporate member is Bohemian Home for the Aged Form 990, Part VI, Section A, Line 7a The sole corporate member, Bohemian Home for the Aged, has the power to elect individuals to the Board of Directors. Form 990, Part VI, Section A, Line 7b The sole corporate member, Bohemian Home for the Aged, has all rights vested in members of a corporation under the Illinois General Not For Profit Corporation Act of 1986, as amended. Form 990, Part VI, Section B, Line 11b The CEO and Board of Directors review Form 990 before filing. Form 990, Part VI, Section B, Line 12c All Board of Directors must complete an annual disclosure statement in accordance with corporate compliance policy. The statements are reviewed by the Corporate Compliance Committee. Should a conflict arise, it is investigated, documented, and a corrective action is put into place. If necessary, this is reviewed by legal counsel. Form 990, Part VI, Section B, Line 15 Compensation of the CEO and officers is determined by the Board of Directors based on annual performance appraisals, compensation data of comparable nonprofit organizations, and salary surveys specific to the healthcare industry. The annual performance evaluation is reviewed and signed by the Board Chair President. Form 990, Part VI, Section C, Line 19 As part of Tabor Hills Health Care Facility, Inc.'s policy, all financial statements, 990 filings, governing documents, and corporate compliance policies are filed in the administrative offices and are available for public viewing upon request for the same period of disclosure as set forth in IRC Section 6104(d). Form 990, Part IX, Line 11g Professional Fees-Program Svcs: Agency - 2,192,802, Therapy 689,244, Medical Director 33,994, Consultants 26,237, Other 1,042. Professional Fees-Mgmt and Gen: Financial Services Consulting 88,316 Form 990, Part XI, Line 9 Inter-organization Transfers 4,295,409. Change in pension obligation liability 1,666,663. Total to Form 990, Part XI, Line 9 5,962,072. Bohemian Home for the Aged 1347 Crystal Avenue Naperville IL 60563 362181959 Housing and services for elderly independent living IL 501(c)(3) Line 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1