2023-11-15T14:03:42-06:00 2022-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2022-07-01 351282401 NATIONAL FELLOWSHIP BRETHREN RETIREMENT NATI 5743726200 337 GRACE VILLAGE DR WINONA LAKE IN 46590 MARK SCHWOB DIRECTOR OF FINANCE 5743726498 2023-11-15 1 MARK SCHWOB 999009999 0 EMILIE M KNIERIEM CPA P01330194 3176334705 2023-11-15 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z GRACE VILLAGE RETIREMENT COMMUNITY JUSTIN KIMBRELL 337 GRACE VILLAGE DR WINONA LAKE IN 46590 1873624 0 X GRACEVILLAGE.ORG X 1974 IN GRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY. 10 10 21 75 0 0 301122 34557 3365601 1805527 118233 25615 5660 4000 3790616 1869699 0 0 0 0 608755 380627 0 0 184297 1409373 1518996 2018128 1899623 1772488 -29924 12170280 12174845 9845670 9805131 2324610 2369714 GRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY. GRACE VILLAGE OFFERS INDEPENDENT LIVING OPTIONS THAT INCLUDE MEALS AND NURSING SERVICES WHEN NEEDED. 0 0 1008041 1805527 GRACE VILLAGE OFFERS INDPENDENT LIVING OPTIONS THAT INCLUDE MEALS AND NURSING SERVICES WHEN NEEDED. GRACE VILLAGE ALSO OFFERS THERAPY SERVICES AND IN HOME NON-MEDICAL SERVICES AS NEEDED. 1008041 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 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 1 0 0 0 1 0 0 21 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 0 0 IN X MARK SCHWOB - DIRECTOR OF FINANCE 5743726200 337 GRACE VILLAGE DR WINONA LAKE IN 46590 CHAD HUMMEL VICE CHAIR 0.50 0.50 X X 0 0 0 ADAM LENON SECRETARY & TREASURER 0.50 0.50 X X 0 0 0 DENNIS DUNCAN BOARD MEMBER 0.50 0.50 X 0 0 0 GLENN HALL BOARD MEMBER 0.50 0.50 X 0 0 0 CHUCK JOSEY BOARD MEMBER 0.50 0.50 X 0 0 0 DAVID KOONTZ BOARD MEMBER 0.50 0.50 X 0 0 0 DAN LEININGER BOARD MEMBER 0.50 0.50 X 0 0 0 MARK MCCOLLOM BOARD MEMBER 0.50 0.50 X 0 0 0 JENNIFER PIERCE BOARD MEMBER 0.50 0.50 X 0 0 0 DALE ROBBINS BOARD MEMBER 0.50 0.50 X 0 0 0 JUSTIN KIMBRELL CEO 12.00 28.00 X 0 203693 19570 SONDREA HAMILTON CFO 12.00 28.00 X 0 140434 25044 JEFFRY CARROLL FORMER CEO 0.00 0.00 X 0 130138 4509 0 474265 49123 0 1 1 0 0 34557 34557 NET PATIENT AND RESIDE 623000 1285986 1285986 DEFERRED LIFE LEASE 623000 369541 369541 RENT INCOME FROM GRACE 623000 150000 150000 1805527 21960 21960 7580 0 3925 7580 -3925 3655 3655 4000 4000 4000 1869699 1805527 0 29615 X 291267 199822 91445 8748 6002 2746 51527 35350 16177 29085 19954 9131 18673 18673 655515 39514 431704 184297 3610 3610 28265 20016 8249 217364 195942 21422 304 304 3850 3850 87483 78735 8748 367979 331181 36798 49614 49614 OTHER EXP 81221 81221 0 DUES & SUB. 5118 0 5118 1899623 1008041 707285 184297 1624551 1989569 1539217 1069708 3000 3000 13343 61978 15413 15413 9099 65190 24811187 17123236 7829934 7687951 1106339 1132036 29384 150000 12170280 12174845 178077 124656 6208704 6358844 3384893 3312394 73996 9237 9845670 9805131 X 2319472 2364576 5138 5138 2324610 2369714 12170280 12174845 X -29924 11423 63605 X X 0 1 X 1 0 X 28045 77706 80937 301122 34557 522367 3267431 3303708 3008832 3365601 1805527 14751099 3295476 3381414 3089769 3666723 1840084 15273466 0 0 0 15273466 21351 21092 8195 19543 21960 92141 21351 21092 8195 19543 21960 92141 5145 4737 192718 5660 4000 212260 3321972 3407243 3290682 3691926 1866044 15577867 0.98050 0.98120 0.00590 0.00600 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 134848 134848 22448106 15944072 6504034 2153373 1179164 974209 74860 74860 7687951 SCHWAB - LIFE LEASE ACCOUNT 70742 C SCHWAB - GENERAL INVESTMENT ACCOUNT 853953 C LCB FREEDOM CD 207341 C 1132036 DEPOSITS 7995 RENT CREDITS 98023 INTEREST RATE SWAP LIABILITY -92989 LOAN INSURANCE COSTS -3792 9237 X 1944727 11423 63605 75028 1869699 0 1869699 1899623 0 1899623 0 1899623 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THEIR ORGANIZATIONS AND RECOGNIZE A TAX LIABILITY IF THEY HAVE TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY GRACE AND NATIONAL FELLOWSHIP AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2022 AND JUNE 30, 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATIONS ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN/LOSS ON INTEREST RATE SWAP 63,605. 0 0 0 0 0 0 0 0 0 JUSTIN KIMBRELL CEO 0 203693 0 0 0 0 0 19570 0 0 0 223263 0 0 SONDREA HAMILTON CFO 0 140434 0 0 0 0 0 8840 0 16204 0 165478 0 0 JEFFRY CARROLL FORMER CEO 0 130138 0 0 0 0 0 4509 0 0 0 134647 0 0 PART I, LINE 3 GRACE VILLAGE HEALTHCARE FACILITY, A RELATED ORGANIZATION, USES THE FOLLOWING METHODS TO DETERMINE THE CEO'S COMPENSATION: -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION B, LINE 11B THE CFO ASSISTS BLUE & CO., LLC IN PREPARATION OF THE 990 BEFORE IT IS FILED. THE CFO REVIEWS THE FORM 990 BEFORE IT IS FILED. BLUE & CO. FILES THE FORM 990 ONCE FINAL APPROVAL IS RECEIVED FROM THE CFO. THE CEO AND FULL BOARD ARE GIVEN A COPY OF THE FORM 990 UPON COMPLETION OF THE PREPARATION AND FILING. FORM 990, PART VI, SECTION B, LINE 12C GRACE VILLAGE TRIES TO AVOID SITUATIONS THAT COULD POTENTIALLY BE SEEN AS CONFLICTS OF INTEREST. IF A CONFLICT IS FOUND, IT IS DEALT WITH ON A CASE BY CASE BASIS, AND THE BOARD OF DIRECTORS MAKES A DECISION AS TO MATERIALITY OF THE CONFLICT, AND WHETHER TO TERMINATE TRANSACTIONS WITH PARTIES THAT HAVE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST ARE MONITORED AND DEALT WITH AT EVERY LEVEL OF THE ORGANIZATION, FROM HOURLY EMPLOYEES, TO SALARIED EMPLOYEES, TO BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S SALARY IS PAID BY A RELATED ORGANIZATION AND IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS OF THAT ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 39,514. MANAGEMENT AND GENERAL EXPENSES 431,704. FUNDRAISING EXPENSES 184,297. TOTAL EXPENSES 655,515. FORM 990, PART XI, LINE 9: GAIN/LOSS ON INTEREST RATE SWAP 63,605. FORM 990, PART XII, LINE 2C THE PROCESS FOR FOR SELECTION OF INDEPENDENT ACCOUNTANT AND OVERSIGHT OF SUCH PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. GRACE VILLAGE HEALTHCARE FACILITY INC 337 GRACE VILLAGE DRIVE WINONA LAKE IN 46590 351447417 NURSING HOME/ASSISTED LIVING FACILITY IN 501C3 LINE 10 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0