2022-03-25T09:19:34-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2020-07-01 201053401 MIDWEST SENIOR MINISTRIES MIDW 3145877903 2 CITY PLACE DRIVE NO 200 ST LOUIS MO 63141 CHUCK SCHMITZ CFO 3145877903 2022-03-17 1 CHUCK SCHMITZ XXX-XX-XXXX DAVID LOWENTHAL P00378651 3122071040 2022-03-17 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CHUCK SCHMITZ 2 CITY PLACE DRIVE NO 200 ST LOUIS MO 63141 9586362 0 X HTTPS://CHRISTIANHORIZONSLIVING.ORG/ X 2005 IL WE EXIST TO HONOR GOD BY PROVIDING A CONTINUUM OF EXCELLENT CARE AND SUPPORT SERVICES, PRIMARILY FOR OLDER ADULTS. 15 15 53 0 1475541 0 0 0 13139952 9590510 0 0 32 -4148 13139984 9586362 0 0 0 0 2242733 2235512 0 0 0 10213066 7747814 12455799 9983326 684185 -396964 12712163 12698526 230938 614265 12481225 12084261 X OUR MISSION IS TO HONOR GOD BY PROVIDING A CONTINUUM OF EXCELLENT CARE AND SUPPORT SERVICES FOR OLDER ADULTS, OUR SERVICES ARE DRIVEN BY THREE GUIDING PRINCIPALS: GOD HONORING CARE - WE UPHOLD CHRISTIAN VALUES AND PROACTIVELY MEET THE CONTINUING NEEDS OF OLDER ADULTS FROM EVERY BACKGROUND IN A SAFE, SECURE AND CARING ENVIRONMENT; KEEPING THE PROMISE - BELIEVING THAT GOD'S PROMISE OF ABUNDANT LIFE EXTENDS TO EVERYONE, WE DEMONSTRATE LOVE, COMPASSION AND HOPE AT EVERY OPPORTUNITY; MEETING YOUR NEEDS - WITH A FOCUS ON RESPONSIVE AND COMPASSIONATE CARE, WE ARE CONTINUOUSLY IMPROVING TO ENSURE WE ALWAYS MEET YOUR NEEDS AND TRUST. 0 0 8289677 0 6756313 MIDWEST SENIOR MINISTRIES PROVIDES PHARMACY SERVICES, INCLUDING PHARMACEUTICALS, CONSULTING AND SUPPLIES, TO RESIDENTS OF RELATED NON-PROFIT SENIOR LIVING COMMUNITIES AND AFFILIATES PROVIDING CARE IN A CHRISTIAN ENVIRONMENT. 8289677 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 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 1 1 0 0 0 1 0 0 1 53 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X CHUCK SCHMITZ 3145877903 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 63141 RON SEWELL BOARD MEMBER - CHAIRMAN (PART YEAR) 0.30 2.00 X X 0 1000 0 NICK FILING BOARD MEMBER - CHAIRMAN 0.30 2.00 X X 0 1000 0 BILLY CARTER BOARD MEMBER - TREASURER 0.30 2.00 X X 0 1000 0 SCOTT WILLIAMS BOARD MEMBER - SECRETARY 0.30 2.00 X X 0 1000 0 RANDY CLARK BOARD MEMBER 0.30 2.00 X 0 1000 0 STEVE GNUSE BOARD MEMBER 0.30 2.00 X 0 1000 0 THOMAS KERINS BOARD MEMBER 0.30 2.00 X 0 1000 0 DON FITZGERALD BOARD MEMBER 0.30 2.00 X 0 1000 0 DOUG WILEY BOARD MEMBER 0.30 2.00 X 0 1000 0 MIKE DUNAWAY BOARD MEMBER 0.30 2.00 X 0 1000 0 ROBERT CROSBY BOARD MEMBER (PART YEAR) 0.30 2.00 X 0 1000 0 TIMOTHY BURRELL BOARD MEMBER 0.30 2.00 X 0 1000 0 JIM FRASURE BOARD MEMBER (PART YEAR) 0.30 2.00 X 0 1000 0 MARCUS THOMAS BOARD MEMBER 0.30 2.00 X 0 1000 0 DAVID SANDEFUR BOARD MEMBER 0.30 2.00 X 0 1000 0 BRENDA EDEN BOARD MEMBER 0.30 2.00 X 0 1000 0 TERRY GOODNER BOARD MEMBER 0.30 2.00 X 0 750 0 SUSAN KLEIN BOARD MEMBER 0.30 2.00 X 0 750 0 DONALD BELL CEO 2.00 38.00 X 0 540095 23918 CHUCK SCHMITZ CFO 2.00 38.00 X 0 351095 23918 RAYMOND DICKISON COO 2.00 38.00 X 0 322799 23918 JENELLE BERTOLINO-ISHMAEL CHIEF STRATEGY OFFICER 2.00 38.00 X 0 316771 23918 ILLA DAVID CIO 2.00 38.00 X 0 297228 15500 MICHAEL BOYUM VP OF SALES 0.40 39.60 X 0 269152 15418 KAREN LARSON VP OF COMMUNITY OPERATIONS 2.00 38.00 X 0 229665 14418 BARB SHEPARD VP OF HR 2.00 38.00 X 0 215050 23918 JOHN RUPKEY PHARMACY MANAGER 2.00 38.00 X 220007 0 5500 220007 2559355 170426 5 0 1 0 0 PHARMACY OPERATIONS 446110 9590510 8114969 1475541 9590510 DISCOUNTS 900099 96 96 INSURANCE GAIN/LOSS 900099 -4244 -4244 -4148 9586362 8114969 1475541 -4148 1901447 1490755 410692 5500 5500 204538 162606 41932 124027 97239 26788 788732 788732 40 40 229616 4390 225226 7217 7217 168383 91966 76417 79432 79432 76702 65991 10711 79782 11819 67963 2957 2957 215709 201835 13874 31757 31757 COST OF GOODS SOLD 5752143 5752143 COURIER EXPENSE 251487 251487 BAD DEBT 38083 38083 LICENSES, DUES & SUBSCR 24183 24183 1591 1591 9983326 8289677 1693649 0 1560872 1068134 902422 825865 56155 40122 1764909 1342547 521090 422362 9671624 10342043 12712163 12698526 230938 241546 0 314020 0 58699 230938 614265 X 12481225 12084261 12481225 12084261 12712163 12698526 -396964 0 X 0 1 X 1 0 X 7636504 7927107 8602742 12042347 8114969 44323669 7636504 7927107 8602742 12042347 8114969 44323669 0 0 0 44323669 720 720 720 720 10764 50 27 32 -4148 6725 7647268 7927877 8602769 12042379 8110821 44331114 0.99980 0.99970 0.00000 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY SHOP - SPACE RENTAL - MISCELLANEOUS - DISCOUNTS - CABLE TV - GARAGE RENTAL - MANAGEMENT FEES - VENDING/MEAL - INSURANCE GAIN - 2016 AMOUNT: $ 10,734. DISCOUNTS - 2016 AMOUNT: $ 30. 2017 AMOUNT: $ 50. 2018 AMOUNT: $ 27. 2019 AMOUNT: $ 32. 2020 AMOUNT: $ -4,148. 307219 193230 113989 1448742 1149317 299425 8948 8948 422362 INTERCOMPANY RECEIVABLES 10283344 RIGHT-OF-USE OPERATING ASSETS 58699 10342043 LEASE PAYABLE 58699 58699 0 0 0 0 0 0 0 0 0 DONALD BELL CEO 0 445876 0 94219 0 0 0 15500 0 8418 0 564013 0 0 CHUCK SCHMITZ CFO 0 272944 0 65292 0 12859 0 15500 0 8418 0 375013 0 0 RAYMOND DICKISON COO 0 266180 0 56619 0 0 0 15500 0 8418 0 346717 0 0 JENELLE BERTOLINO-ISHMAEL CHIEF STRATEGY OFFICER 0 255186 0 61585 0 0 0 15500 0 8418 0 340689 0 0 ILLA DAVID CIO 0 238220 0 59008 0 0 0 15500 0 0 0 312728 0 0 MICHAEL BOYUM VP OF SALES 0 222893 0 41165 0 5094 0 7000 0 8418 0 284570 0 0 KAREN LARSON VP OF COMMUNITY OPERATIONS 0 198832 0 30833 0 0 0 6000 0 8418 0 244083 0 0 BARB SHEPARD VP OF HR 0 180855 0 34195 0 0 0 15500 0 8418 0 238968 0 0 JOHN RUPKEY PHARMACY MANAGER 173281 0 30000 0 16726 0 5500 0 0 0 225507 0 0 0 PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S CEO IS ESTABLISHED BY A RELATED ORGANIZATION, MIDWEST CHRISTIAN VILLAGES. MIDWEST CHRISTIAN VILLAGES USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES MANAGEMENT DUTIES INCLUDING SUPERVISING PERSONNEL, OPERATIONS, AND BUDGETING TO MIDWEST CHRISTIAN VILLAGES, A MANAGEMENT COMPANY AND RELATED EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND THE CEO HAVE REVIEWED THE 990 PRIOR TO FILING. A DRAFT COPY OF THE 990 IS MADE AVAILABLE TO ALL DIRECTORS FOR THEIR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST STATEMENT IS INCLUDED IN THE EMPLOYEE HANDBOOK WHICH EVERY EMPLOYEE IS GIVEN A COPY OF AND SIGNS AN ACKNOWLEDGEMENT FOR ON THEIR FIRST DAY OF EMPLOYMENT. IF A VIOLATION OCCURS, EMPLOYEES CAN REPORT DIRECTLY TO THEIR SUPERVISOR OR USE THE 800 NUMBERS WHICH ARE POSTED AT EACH LOCATION. VIOLATIONS ARE INVESTIGATED BY INDIVIDUALS AT THE VICE PRESIDENT LEVEL, AND AT LEAST TWO INDIVIDUALS WOULD MAKE THE FINAL DETERMINATION AS TO THE APPROPRIATE ACTION TO BE TAKEN. THE BOARD OF DIRECTORS HAS ADOPTED A CONFLICT OF INTEREST POLICY. ANNUALLY EVERY BOARD MEMBER COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM AND IDENTIFIES ANY POTENTIAL CONFLICTS. THEY ALSO CERTIFY THAT THEY HAVE REVIEWED AND AGREE TO ABIDE BY THE CURRENT POLICY IN PLACE. IF A POTENTIAL CONFLICT ARISES IT IS REVIEWED BY THE BOARD OF DIRECTORS AND DISCUSSED AND VOTED ON. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, OFFICERS AND KEY EMPLOYEES IS DETERMINED BY A RELATED ORGANIZATION, MIDWEST CHRISTIAN VILLAGES. THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE CONSISTING OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS AND SUPPORTED BY THE ORGANIZATION'S VPHR. THE EXECUTIVE COMPENSATION COMMITTEE OPERATES UNDER A BOARD APPROVED CHARTER, COMPENSATION PHILOSOPHY AND RETAINS AN INDEPENDENT CONSULTANT TO COMPLETE A COMPREHENSIVE EXECUTIVE COMPENSATION EVALUATION UTILIZING CONSULTANT'S LIBRARY OF PUBLIC AND PRIVATE DATA SOURCES, SUPPLEMENTED BY THEIR EXPERIENCES IN THE INDUSTRY CULMINATING IN A WRITTEN REPORT SUBMITTED TO THE EXECUTIVE COMPENSATION COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE FINDINGS OF THE INDEPENDENT CONSULTANT, HAS THE OPPORTUNITY TO DISCUSS THE FINDINGS AMONG THE COMMITTEE MEMBERS AND WITH THE CONSULTANT. AS SPECIFIED BY THE BY-LAWS THE EXECUTIVE COMPENSATION COMMITTEE PROVIDES A RECOMMENDATION FOR THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF OTHER EXECUTIVE POSITIONS. THE EXECUTIVE COMPENSATION COMMITTEE PROVIDES THE COMMITTEE-APPROVED COMPENSATION PHILOSOPHY AND APPROVED COMPENSATION FOR THE CEO, COO AND CFO TO A THIRD PARTY TO OBTAIN A WRITTEN ASSESSMENT OF REASONABLENESS WITH THE CONTEXT OF THE STANDARDS SET FORTH UNDER THE INTERNAL REVENUE CODE SECTION 4958 AND RELATED DEPARTMENT OF TREASURY REGULATIONS. FORM 990, PART VI, SECTION C, LINE 19 ANNUAL AUDIT, MONTHLY FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE ALSO AVAILABLE UPON REQUEST. SENIOR CARE PHARMACY SERVICES LLC 1204 BEAR LANE MONTICELLO IL 61856 300971176 PHARMACY SERVICES IL 9586362 12698526 MIDWEST SENIOR MINISTRIES INC CHRISTIAN HOMES INC 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 63141 370841562 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 10 N/A 0 HICKORY POINT CHRISTIAN VILLAGE INC 565 MARION AVE FORSYTH IL 62535 370987659 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 10 N/A 0 LEWIS MEMORIAL CHRISTIAN VILLAGE 3400 W WASHINGTON STREET SPRINGFIELD IL 62711 510173104 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 10 N/A 0 HOOSIER CHRISTIAN VILLAGE 621 S SUGAR STREET BROWNSTOWN IN 47220 237423749 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(C)(3) LINE 10 N/A 0 SPRING RIVER CHRISTIAN VILLAGE 201 S NORTHPARK LANE JOPLIN MO 64801 431341462 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS MO 501(C)(3) LINE 10 N/A 0 CROWN POINT CHRISTIAN VILLAGE 6685 E 117TH STREET CROWN POINT IN 46307 311114614 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(C)(3) LINE 10 N/A 0 RISEN SON CHRISTIAN VILLAGE 3000 RISEN SON BLVD COUNCIL BLUFFS IA 51503 421279738 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IA 501(C)(3) LINE 10 N/A 0 MIDWEST CHRISTIAN VILLAGES 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 62535 260275009 MGMT NURSING AND RETIREMENT MO 501(C)(3) LINE 10 N/A 0 CHRISTIAN HORIZONS CHARITABLE FOUNDATION 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 63141 850509383 FUNDRAISING IL 501(C)(3) LINE 12B, II N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0