2022-03-02T14:11:52-06:00 2021-06-30 381357951 PLANTE & MORAN PLLC 3000 TOWN CENTER SUITE 100 SOUTHFIELD MI 48075 990 2020-07-01 300036865 GREENCROFT MIDDLEBURY INC GREE 5745374000 PO BOX 819 GOSHEN IN 46527 SCOTT MARTIN VP OF FINANCE 5745374000 2022-02-08 1 SCOTT MARTIN 999009999 DAVID LOWENTHAL P00378651 2483522500 2022-02-08 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z TIM DELUCA 1721 GREENCROFT BLVD GOSHEN IN 46526 1349394 0 X WWW.GREENCROFT.ORG X 1999 IN GREENCROFT MIDDLEBURY PROVIDES ACTIVE, AFFORDABLE RETIREMENT LIVING IN HOMES WITH SUPPORTIVE SERVICES. SERVICES PROVIDED TO RESIDENTS AND THE BROADER MIDDLEBURY COMMUNITY AT REDUCED OR NO COST AMOUNTED TO $97,000 FOR FYE JUNE 30, 2021. 7 7 0 42 0 0 119900 643650 708714 676049 690 19104 16189 10591 845493 1349394 11500 12600 0 0 194689 144726 0 0 0 626159 636487 832348 793813 13145 555581 7143186 7708882 6639504 6529773 503682 1179109 GREENCROFT MIDDLEBURY CREATES A DYNAMIC LIVING COMMUNITY THAT EMBRACES THE CREATIVITY, CONTRIBUTIONS AND CHALLENGES OF AGING FOR ALL, GROUNDED IN SERVICE EXCELLENCE, COMPASSIONATE CARE AND MENNONITE VALUES. 0 0 607174 12600 686640 GREENCROFT MIDDLEBURY IS A NON-PROFIT COMMUNITY BENEFIT CORPORATION THAT PROVIDES INDEPENDENT LIVING SERVICES TO MORE THAN 50 RESIDENTS ON A 23-ACRE CAMPUS. ASSISTED LIVING AND HEALTHCARE NURSING SERVICES ARE AVAILABLE VIA A CONTRACT BETWEEN GREENCROFT MIDDLEBURY AND GREENCROFT GOSHEN. SUPPORTING SERVICES FOR RESIDENTS AND OTHER AREA SENIORS ARE PROVIDED THROUGH THE GREENCROFT MIDDLEBURY SENIOR CENTER ON CAMPUS. DURING THE YEAR ENDED JUNE 30, 2021, OVER 13% OF TOTAL REVENUES WERE USED TO PROVIDE COMMUNITY BENEFITS IN THE FORM OF REDUCED/FREE SENIOR CENTER SERVICES. IN ADDITION, RESIDENTS WHO DO NOT MISUSE THEIR ASSETS MAY BE ELIGIBLE FOR SUPPORT FROM GREENCROFT MIDDLEBURY IF THEIR ASSETS RUN OUT. 607174 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 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IN X SCOTT MARTIN 5745374000 1721 GREENCROFT BLVD GOSHEN IN 46527 SCOTT MARTIN TREASURER 1.00 42.60 X 0 148432 47316 RYDELL BONTRAGER SECRETARY 1.00 42.70 X 0 118450 48510 AIMEE RIEMKE ASSISTANT SECRETARY 0.20 39.40 X 0 111115 51617 TIM DELUCA PRESIDENT 30.00 10.00 X 0 73878 30100 DALE SHENK ASSISTANT TREASURER 0.30 10.90 X 0 74524 0 JEREMY MILLER CHAIR 1.00 0.00 X X 0 0 0 KARLA BEASLEY BOARD MEMBER 1.00 0.00 X 0 0 0 MIRANDA CRIPE BOARD MEMBER 1.00 0.00 X 0 0 0 KIM HUFFMAN BOARD MEMBER 1.00 0.00 X 0 0 0 GREG KRIDER BOARD MEMBER (PART YEAR) 1.00 0.00 X 0 0 0 OVRA LEHMAN BOARD MEMBER 1.00 0.00 X 0 0 0 ROSEALENE LONG BOARD MEMBER (PART YEAR) 1.00 0.00 X 0 0 0 CAROLYN MILLER BOARD MEMBER 1.00 0.00 X 0 0 0 LOWELL MILLER BOARD MEMBER 1.00 0.00 X 0 0 0 0 526399 177543 0 0 1 0 0 643650 643650 NET RESIDENT SERVICES 623000 676049 676049 676049 19104 19104 MAINTENANCE INCOME 811000 10291 10291 TENANT CHARGES 812900 300 300 10591 1349394 686640 0 19104 X 12600 12600 122439 91829 30610 6121 4591 1530 6855 5141 1714 9311 6984 2327 34257 34257 7900 7900 99693 19939 79754 4930 4930 26813 7295 19518 133849 133849 186 186 1411 1411 8750 8750 286360 286360 4649 4649 FACILITY MAINTENANCE 24415 24415 DUES 1284 193 1091 LICENSES 876 131 745 SMALL EQUIPMENT 174 26 148 940 141 799 793813 607174 186639 0 175 175 107443 26690 0 -734 2109 2193 10074247 3288305 6868955 6785942 164504 894616 7143186 7708882 34597 38986 1566580 1577792 5038327 4912995 6639504 6529773 X 357178 284493 146504 894616 503682 1179109 7143186 7708882 X 555581 119846 X X 0 1 X 1 0 X 29110 5200 857 119900 643650 798717 671409 709452 650424 724903 686640 3442828 700519 714652 651281 844803 1330290 4241545 100100 390000 490100 460679 381107 319875 264764 47941 1474366 460679 381107 319875 364864 437941 1964466 2277079 46 4038 3934 2111 19104 29233 46 4038 3934 2111 19104 29233 700565 718690 655215 846914 1349394 4270778 0.53320 0.48440 0.00680 0.00290 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 95598 125000 27758 3750 244606 96815 2499 3716 95598 95217 5293 3695 96815 93395 5430 3608 95217 87741 9128 3474 93395 0.64270 0.24680 0.11050 0 1 1 659072 659072 6501591 2243811 4257780 2511442 911514 1599928 187189 130480 56709 214953 2500 212453 6785942 BENEFICIAL INTEREST IN GREENCROFT COMMUNITIES FOUNDATION 894616 894616 LIFE LEASE NOTES PAYABLE 3036873 DUE TO AFFILIATES 1791202 RESIDENT REFUNDS 84920 4912995 PART V, LINE 4: ENDOWMENT FUNDS ARE HELD BY GREENCROFT COMMUNITIES FOUNDATION INC. FOR THE BENEFIT OF GREENCROFT MIDDLEBURY, INC. GREENCROFT COMMUNITIES FOUNDATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PERPETUAL SOURCE OF SUPPORT TO PROGRAMS SUPPORTED BY ITS ENDOWMENTS WHILE SEEKING TO PRESERVE THE PURCHASING POWER OF THE ENDOWMENT ASSETS. THE PURPOSE OF THE ENDOWMENTS IS TO PROVIDE SUPPORT FOR THE CHARITABLE PROGRAMS OF GREENCROFT MIDDLEBURY, INC. 1 GREENCORFT COMMUNITIES FOUNDATION INC PO BOX 819 GOSHEN IN 46527 237126990 501(C)(3) 12600 N/A N/A TO SUPPORT OPERATIONS 1 0 PART I, LINE 2: THE ORGANIZATION MAKES GRANTS TO RELATED ORGANIZATIONS. GRANTS MADE ARE UNRESTRICTED AND CAN BE USED IN ANY WAY THE RECIPIENT SEES FIT TO FURTHER ITS TAX-EXEMPT PURPOSE. 0 0 0 0 0 0 0 0 0 SCOTT MARTIN TREASURER 0 143436 0 4600 0 396 0 19933 0 27383 0 195748 0 0 RYDELL BONTRAGER SECRETARY 0 114307 0 4053 0 90 0 15404 0 33106 0 166960 0 0 AIMEE RIEMKE ASSISTANT SECRETARY 0 106583 0 4389 0 143 0 18333 0 33284 0 162732 0 0 SCHEDULE J, PART I THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR THE PRESIDENT/CEO: 1. COMPENSATION SURVEY OR STUDY 2. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART I, LINE 5 AND PART V, LINE 2A: THE ORGANIZATION'S EMPLOYEES ARE PAID BY GREENCROFT GOSHEN, INC (EIN 35-1270709), A RELATED TAX-EXEMPT ORGANIZATION. THESE EMPLOYEES ARE INCLUDED IN THE FORM W-3, TRANSMITTAL OF WAGE AND TAX STATEMENTS, THAT IS FILED BY GREENCROFT GOSHEN. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION IS UNDER A MANAGEMENT/AFFILIATION CONTRACT WITH GREENCROFT RETIREMENT COMMUNITIES, INC. (GRC), A RELATED TAX-EXEMPT ORGANIZATION. ACCORDING TO THE AGREEMENT, GRC HAS THE SOLE AND EXCLUSIVE RIGHT TO SUPERVISE, MANAGE, AND OPERATE THE ORGANIZATION'S FACILITY ("THE FACILITY"). IN ADDITION, GRC HAS THE SOLE CONTROL AND DISCRETION WITH REGARD TO THE OPERATION AND MANAGEMENT OF THE FACILITY FOR ALL CUSTOMARY PURPOSES, AS WELL AS THE RIGHT TO DETERMINE ALL OPERATING POLICIES AFFECTING OR CONCERNING THE APPEARANCE AND MAINTENANCE STANDARDS OF OPERATION, AND ANY OTHER MATTER AFFECTING THE FACILITY OR THE OPERATION THEREOF. THE AGREEMENT TERMINATES IN JUNE 2028. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ONE MEMBER, GREENCROFT RETIREMENT COMMUNITIES, INC. (GRC), THAT IS ALSO A RELATED TAX-EXEMPT ORGANIZATION. THE RESERVED POWERS OF THE SOLE MEMBER ARE AS FOLLOWS: 1. APPROVAL TO ANY CHANGES IN CORPORATE MISSION, WHICH MAY BE PROPOSED BY THE ORGANIZATION, BUT WHICH SHALL BECOME EFFECTIVE ONLY UPON APPROVAL OF GRC 2. APPROVAL OF NOMINATED CANDIDATES TO SERVE AS DIRECTOR OF THE ORGANIZATION 3. THE CREATION OR DISCONTINUATION OF PROGRAMS OR SERVICES OFFERED BY THE ORGANIZATION 4. AMENDMENTS TO THE BYLAWS AND ARTICLES OF INCORPORATION 5. APPROVAL OR THE ADOPTION OF THE ANNUAL BUDGET 6. APPROVAL OF NON-BUDGETED CONTRACTS AND/OR NON-BUDGETED PURCHASES OF OVER $50,000 7. THE INCURRENCE OF INDEBTEDNESS OF OVER $500,000 8. THE SALE OF REAL ESTATE 9. THE DONATION OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS 10. ANY MERGER OR CONSOLIDATION WITH ANY OTHER ORGANIZATION, OR THE PARTIAL OR TOTAL DISSOLUTION OF THE ORGANIZATION 11. THE CREATION OF SUBSIDIARY CORPORATIONS, LLCS, PARTNERSHIPS, OR OTHER ENTERPRISES 12. THE ACQUISITION OF CONTROLLING INTERESTS IN ANOTHER ENTITY 13. THE APPOINTMENT OF THE PRESIDENT/CEO, CFO, SECRETARY, AND TREASURER OF THE CORPORATION (BUT NOT THE OFFICERS OF THE BOARD OF DIRECTORS) 14. THE REMOVAL OF THE CHAIR OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE 15. THE REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE NOTWITHSTANDING THESE RESERVED POWERS, THE MEMBER HAS NO FINANCIAL OBLIGATIONS OR RESPONSIBILITIES FOR ANY ACTIONS OF THE ORGANIZATION BY REASON OF SERVING AS A MEMBER. FORM 990, PART VI, SECTION A, LINE 7A SEE NARRATIVE FOR PART VI, SECTION A, LINE 6 FORM 990, PART VI, SECTION A, LINE 7B SEE NARRATIVE FOR PART VI, SECTION A, LINE 6 FORM 990, PART VI, SECTION B, LINE 11B A FINAL DRAFT OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS PRESENTED BY OUR TAX ADVISORS TO THE ORGANIZATION'S AUDIT COMMITTEE AT A REGULARLY SCHEDULED MEETING. A COPY OF THE FINAL DRAFT IS THEN PROVIDED TO EACH BOARD MEMBER PRIOR TO ITS FILING. THIS ALLOWS THE BOARD OF DIRECTORS AND MANAGEMENT TO REVIEW AND PROVIDE COMMENTS AND EXPLANATIONS REGARDING THE FORM. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND OFFICERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE WITH THE ORGANIZATION. THE TREASURER REVIEWS EACH POLICY STATEMENT SIGNED BY THESE INDIVIDUALS TO DETERMINE IF ANY CONFLICTS HAVE OCCURRED AND NEED TO BE BROUGHT TO THE ATTENTION OF THE BOARD. IF A CONFLICT ARISES, THE RESPECTIVE BOARD MEMBER WILL ABSTAIN HIM/HERSELF FROM ANY RELATED DISCUSSION, VOTE OR SIMILAR ACTION ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 GREENCROFT MIDDLEBURY'S (GM) PHILOSOPHY IS TO COMPENSATE TEAM MEMBERS IN A FAIR MANNER FOR THE WORTH OF WORK PROVIDED WITHIN THE CURRENT MARKET VALUE RANGE FOR EACH POSITION IN THE ORGANIZATION. GM CONDUCTS PERIODIC REVIEW OF THE MARKET TO DEVELOP AVERAGE WAGES FOR POSITIONS WITHIN GREENCROFT MIDDLEBURY. GREENCROFT MIDDLEBURY STARTS TEAM MEMBERS THAT MEET THE MINIMUM REQUIREMENTS FOR THE POSITION AT/OR NEAR THE STARTING WAGE. WE MAKE ADJUSTMENTS TO THE STARTING WAGE BASED ON YEARS OF EXPERIENCE IN THAT SPECIFIC POSITION. OUR COMPENSATION PHILOSOPHY FOR TEAM MEMBERS OF OUR ORGANIZATION IS BASED ON VARIOUS TIERS. THE FIRST TIER IS GENERAL TEAM MEMBERS. WE HAVE HIRED AN OUTSIDE CONSULTANT TO DEVELOP A COMPENSATION SYSTEM FOR ALL OF GREENCROFT MIDDLEBURY'S POSITIONS. THE CONSULTANTS DEVELOPED A SYSTEM WITH WAGE SCALES THAT USE THE MARKETPLACE AVERAGE FOR KEY POSITIONS AS THE STARTING POINT FOR THE SCALES. THE WAGES SCALES HAVE A MINIMUM, A 25TH PERCENTILE, A 50TH PERCENTILE (AVERAGE) A 75TH PERCENTILE AND A MAXIMUM. WE STRIVE TO KEEP OUR AVERAGE FOR POSITIONS AT THE MID-POINT OF A RANGE DEVELOPED BY OUR CONSULTANTS. PERIODICALLY WE HIRE A CONSULTANT TO UPDATE THE MARKETPLACE AVERAGE FOR SEVERAL KEY POSITIONS. THE CONSULTANT WILL USE AREA MARKETPLACE DATA, LEADINGAGE DATA, AND OTHER INDUSTRY DATA TO DEVELOP THE AVERAGE. OUR COMPENSATION PHILOSOPHY FOR MANAGEMENT AND EXECUTIVE TEAM MEMBERS (DIRECTORS AND VICE PRESIDENT) OF OUR ORGANIZATION IS SLIGHTLY DIFFERENT. THE SECOND TIER IS MANAGEMENT TEAM MEMBERS. THE WAGE SCALE SYSTEM IS THE SAME FOR OUR TEAM MEMBERS. HOWEVER, OUR POLICY STATES THAT DIRECTORS ARE LIKE OTHER TEAM MEMBERS AND CAN EARN UP TO THE 100TH PERCENTILE OF THE RANGE FOR THEIR POSITION. OUR THIRD TIER IS VICE PRESIDENT TEAM MEMBERS. THE WAGE SCALE SYSTEM IS THE SAME FOR OUR TEAM MEMBERS. THE RANGE USES THE MEDIAN AS THE MID-POINT NOT THE AVERAGE. GENERALLY, THE MEDIAN IS BELOW THE AVERAGE. THE OVERALL COMPENSATION POLICY AND THE VP COMPENSATION POLICY ARE APPROVED BY THE GREENCROFT COMMUNITIES (GC) BOARD OF DIRECTORS. THE GREENCROFT MIDDLEBURY (GM) BOARD REVIEWS THE COMPENSATION POLICIES. ANNUALLY THE GC BOARD AND THE GM BOARD REVIEW THE COMPENSATION OF THE EXECUTIVE TEAM. THEY COMPARE CURRENT WAGES WITH NATIONAL DATA PROVIDED BY LEADINGAGE (FORMERLY THE AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING - AAHSA). THE BOARDS REVIEW THE CURRENT WAGE, THE PERCENTILE RANKING OF THE EMPLOYEE IN HIS/HER RESPECTIVE RANGE AND THE MEDIAN OF THE MARKETPLACE COMPARED TO THE MID-POINT OF THE EMPLOYEE'S RANGE. THE BOARDS DOCUMENT THESE MEETINGS AND ACTIONS TAKEN IN THEIR BOARD MINUTES. THE GM BOARD HAS REVIEWED THE BASE WAGE AND THE VARIABLE PAY FOR THE PRESIDENT OF GREENCROFT MIDDLEBURY. IN THE FISCAL YEAR 2021 FOR THE PRESIDENT WAS AT THE 88TH PERCENTILE OF THE RANGE FOR THIS POSITION IN BASE COMPENSATION. THIS PROCESS WAS LAST PERFORMED IN FISCAL YEAR 2021. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 3,337. MANAGEMENT AND GENERAL EXPENSES 13,346. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,683. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 6,602. MANAGEMENT AND GENERAL EXPENSES 26,408. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,010. CORPORATE SERVICES: PROGRAM SERVICE EXPENSES 10,000. MANAGEMENT AND GENERAL EXPENSES 40,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,000. FORM 990, PART XI, LINE 9: BENEFICIAL INTEREST ACTIVITY 119,846. FORM 990, PART XII, LINE 2C: THE AUDIT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. GREENCROFT COMMUNITIES FOUNDATION INC PO BOX 819 GOSHEN IN 46527 237126990 FUNDRAISING IN 501(C)(3) LINE 7 GREENCROFT RETIREMENT COMMUNITIES INC 1 GREENCROFT GOSHEN INC PO BOX 819 GOSHEN IN 46527 351270709 HEALTHCARE IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 GREENCROFT MANOR III INC PO BOX 819 GOSHEN IN 46527 351431475 HOUSING IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 GREENCROFT MANOR II INC PO BOX 819 GOSHEN IN 46527 351377430 HOUSING IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 GREENCROFT CENTRAL MANOR INC PO BOX 819 GOSHEN IN 46527 356047318 HOUSING IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 GREENCROFT RETIREMENT COMMUNITIES INC PO BOX 819 GOSHEN IN 46527 300036587 MANAGEMENT IN 501(C)(3) LINE 12C, III-FI N/A 0 HAVEN HUBBARD HOMES INC DBA HAMILTON GROVE 31869 CHICAGO TRAIL NEW CARLISLE IN 46552 350870110 HEALTHCARE IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 OAK GROVE CHRISTIAN RETIREMENT VILLAGE INC 221 WEST DIVISION ROAD DEMOTTE IN 46310 351986767 HEALTHCARE IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 SOUTHFIELD VILLAGE INC 6450 MIAMI CIRCLE SOUTH BEND IN 46614 351866553 HEALTHCARE IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 WALNUT HILLS RETIREMENT COMMUNITIES INC PO BOX 129 WALNUT CREEK OH 44687 351317338 HEALTHCARE IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 GREENCROFT HOME HEALTH SERVICES INC PO BOX 819 GOSHEN IN 46527 351606010 HOME HEALTH IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 CHICAGO TRAIL VILLAGE INC 31869 CHICAGO TRAIL NEW CARLISLE IN 46552 310990629 HOUSING IN 501(C)(3) LINE 10 HAVEN HUBBARD HOMES INC DBA HAMILTON GROVE 1 MENNONITE HEALTH SERVICES 234 S MAIN STREET SUITE A GOSHEN IN 46526 231421919 HEALTHCARE IN 501(C)(3) LINE 10 N/A 0 EDGEWATER PLACE INC 11351 LAFAYETTE PLAIN CITY ROAD PLAIN CITY OH 43064 823596152 HEALTHCARE IN 501(C)(3) LINE 10 GREENCROFT RETIREMENT COMMUNITIES INC 1 GREENCROFT MANAGEMENT INC PO BOX 819 GOSHEN IN 46527 270259652 MANAGEMENT SERVICES IN N/A C 0 0 1 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 1 1 GREENCROFT RETIREMENT COMMUNITIES INC E 1750000 CASH VALUE GREENCROFT RETIREMENT COMMUNITIES INC M 84257 ACTUAL COST