2022-11-04T15:17:53-05:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2021-01-01 621827185 THE VILLAGE AT GERMANTOWN INC VILL 9017522500 7820 WALKING HORSE CIRCLE GERMANTOWN TN 38138 CLAY COLLINS CFO 9017522500 2022-11-02 1 CLAY COLLINS 999009999 AMBER ROGNAN-HAMILTON P01251012 3149254300 2022-11-02 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MICHAEL CRAFT 7820 WALKING HORSE CIRCLE GERMANTOWN TN 38138 33378536 0 X WWW.VILLAGE-GERMANTOWN.COM X 2000 TN TO OPERATE AS A CONTINUING CARE RETIREMENT COMMUNITY 8 8 512 8 0 0 2488978 1717455 22150128 20839123 555616 1652807 469254 285369 25663976 24494754 0 0 0 0 11012416 12201361 0 0 0 21635842 15279141 32648258 27480502 -6984282 -2985748 102928651 101890049 155338369 155528428 -52409718 -53638379 X TO PROVIDE A QUALITY, STIMULATING, AND SAFE COMMUNITY THAT PROMOTES INDEPENDENCE AND WELLNESS THROUGH INNOVATIVE PROGRAMS, SUPPORTIVE SERVICES, AND AN EXCEPTIONAL STAFF. WE RESPECT AND VALUE THE DIGNITY OF EACH PERSON THROUGH OUR AFFILIATION WITH METHODIST HEALTHCARE. WE SERVE THE COMMUNITY AS A RESOURCE FOR SENIOR WELLNESS PROGRAMS AND INFORMATION. 0 0 23147728 0 20839123 THE VILLAGE AT GERMANTOWN, INC. (THE COMPANY) WAS FORMED ON JULY 25, 2000 AS A NOT-FOR-PROFIT CORPORATION UNDER THE LAWS AND REGULATIONS OF THE STATE OF TENNESSEE. THE COMPANY'S PURPOSE IS TO ACQUIRE REAL PROPERTY AND TO DEVELOP, MARKET AND OPERATE THE PROPERTY AS A CONTINUING CARE RETIREMENT COMMUNITY IN SHELBY COUNTY, TENNESSEE, KNOWN AS THE VILLAGE AT GERMANTOWN, INC. (THE PROJECT). THE CCRC CONSISTS OF 230 INDEPENDENT LIVING UNITS (INCLUDING 202 APARTMENTS AND 28 PATIO HOMES), AND A HEALTHCARE CENTER CONSISTING OF 32 ASSISTED LIVING UNITS, 16 SPECIAL CARE DEMENTIA UNITS, AND 50 SKILLED NURSING BEDS. THE ORGANIZATION RECEIVED CERTIFICATE OF NEED APPROVAL FOR AN ADDITIONAL 5 SKILLED NURSING BEDS. PERMANENT FINANCING OF THE PROJECT OCCURRED IN DECEMBER OF 2003 WITH CONSTRUCTION BEGINNING THAT SAME MONTH. THE PROJECT WAS SUBSTANTIALLY AVAILABLE FOR OCCUPANCY BEGINNING ON OCTOBER 2005. IN FISCAL 2021, THE VILLAGE BILLED 23,951 HEALTHCARE DAYS - 2,248 FOR DEMENTIA, 6,793 FOR ASSISTED LIVING, AND 14,910 FOR SKILLED. OF THESE DAYS, 7,630 WERE MEDICARE DAYS AND 16,321 PRIVATE PAY DAYS/INSURANCE BILLABLE DAYS. OUR INDEPENDENT LIVING OCCUPANCY WAS 195 OF 230. 23147728 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 92 0 512 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 TN X X CLAY COLLINS 9017522508 7820 WALKING HORSE CIRCLE GERMANTOWN TN 38138 DR JAMES HARKESS SECRETARY 1.00 X X 0 0 0 MARK HALPERIN DIRECTOR 1.00 X 0 0 0 CHRIS MCLEAN CHAIRMAN 1.00 X X 0 0 0 JEAN MORTON DIRECTOR 1.00 X 0 0 0 RITA SPARKS DIRECTOR 1.00 X 0 0 0 REBECCA CULLISON DIRECTOR 1.00 X 0 0 0 CHUCK LANE DIRECTOR 1.00 X 0 0 0 DR STEVE THRELKELD DIRECTOR 1.00 X 0 0 0 MICHAEL CRAFT CEO 40.00 X 286723 0 19616 REBECCA DEROUSSE VP OF HEALTHCARE SERVICES 40.00 X 174358 0 15535 CLAY COLLINS CFO 40.00 X 195948 0 17378 MELISSA RUKSTAD DIRECTOR OF WELLNESS 40.00 X 157216 0 13362 LESLIE REED DIRECTOR OF MARKETING 40.00 X 150480 0 12358 VICKIE BRADLEY DIRECTOR OF HR 40.00 X 127289 0 11121 MARIA WYATT DIRECTOR OF DINING 40.00 X 102867 0 11794 1194881 0 101164 7 0 1 0 FUNCTIONAL PATHWAYS OF TN LLC 10133 SHERRIL BLVD SUITE 200 KNOXVILLE TN 37932 THERAPY 913834 BLUSKY RESTORATION CONTRACTORS LLC 9110 E NICHOLS AVE CENTENNIAL CO 80112 MAINTENANCE 668275 STEPHENSON HOME SOLUTIONS LLC 305 JAYME LYNN LANE COMO MS 38619 MAINTENANCE 650629 COMPASS LABORATORY SERVICES 1910 NONCONNAH BLVD MEMPHIS TN 38132 LAB TESTING 564526 CERTIFIED MEDICAL STAFFING LLC 5219 SUMMER MEADOWS LN ARLINGTON TN 38002 MEDICAL STAFFING 321545 13 1369427 348028 283028 1717455 PROGRAM SERVICE REVENUE 623000 20839123 20839123 20839123 492164 492164 67863 67863 9964062 12500 8883782 0 1080280 12500 1092780 1092780 MEAL INCOME 623000 142733 142733 BEAUTY SHOP 623000 118651 118651 MISCELLANEOUS 623000 14186 14186 9799 9799 285369 24494754 20839123 0 1938176 X 657029 657029 9271314 8611372 659942 139418 121480 17938 1485117 1295259 189858 648483 565048 83435 155214 155214 3283664 2851812 431852 210079 2556 207523 604655 505675 98980 254055 244028 10027 1917042 845065 1071977 47683 47458 225 12696 12542 154 2246375 2159491 86884 4398772 4228640 170132 315125 315125 FOOD SUPPLIES 1001376 839172 162204 ANCILLARY SUPPLIES 283303 283303 MAINTENANCE 212914 204679 8235 OTHER EXPENSES 116767 116289 478 219421 213859 5562 27480502 23147728 4332774 0 502440 2419970 647102 336477 750020 1080748 87677 141978 171604 211115 115397565 49470191 68021398 65927374 32707759 31012420 40651 759967 102928651 101890049 6158482 6878389 4140529 4390999 20277701 19555217 44687920 0 43494024 80073737 81209799 155338369 155528428 X -52409718 -53638379 -52409718 -53638379 102928651 101890049 X -2985748 252185 1504902 X X 0 1 X 1 0 X 19732 26125 186278 2488978 1717455 4438568 21823633 22880505 24401785 22150128 20839123 112095174 271183 271183 21843365 22906630 24588063 24639106 22827761 116804925 53816 55054 94145 203015 0 53816 55054 94145 203015 116601910 401475 275387 645120 626703 560027 2508712 401475 275387 645120 626703 560027 2508712 742531 730466 548704 374252 14186 2410139 22987371 23912483 25781887 25640061 23401974 121723776 0.95790 0.95470 0.02060 0.01890 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISC - 2017 AMOUNT: $ 34,340. 2018 AMOUNT: $ 43,492. 2019 AMOUNT: $ 20,598. 2020 AMOUNT: $ 56,068. 2021 AMOUNT: $ 14,186. MEAL INCOME - 2017 AMOUNT: $ 263,395. 2018 AMOUNT: $ 228,544. 2019 AMOUNT: $ 250,920. 2020 AMOUNT: $ 137,888. BEAUTY SHOP - 2017 AMOUNT: $ 197,395. 2018 AMOUNT: $ 141,857. 2019 AMOUNT: $ 213,304. 2020 AMOUNT: $ 107,834. ENG AND MAINT - 2017 AMOUNT: $ 224,433. 2018 AMOUNT: $ 297,313. 2019 AMOUNT: $ 44,702. 2020 AMOUNT: $ 68,527. GUEST ACCOMMODATIONS - 2017 AMOUNT: $ 22,968. 2018 AMOUNT: $ 19,260. 2019 AMOUNT: $ 19,180. 2020 AMOUNT: $ 3,935. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 5349049 5349049 100031036 45295400 54735636 1931131 874442 1056689 7579796 3300349 4279447 506553 506553 65927374 ENTRANCE FEE DEPOSITS 319648 REFUNDABLE ENTRANCE FEE 80890151 81209799 X 26251841 252185 1504902 1757087 24494754 0 24494754 27480502 0 27480502 0 27480502 PART X, LINE 2: THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IT IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAX EXCEPT FOR THOSE THAT ARE ALREADY REPORTED ANNUALLY. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF DERIVATIVE INSTRUMENTS 1,504,902. X X 0 0 0 0 0 0 0 1 0 MICHAEL CRAFT CEO 240591 0 46132 0 0 0 9942 0 9674 0 306339 0 0 0 CLAY COLLINS CFO 177195 0 18753 0 0 0 8208 0 9170 0 213326 0 0 0 REBECCA DEROUSSE VP OF HEALTHCARE SERVICES 158709 0 15649 0 0 0 6974 0 8561 0 189893 0 0 0 MELISSA RUKSTAD DIRECTOR OF WELLNESS 142277 0 14939 0 0 0 6562 0 6800 0 170578 0 0 0 LESLIE REED DIRECTOR OF MARKETING 92802 0 57678 0 0 0 4815 0 7543 0 162838 0 0 0 PART I, LINE 7 THE ORGANIZATION PAYS PERFORMANCE BONUSES. A HEALTH EDUCATION & HOUSING FACILITIES BOARD OF THE COUNTY OF SHELBY TN 521283414 82169JAP8 2014-10-01 22059660 FINANCE THE ACQUISITION, CONSTRUCTION, AND EQUIPPING OF THE EXPANSION 0 0 0 A 1230000 22127523 1359264 441193 20259203 2017 0 0 1 1 A 0 1 1 1 0 0.00210 0.00000 0.00210 0 0 1 A 0 0 0 1 0 0 1 BAYERISCHE LANDESBANK 8.000000000000 1 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: HEALTH EDUCATION & HOUSING FACILITIES BOARD OF THE COUNTY OF S DATE THE REBATE COMPUTATION WAS PERFORMED: 10/28/2019 SCHEDULE K PART I (E) AND PART II LINE 3 ISSUE PRICE AND TOTAL PROCEEDS OF ISSUE DIFFER AS A RESULT OF INVESTMENT EARNINGS. X RESIDENTIAL UPGRADES 10 283028 GL 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR OF THE ORGANIZATION PRIOR TO FILING WITH THE IRS. EACH BOARD MEMBER RECEIVES A COPY OF THE FORM 990 FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C EMPLOYEES ARE REQUIRED TO SIGN THE CONFLICT OF INTEREST POLICY ANNUALLY. FURTHERMORE, THE POLICY IS EXPLAINED DURING EACH NEW HIRE ORIENTATION AND THE ORGANIZATION MAINTAINS AN OPEN DOOR POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE INDEPENDENT BOARD OF DIRECTORS CONDUCTS AN ANNUAL REVIEW OF THE CEO AND DETERMINES COMPENSATION WITH THE USE OF COMPARABILITY DATA (CCRC SALARY AND BENEFITS REPORT) THE EXECUTIVE DIRECTOR DETERMINES COMPENSATION FOR DEPARTMENT DIRECTORS WITH INPUT FROM THE HR DIRECTOR ALONG WITH THE CCRC SALARY AND BENEFITS REPORT. THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION FOR THE KEY EMPLOYEES, INCLUDING THE CFO. THIS PROCESS IS DOCUMENTED DURING THE ANNUAL REVIEW PROCESS USING COMPARABILITY DATA (CCRC SALARY AND BENEFITS REPORT) FOR ORGANIZATIONS WITH COMPARABLE REVENUE. ANNUAL COMPENSATION INCREASES ARE DETERMINED IN THE BUDGETING PROCESS AND APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. THE ORGANIZATION MAKES ITS AUDITED FINANCIAL STATEMENTS AVAILABLE ON THE INTERNET AT HTTP://EMMA.MSRB.ORG/. FORM 990, PART IX, LINE 11G SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 111,768. MANAGEMENT AND GENERAL EXPENSES 227,037. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 338,805. AGENCY SERVICES: PROGRAM SERVICE EXPENSES 976,885. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 976,885. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 469,308. MANAGEMENT AND GENERAL EXPENSES 23,451. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 492,759. ANCILLIARY SERVICES: PROGRAM SERVICE EXPENSES 1,196,347. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,196,347. CONSULTING: PROGRAM SERVICE EXPENSES 97,504. MANAGEMENT AND GENERAL EXPENSES 181,364. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 278,868. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF DERIVATIVE INSTRUMENTS 1,504,902. FORM 990, PAGE 12, PART XII, LINE 2C THE ORGANIZATION'S POLICY REGARDING THE OVERSIGHT OF THE AUDIT IS CONSISTENT WITH THE PRIOR YEAR.