2021-05-24T08:03:04-05:00 2020-09-30 420714325 RSM US LLP 30 S Wacker Drive Ste 3300 Chicago IL 60606 990 2019-10-01 363867476 Tabor Hills Health Care Facility Inc TABO 6307786677 1347 Crystal Avenue Naperville IL 60563 Frances Salinas Chief Executive Officer 6307786677 2021-04-05 1 Rebekuh Eley P01247672 3126343400 2019 2022-09-23 18:48:47Z Frances Salinas 1347 Crystal Avenue Naperville IL 60563 13650891 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 10 256 35 0 0 0 641353 11976682 13004561 0 0 337 4977 11977019 13650891 0 0 0 0 9770171 9302842 0 0 0 4421959 5496807 14192130 14799649 -2215111 -1148758 16152137 16030774 4545587 6244211 11606550 9786563 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 13702295 13004561 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 205 residents enrolled in the Medicare program during fiscal year 2020. Of these approximately 75% returned to the community, 15% returned or stayed on our campus, and 10% returned to the hospital or expired. Total days care for fiscal year 2020: 44,541 (Medicare Days 5,484, Public Aid Days 13,126) 13702295 1 1 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 1 137 0 1 256 1 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 Claudia Mendoza 6307786677 1347 Crystal Avenue Naperville IL 60563 Frances Salinas CEO 40.00 1.00 X X 192404 0 62951 Muneera Dhada Director of Therapy 40.00 X 139734 0 21841 Rima Bentulan Registered Nurse 40.00 X 128529 0 22287 Lorna Dedin Asst. Director of Nursing 55.00 X 121500 0 25150 Jennifer Ulmer Former CEO 0.00 0.00 X 107708 0 34547 Debbie Harvat Director of Nursing 50.00 X 114544 0 21352 Emelinda Lantin Registered Nurse 40.00 X 118628 0 13698 Robert Peiler Vice President 18.00 1.00 X X 11077 0 0 Gloria J Pindiak President 1.50 1.00 X X 0 0 0 James Hill Treasurer 1.50 1.00 X X 0 0 0 Lynda Filipello Secretary 1.50 1.00 X X 0 0 0 John Bozett Director 1.50 1.00 X 0 0 0 Angeline Bultas Director 1.50 1.00 X 0 0 0 John Eckman Director 1.50 1.00 X 0 0 0 James Kopriva Director 1.50 1.00 X 0 0 0 Judy Mayer Director 1.50 1.00 X 0 0 0 Dr Frank Michalek Director 1.50 1.00 X 0 0 0 Aaron Troy Director 1.50 1.00 X 0 0 0 934124 0 201826 11 1 1 0 Grapetree Medical Staffing 2501 Boji Bend Drive Suite 100 Milford IA 51351 Nursing Services 410028 Hartwig Plumbing & Heating Inc 20800 E Brink Street Harvard IL 60033 Repair & Maintenance 252971 JM Hawkins Inc 800 Roosevelt Rd Bldg B Suite 20 Glen Ellyn IL 60137 Computer Services 156742 Favorite Healthcare Staffing Inc 7255 W 98th Terrace 150 Overland Park KS 66212 Nursing Services 120194 Total Nurses Network 7026 W North Avenue 2W Chicago IL 60707 Nursing Services 116923 5 636353 5000 641353 Resident Care 623311 13004561 13004561 13004561 Beautician and Barber 900099 4977 4977 4977 13650891 13004561 0 4977 166961 166961 7678103 7207808 470295 93163 93163 799970 799970 564645 564645 78014 78014 60108 60108 1182476 1182476 22717 22717 19821 19821 188435 188435 349669 297790 51879 13229 13229 1049 1049 117596 117596 659593 659593 269194 269194 Pharmacy & Supplies 610028 610028 Bad Debt Expense 609311 609311 Resident Food 415106 415106 Maint. & Repairs 353066 353066 547395 521500 25895 14799649 13702295 1097354 0 1756847 1432501 72844 91217 28115555 13878440 13715803 14237115 606643 269941 16152137 16030774 1141147 886154 68481 3065745 2835595 0 1580700 338695 873281 4545587 6244211 X 11606550 9786563 11606550 9786563 16152137 16030774 X -1148758 -671229 X 0 1 X 0 0 X 641353 641353 14739368 13299543 12186791 11976682 13004561 65206945 20592 19002 4213 337 4977 49121 14759960 13318545 12191004 11977019 13650891 65897419 0 0 0 65897419 14759960 13318545 12191004 11977019 13650891 65897419 1.00000 1.00000 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 574693 574693 21160839 8477828 12683011 2324394 1880129 444265 4055629 3520483 535146 14237115 Resident Credit Balances 595186 Due to Third Party Payor 2299 Pension Liability 275796 873281 X 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 percent 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, 2020 and 2019, 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, 2016 and prior. X 0 1 X X X 1 0 0 0 0 0 0 0 0 Frances Salinas CEO 188159 0 0 0 4245 0 37701 0 25250 0 255355 0 0 0 Muneera Dhada Director of Therapy 139734 0 0 0 0 0 16864 0 4977 0 161575 0 0 0 Rima Bentulan Registered Nurse 128529 0 0 0 0 0 0 0 22287 0 150816 0 0 0 Jennifer Ulmer Former CEO 87246 0 0 0 20462 0 30138 0 4409 0 142255 0 0 0 Part I, Line 1a Tabor Hills offers a benefit to full time employees in which a portion of their gym membership is covered by Tabor Hills. These amounts were reported as taxable compensation. Tabor Hills no longer provides this benefit to its employees as of April 2020. Part I, Line 1b In 2001, Gloria Pindiak, the CEO back then along with the HR benefits department proposed this decision to the board of directors who agreed to offer this as a perk/fringe benefit for all of our full-time employees from gym centers such as Life Time Fitness and LA Fitness. Part I, Line 4a Jennifer Ulmer received severance payments of $20,462 during 2019, which was reported as taxable compensation on Part II, Col. B(iii). A Illinois Finance Authority - Series 2017 861091967 2017-09-19 3553600 Payment of Existing 2006 Bonds 0 0 0 A 690979 3553600 3553600 2008 1 0 1 1 A 1 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 A 1 Part I, Column (e): Series 2017: The total issue price of the the tax-exempt bond reported on Form 8038 was $16,000,000. 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 XI, line 9: Interorganization Transfers 63,850. Change in pension obligation liability -735,079. 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