NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCORPORATED: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCORPORATED (EIN 35-1282401)
Tax period
2020-07-01 to 2021-06-30
Filed
2021-11-10
IRS object ID
202103149349303645
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-10T12:22:26-06:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 N MERIDIAN ST SUITE 200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351282401EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NATIONAL FELLOWSHIP BRETHREN RETIREMENTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNATIBusinessNameControlTxt
Phone5743726200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJUSTIN KIMBRELLPersonNm
Person TitleCEOPersonTitleTxt
Phone5743726200PhoneNum
Signature2021-11-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJUSTINPersonFirstNm
Person LastKIMBRELLPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANGELA N CRAWFORD CPAPreparerPersonNm
PTINP00573197PTIN
Phone3176334705PhoneNum
Preparation2021-11-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GRACE VILLAGE RETIREMENT COMMUNITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJUSTIN KIMBRELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,820,759GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressGRACEVILLAGE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1974FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionGRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee30TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$77,706PYContributionsGrantsAmt
CY Contributions Grants$80,937CYContributionsGrantsAmt
PY Program Service Revenue$3,303,708PYProgramServiceRevenueAmt
CY Program Service Revenue$3,008,832CYProgramServiceRevenueAmt
PY Investment Income$49,092PYInvestmentIncomeAmt
CY Investment Income$145,234CYInvestmentIncomeAmt
PY Other Revenue$4,737PYOtherRevenueAmt
CY Other Revenue$192,718CYOtherRevenueAmt
PY Total Revenue$3,435,243PYTotalRevenueAmt
CY Total Revenue$3,427,721CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,017,119PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$935,857CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$25,511CYTotalFundraisingExpenseAmt
PY Other Expenses$2,321,728PYOtherExpensesAmt
CY Other Expenses$1,626,792CYOtherExpensesAmt
PY Total Expenses$3,338,847PYTotalExpensesAmt
CY Total Expenses$2,562,649CYTotalExpensesAmt
PY Revenues Less Expenses$96,396PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$865,072CYRevenuesLessExpensesAmt
Total Assets BOY$10,395,811TotalAssetsBOYAmt
Total Assets EOY$10,579,802TotalAssetsEOYAmt
Total Liabilities BOY$10,920,509TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,119,856TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$524,698NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$459,946NetAssetsOrFundBalancesEOYAmt
MissionGRACE 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,805,359ExpenseAmt
Revenue$3,008,832RevenueAmt
DescGRACE 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.Desc
Total Program Service Expenses$1,805,359TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee30EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SONDREA HAMILTON VP AND CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5743726200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
CHAD HUMMEL
BOARD MEMBER JUL-DEC'21/CHAIR JAN-JUN'210.500.50Yes (X)Yes (X)$0$0$0
ADAM LENON
SECRETARY & TREASURER0.500.50Yes (X)Yes (X)$0$0$0
DENNIS DUNCAN
BOARD MEMBER0.500.50Yes (X)$0$0$0
GLENN HALL
BOARD MEMBER-TERM BEGAN JAN'210.500.50Yes (X)$0$0$0
CHUCK JOSEY
BOARD MEMBER0.500.50Yes (X)$0$0$0
DAVID KOONTZ
BOARD MEMBER0.500.50Yes (X)$0$0$0
DAN LEININGER
BOARD MEMBER-TERM BEGAN JAN'210.500.50Yes (X)$0$0$0
MARK MCCOLLOM
BOARD MEMBER0.500.50Yes (X)$0$0$0
NATHAN MUELLER
BOARD MEMBER0.500.50Yes (X)$0$0$0
JENNIFER PIERCE
BOARD MEMBER-TERM BEGAN JAN'210.500.50Yes (X)$0$0$0
DALE ROBBINS
BOARD MEMBER-TERM BEGAN JAN'210.500.50Yes (X)$0$0$0
PASTOR MATT ELLIOTT
BOARD MEMBER-TERM ENDED DEC'210.500.50Yes (X)$0$0$0
GARY HAMMAN
CHAIR-TERM ENDED DEC'210.500.50Yes (X)Yes (X)$0$0$0
GARY HERBRUCK
VICE CHAIR-TERM ENDED OCT'200.500.50Yes (X)Yes (X)$0$0$0
RON REDPATH
BOARD MEMBER-TERM ENDED DEC'200.500.50Yes (X)$0$0$0
MATTHEW TEEVAN
BOARD MEMBER-TERM ENDED OCT'200.500.50Yes (X)$0$0$0
JUSTIN KIMBRELL
CEO28.0012.00Yes (X)$0$90,673$3,702
SONDREA HAMILTON
CFO28.0012.00Yes (X)$110,657$0$7,978
FieldValueIRS element (for citing)
Total Reportable Comp From Org$110,657TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$90,673TotReportableCompRltdOrgAmt
Total Other Compensation$11,680TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$80,937AllOtherContributionsAmt
Total Contributions$80,937TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT AND RESIDE623000$2,045,381$2,045,381
DEFERRED LIFE LEASE623000$663,451$663,451
RENT INCOME FROM GRACE623000$300,000$300,000
FieldValueIRS element (for citing)
Total Program Service Revenue$3,008,832TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,195TotalRevenueColumnAmt
Exclusion$8,195ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$147,917SecuritiesAmt
Other$382,160OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$135,434SecuritiesAmt
Other$257,604OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$12,483SecuritiesAmt
Other$124,556OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$137,039TotalRevenueColumnAmt
Exclusion$137,039ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$192,718TotalRevenueColumnAmt
Exclusion$192,718ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$192,718OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,427,721TotalRevenueColumnAmt
Related Or Exempt Func Income$3,008,832RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$337,952ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$118,635TotalAmt
Management And General$118,635ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$529,609TotalAmt
Program Services$413,669ProgramServicesAmt
Management And General$115,940ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$10,359TotalAmt
Program Services$6,610ProgramServicesAmt
Management And General$3,749ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$203,998TotalAmt
Program Services$130,179ProgramServicesAmt
Management And General$73,819ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$73,256TotalAmt
Program Services$46,747ProgramServicesAmt
Management And General$26,509ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$31,915TotalAmt
Management And General$31,915ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$97,526TotalAmt
Management And General$72,015ManagementAndGeneralAmt
Fundraising$25,511FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$25,314TotalAmt
Management And General$25,314ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$56,920TotalAmt
Program Services$40,091ProgramServicesAmt
Management And General$16,829ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$348,051TotalAmt
Program Services$308,762ProgramServicesAmt
Management And General$39,289ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$359TotalAmt
Program Services$235ProgramServicesAmt
Management And General$124ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$185,825TotalAmt
Program Services$167,242ProgramServicesAmt
Management And General$18,583ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$761,939TotalAmt
Program Services$685,745ProgramServicesAmt
Management And General$76,194ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$86,932TotalAmt
Management And General$86,932ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
OTHER EXP$22,666$5,529$17,137
DUES & SUB.$9,345$550$8,795

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,562,649TotalAmt
Program Services$1,805,359ProgramServicesAmt
Management And General$731,779ManagementAndGeneralAmt
Fundraising$25,511FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$78,380BOYAmt
EOY$1,550,356EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$362,300BOYAmt
EOY$129,660EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,000BOYAmt
EOY$3,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,849BOYAmt
EOY$313,612EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$16,518BOYAmt
EOY$14,374EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$33,498BOYAmt
EOY$5,279EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$24,572,895LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,262,088LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,172,834BOYAmt
EOY$8,310,807EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$389,623BOYAmt
EOY$252,714EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$324,809BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,395,811BOYAmt
EOY$10,579,802EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$153,912BOYAmt
EOY$133,283EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,314,236BOYAmt
EOY$5,863,540EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,879,299BOYAmt
EOY$3,758,444EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$573,062BOYAmt
EOY$364,589EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,920,509BOYAmt
EOY$10,119,856EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$525,935BOYAmt
EOY$453,972EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,237BOYAmt
EOY$5,974EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$524,698BOYAmt
EOY$459,946EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,395,811BOYAmt
EOY$10,579,802EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$865,072ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$6,167NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$113,405OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$125,311CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$34,431CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$28,045CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$77,706CurrentTaxYearMinus1YearAmt
Current Tax Year$80,937CurrentTaxYearAmt
Total$346,430TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,851,823CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,141,982CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,267,431CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,303,708CurrentTaxYearMinus1YearAmt
Current Tax Year$3,008,832CurrentTaxYearAmt
Total$15,573,776TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,977,134CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,176,413CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,295,476CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,381,414CurrentTaxYearMinus1YearAmt
Current Tax Year$3,089,769CurrentTaxYearAmt
Total$15,920,206TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$15,920,206PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,721CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,108CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$21,351CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,092CurrentTaxYearMinus1YearAmt
Current Tax Year$8,195CurrentTaxYearAmt
Total$115,467TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,721CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,108CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$21,351CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,092CurrentTaxYearMinus1YearAmt
Current Tax Year$8,195CurrentTaxYearAmt
Total$115,467TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,626CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,473CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,145CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,737CurrentTaxYearMinus1YearAmt
Current Tax Year$192,718CurrentTaxYearAmt
Total$217,699TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,016,481CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,216,994CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,321,972CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,407,243CurrentTaxYearMinus1YearAmt
Current Tax Year$3,290,682CurrentTaxYearAmt
Total$16,253,372TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97950PublicSupportCY509Pct
Public Support PY5090.97100PublicSupportPY509Pct
Investment Income CY0.00710InvestmentIncomeCYPct
Investment Income PY0.02750InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$147,948OtherCostOrOtherBasisAmt
Book Value$147,948BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,287,925OtherCostOrOtherBasisAmt
Depreciation$14,668,134DepreciationAmt
Book Value$7,619,791BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,112,914OtherCostOrOtherBasisAmt
Depreciation$1,593,954DepreciationAmt
Book Value$518,960BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,108OtherCostOrOtherBasisAmt
Book Value$24,108BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,310,807TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
DEPOSITS$27,430
RENT CREDITS$112,460
INTEREST RATE SWAP LIABILITY$204,897
LOAN INSURANCE COSTS-$8,342
DEFERRED COMPENSATION PLAN OBLIGATI$28,144
FieldValueIRS element (for citing)
Total Liability$364,589TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$3,547,293TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$6,167NetUnrealizedGainsInvstAmt
Other Revenue$113,405OtherRevenueAmt
Revenue Not Reported$119,572RevenueNotReportedAmt
Revenue Subtotal$3,427,721RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$3,427,721TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,562,649TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$2,562,649ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,562,649TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 JUNE 30, 2021 AND 2020, 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 113,405.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE 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 12CGRACE 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 15ATHE 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 19UPON REQUEST
FORM 990, PART XI, LINE 9:GAIN/LOSS ON INTEREST RATE SWAP 113,405.
FORM 990, PART XII, LINE 2CTHE PROCESS FOR FOR SELECTION OF INDEPENDENT ACCOUNTANT AND OVERSIGHT OF SUCH PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1GRACE VILLAGE HEALTHCARE FACILITY INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd
FieldValueIRS element (for citing)
EIN351447417EIN
Primary ActivitiesNURSING HOME/ASSISTED LIVING FACILITYPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
GRACE VILLAGE HEALTHCARE FACILITY INC
J$300,000
GRACE VILLAGE HEALTHCARE FACILITY INC
M$297,118

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