2021-05-10T16:34:07-05:00 2020-06-30 350921680 CROWE LLP 9600 Brownsboro Road Suite 400 Louisville KY 402411122 990 2019-07-01 621459304 HOOSIER CARE III INC HOOS 6156479004 PO BOX 58908 NASHVILLE TN 37205 Douglass B Smith PRESIDENT 2021-05-10 true Rachel Spurlock P00520729 5023263996 2019 2022-09-23 18:48:47Z X Douglass B Smith PO BOX 58908 NASHVILLE TN 37205 0 false X N/A X 1991 DE THE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY. X 8 5 205 80 0 0 19185 0 13084358 0 787 0 815 0 13105145 0 0 0 5747450 0 0 0 7097515 0 12844965 0 260180 0 6429885 0 8946364 0 -2516479 0 THE ORGANIZATION WAS FOUNDED TO PROVIDE RESIDENTIAL AND NURSING SERVICES FOR THE ELDERLY. false false 0 0 0 THIS ORGANIZATION OPERATES A 101 BED SKILLED NURSING FACILITY AND A 59 BED ASSISTED LIVING/SENIOR HOUSING FACILITY FOR THE CARE OF ELDERLY PATIENTS IN NEWARK, DELAWARE. 0 true false false false false false false false false false false false false false true false true false false false false false false false false false false false true false false false false false false false false false false false true true true false false false true X 42 0 true 205 true false false false false false false false false false false false false X 8 5 true true false false false false false true false false false true true true true true true false false false X DOUGLASS B SMITH 6156479004 PO BOX 58908 NASHVILLE TN 37205 Douglass Smith Director/President of Emerald Shelter Group 2.0 38.0 X X 0 388946 12012 Stephen F Wood Sr EXECUTIVE CHAIRMAN OF EMERALD SHELTER GROUP 1.3 18.8 X X 0 500000 0 Jim Ridenour DIRECTOR 0.1 6.9 X 0 82683 0 Jo Ann Corbitt Director 0.1 6.9 X 0 80273 0 John E Gillmor Director 0.1 6.9 X 0 75000 0 John G Foos DIRECTOR 0.1 6.9 X 0 72500 0 Laura Hawken Director 0.1 6.9 X 0 47950 0 Stephen F Wood Jr DIRECTOR 0.1 6.9 X 0 70000 0 Andrea Barach VP AND CORPORATE SECRETARY 1.0 39.0 X 0 242242 6039 John Noffsinger COO 2.0 38.0 X 0 230640 6039 Kylie Waters CFO (termed 5/1/2020) 2.0 38.0 X 0 187157 6667 Finda Menjor-Kromah Churchman Director of Nursing 40.0 0 X 119078 0 20970 Jennifer Vasquez Churchman Assistant Director of Nursing 40.0 0 X 104399 0 0 Kim Blunt Churchman Executive Director 40.0 0 X 148285 0 21192 Mike Amoah-Mensah Registered Nurse 40.0 0 X 108701 0 19978 480463 1977391 92897 4 false true false Healthcare Services Group 3220 Tillman Dr SUITE 300 Bensalem PA 19020 Laundry, Food, Environmental 1225313 MEDICAL REHABILITATION CENTER 1050 CHINOE ROAD SUITE 350 LEXINGTON KY 40502 MANAGEMENT SERVICES 969000 Functional Pathways of TN LLC 10133 Sherrill Blvd STE 200 Knoxville TN 379323347 Rehabilitation 703563 OMNICARE INC PO BOX 78000 DETROIT MI 48278 PHARMACY SERVICES 400265 EXCEPTIONAL REHAB 1050 CHINOE RD SUITE 350 LEXINGTON KY 40502 REHABILITATION 342449 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957190 0 1157720 0 0 0 0 0 55813 0 0 0 3908425 0 0 0 350737 0 6429885 0 1031719 0 0 0 7472940 0 441705 0 8946364 0 X -2516479 0 -2516479 0 6429885 0 X 0 2516479 X true X true X true false X 416 299 19185 0 19900 10449945 11463742 13013942 13084358 0 48011987 0 0 0 10449945 11464158 13014241 13103543 0 48031887 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48031887 247 252 365 787 0 1651 0 247 252 365 787 0 1651 0 2599 735 110 815 0 4259 10452791 11465145 13014716 13105145 0 48037797 0.9999 0.9998 0.0000 0.0000 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - MISCELLANEOUS REVENUE, COLUMN A - 2599.0, COLUMN B - 735.0, COLUMN C - 110.0, COLUMN D - 815.0, COLUMN E - , COLUMN F - 4259.0; NOTE PAYABLE TO RELATED PARTY 0 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE OPERATING COMPANY IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE AND CORRESPONDING STATE TAX PROVISIONS. THE FACILITY COMPANY IS A SINGLE MEMBER LIMITED LIABILITY COMPANY, AND ALL INCOME IS INCLUDED IN THE INCOME OF THE INDIVIDUAL MEMBER (THE OPERATING COMPANY). ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. U.S. GAAP REQUIRES THAT A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. THE ORGANIZATION'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF DELAWARE FOR THE LAST THREE YEARS AND DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT TWELVE MONTHS. THE ORGANIZATION RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT HAVE ANY AMOUNT ACCRUED FOR INTEREST AND PENALTIES AT JUNE 30, 2020 AND 2019. false false false false false false false false Douglass Smith Director/President of Emerald Shelter Group 0 388946 0 0 0 0 0 0 0 12012 0 400958 0 0 Stephen F Wood Sr EXECUTIVE CHAIRMAN OF EMERALD SHELTER GROUP 0 500000 0 0 0 0 0 0 0 0 0 500000 0 0 Andrea Barach VP AND CORPORATE SECRETARY 0 242242 0 0 0 0 0 0 0 6039 0 248281 0 0 John Noffsinger COO 0 230640 0 0 0 0 0 0 0 6039 0 236679 0 0 Kylie Waters CFO (termed 5/1/2020) 0 187157 0 0 0 0 0 0 0 6667 0 193824 0 0 Kim Blunt Churchman Executive Director 148285 0 0 0 0 0 0 0 21192 0 169477 0 0 0 Real Property 2020-04-07 22660000 Appraisal 842476830 Churchman DE SNF Realty LLC c/o CCC JV LLC Attn Arie Friedman 7077 Av du Parc 600 Montreal Quebec CA QCH3N1X7 LLC Personal Property 2020-04-07 840000 Appraisal 842476830 Churchman DE SNF Realty LLC c/o CCC JV LLC Attn Arie Friedman 7077 Av du Parc 600 Montreal Quebec CA QCH3N1X7 LLC Intangibles and Goodwill 2020-04-07 2000000 Appraisal 842412774 Churchman DE SNF Management LLC c/o CCC JV LLC Attn Arie Friedman 7077 Av du Parc 600 Montreal Quebec CA QCH3N1X7 LLC false false false false Form 990, Part V, Line 1a NUMBER OF EMPLOYEES AND VENDORS EXCEPTIONAL LIVING CENTERS FILES ALL APPLICABLE IRS TAX FILINGS FOR THE ORGANIZATION. Form 990, Part VI, Line 15a COMPENSATION COMPENSATION FOR THE TOP MANAGEMENT OFFICAL IS PAID BY A RELATED ORGANIZATION, THEREFORE LINE 15A IS NOT APPLICABLE AND HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS FOR APPROVAL BY THE BOARD OF DIRECTORS. COMPENSATION IS BASED ON AN INDEPENDENT COMPENSATION STUDY AND INCREASES IN COMPENSATION ARE AT THE DISCRETION OF THE BOARD. DURING THE FILING YEAR A COMPENSATION STUDY WAS PERFORMED BY A THIRD PARTY AND INCLUDED A REVIEW OF THE ECONOMIC RESEARCH INSTITUTE'S EXECUTIVE ASSESSOR DATABASE, THE MERCER EXECUTIVE BENCHMARK DATABASE AND SURVEY DATA FROM A GROUP OF PEER COMPANIES WITHIN THE ASSISTED AND LONG-TERM CARE INDUSTRY. Form 990, Part VI, Line 15b COMPENSATION COMPENSATION FOR ALL OTHER OFFICERS OR KEY EMPLOYEES IS PAID BY A RELATED ORGANIZATION, THEREFORE LINE 15B IS NOT APPLICABLE AND HAS BEEN ANSWERED "NO" IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS. COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS FOR APPROVAL BY THE BOARD OF DIRECTORS. COMPENSATION IS BASED ON AN INDEPENDENT COMPENSATION STUDY AND INCREASES IN COMPENSATION ARE AT THE DISCRETION OF THE BOARD. DURING THE FILING YEAR A COMPENSATION STUDY WAS PERFORMED BY A THIRD PARTY AND INCLUDED A REVIEW OF THE ECONOMIC RESEARCH INSTITUTE'S EXECUTIVE ASSESSOR DATABASE, THE MERCER EXECUTIVE BENCHMARK DATABASE AND SURVEY DATA FROM A GROUP OF PEER COMPANIES WITHIN THE ASSISTED AND LONG-TERM CARE INDUSTRY. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons STEPHEN F. WOOD, SR. & STEPHEN F. WOOD, JR. - Family relationship Form 990, Part VI, Line 3 Delegation of management duties THE ORGANIZATION HAS A MANAGEMENT AGREEMENT WITH MEDICAL REHABILITATION CENTERS, LLC, D/B/A EXCEPTIONAL LIVING CENTERS. MANAGEMENT SERVICES INCLUDE SUPERVISION OF FACILITY OPERATIONS, ADMINISTRATIVE SERVICES, MANAGEMENT INFORMATION SYSTEM SERVICES, ACCOUNTING, AND COST REPORT PREPARATION. THERE ARE NO CURRENT OFFICERS, DIRECTORS, OR HIGHEST COMPENSATED EMPLOYEES WHO WERE COMPENSATED BY THE MANAGEMENT COMPANY. Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY, THEREFORE THIS QUESTION HAS BEEN MARKED "NO" IN ACCORDANCE TO THE IRS INSTRUCTIONS. Form 990, Part VI, Line 11b Review of form 990 by governing body A complete copy of the form 990 is reviewed by the organization's legal counsel and an authorized member of the board of directors prior to filing with the IRS. Additionally, a complete copy of the form 990 is provided to all members of the governing body. Form 990, Part VI, Line 12c Conflict of interest policy Annual certifications are received from all officers and directors to determine whether any potential conflicts of interest exist. The board of directors discuss the annual certifications at the board meetings to determine whether an actual conflict of interest exists. If a conflict is determined to exist, that person would be refused from taking part in any decisions concerning the conflicting issue. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE FOR PUBLIC INSPECTION AT THE ORGANIZATION'S OFFICE DURING REGULAR BUSINESS HOURS UPON REQUEST. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Distributions to Affiliate - -12863133; Gain on sale of affiliate - 15029101; Gain from discontinued operations - 350511; CHURCHMAN VILLAGE CENTER LLC 4949 OGLETOWN STANTON RD NEWARK DE 19713 261168743 SENIOR HOUSING/SKILLED NURSING DE 504962 0 HOOSIER CARE III INC BIRCHWOOD SENIOR HOUSING CORPORATION PO BOX 58908 NASHVILLE TN 37205 204800428 SENIOR HOUSING DE 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false CLAREMONT HEALTH SYSTEM INC PO BOX 58908 NASHVILLE TN 37205 621486858 NURSING HOME NJ 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false CLEVELAND SENIOR HOUSING CORPORATION PO BOX 58908 NASHVILLE TN 37205 264739076 SENIOR HOUSING TN 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false DELAWARE HEALTH CORPORATION PO BOX 58908 NASHVILLE TN 37205 621548336 NURSING HOME DE 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false EMERALD UPPER MIDWEST HEALTHCARE HOLDING CORPORATION PO BOX 58908 NASHVILLE TN 37205 364825354 HOLDING COMPANY WI 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false EMERALD SPRING HILL INC PO BOX 58908 NASHVILLE TN 37205 474584314 NURSING HOME TN 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false HEALTH AND HOUSING SUPPORT SERVICES INC PO BOX 58908 NASHVILLE TN 37205 452449379 SUPPORTING ORGANIZATION NV 501(c)(3) Type II HEALTH AND HOUSING SUPPORT SERVICES INC false HOOSIER CARE II INC PO BOX 58908 NASHVILLE TN 37205 311274121 NURSING HOME IN 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false HOOSIER CARE PROPERTIES INC PO BOX 58908 NASHVILLE TN 37205 200377349 HOLDING COMPANY IN 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false HOOSIER CARE INC PO BOX 58908 NASHVILLE TN 37205 311262572 NURSING HOME IN 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false HOOSIER HOUSING GROUP INC PO BOX 58908 NASHVILLE TN 37205 463491686 HOLDING COMPANY NV 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false LAURELWOOD SENIOR HOUSING CORPORATION PO BOX 58908 NASHVILLE TN 37205 320362338 SENIOR HOUSING TN 501(c)(3) 10 HEALTH AND HOUSING SUPPORT SERVICES INC false GATE MANOR HOUSING GP LLC PO BOX 58908 NASHVILLE TN 37205 352531184 AFFORDABLE HOUSING PROJECTS TN NA C Corporation false KNOXVILLE HOUSING PORTFOLIO GP LLC PO BOX 58908 NASHVILLE TN 37205 474536542 AFFORDABLE HOUSING PROJECTS TN NA C Corporation false JACKSON HOUSING PORTFOLIO GP LLC PO BOX 58908 NASHVILLE TN 37205 364843724 AFFORDABLE HOUSING PROJECTS TN NA C Corporation false false false false false true false false false false false false false false false false true false false false