2020-11-17T04:34:24-06:00 2020-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2019-07-01 351282401 NATIONAL FELLOWSHIP BRETHREN RETIREMENT NATI 5743726200 337 GRACE VILLAGE DR WINONA LAKE IN 46590 JUSTIN KIMBRELL CEO 5743726200 2020-11-16 1 ANGELA N CRAWFORD CPA P00573197 3176334705 2020-11-16 38.109.186.2 2020-11-16 11:07:29 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AF923E04E140C4DE71FD41AF2127CF5344A3E036 2019 2021-01-29 14:40:06Z GRACE VILLAGE RETIREMENT COMMUNITY JUSTIN KIMBRELL 337 GRACE VILLAGE DR WINONA LAKE IN 46590 3702684 0 X GRACEVILLAGE.ORG X 1974 IN GRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY. 12 11 28 95 0 0 28045 77706 3267431 3303708 69613 49092 5145 4737 3370234 3435243 0 0 0 0 1041776 1017119 0 0 33869 2787750 2321728 3829526 3338847 -459292 96396 10666498 10395811 11125095 10920509 -458597 -524698 GRACE 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. 0 0 2200238 3303708 GRACE 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. 2200238 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 28 1 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 0 0 IN X SONDREA BERELLI CFO 5743726200 337 GRACE VILLAGE DR WINONA LAKE IN 46590 GARY HAMMAN CHAIR 0.50 0.50 X X 0 0 0 GARY HERBRUCK VICE CHAIR 0.50 0.50 X X 0 0 0 ADAM LENON SECRETARY & TREASURER 0.50 0.50 X X 0 0 0 JESSICA BRICKER BOARD MEMBER 0.50 0.50 X 0 0 0 DENNIS DUNCAN BOARD MEMBER 0.50 0.50 X 0 0 0 PASTOR MATT ELLIOTT BOARD MEMBER 0.50 0.50 X 0 0 0 CHAD HUMMEL BOARD MEMBER 0.50 0.50 X 0 0 0 CHUCK JOSEY BOARD MEMBER 0.50 0.50 X 0 0 0 DAVID KOONTZ BOARD MEMBER 0.50 0.50 X 0 0 0 MARK MCCOLLOM BOARD MEMBER 0.50 0.50 X 0 0 0 NATHAN MUELLER BOARD MEMBER 0.50 0.50 X 0 0 0 RON REDPATH BOARD MEMBER 0.50 0.50 X 0 0 0 MATTHEW TEEVAN BOARD MEMBER 0.50 0.50 X 0 0 0 JEFFRY CARROLL CEO 12.00 28.00 X 0 157210 25000 SONDREA BERELLI CFO 12.00 28.00 X 109447 0 7934 109447 157210 32934 1 0 1 0 0 77706 6351 77706 NET PATIENT AND RESIDE 623000 2362468 2362468 DEFERRED LIFE LEASE 623000 641240 641240 RENT INCOME FROM GRACE 623000 300000 300000 3303708 21092 21092 292299 3142 265326 2115 26973 1027 28000 28000 4737 4737 4737 3435243 3303708 0 53829 X 117762 117762 533251 351457 181794 19687 10628 9059 268927 145184 123743 77492 41835 35657 29990 22178 7812 415768 307468 74431 33869 33490 33490 77816 69093 8723 394186 347135 47051 634 25 609 811 32 779 194040 174636 19404 801316 721184 80132 87294 3495 83799 BAD DEBT 251318 251318 OTHER EXPENSES 25161 5491 19670 DUES & SUBSCRIPTIONS 9904 397 9507 3338847 2200238 1104740 33869 -52377 78380 21972 362300 19000 9000 26269 8849 17650 16518 15189 33498 24821400 15648566 9797825 9172834 569695 389623 251275 324809 10666498 10395811 181855 153912 6637250 6314236 3845320 3879299 460670 573062 11125095 10920509 X -462490 -525935 3893 1237 -458597 -524698 10666498 10395811 X 96396 2367 -164864 X X 0 1 X 1 0 X 78029 125311 34431 28045 77706 343522 2725873 2851823 3141982 3267431 3303708 15290817 2803902 2977134 3176413 3295476 3381414 15634339 0 0 0 15634339 334803 32721 32108 21351 21092 442075 334803 32721 32108 21351 21092 442075 6626 8473 5145 4737 24981 3138705 3016481 3216994 3321972 3407243 16101395 0.97100 0.95080 0.02750 0.04790 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 193948 193948 22546844 14123111 8423733 2056291 1525455 530836 24317 24317 9172834 DEPOSITS 21945 RENT CREDITS 138590 INTEREST RATE SWAP LIABILITY 318302 LOAN INSURANCE COSTS -11375 DEFERRED COMPENSATION PLAN OBLIGATI 105600 573062 X 3226205 -44174 -164864 -209038 3435243 0 3435243 3292306 -46541 -46541 3338847 0 3338847 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, 2020 AND 2019, 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 -164,864. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN ON LIFE INSURANCE POLICIES -46,541. 0 0 0 0 0 0 0 0 0 JEFFRY CARROLL CEO 0 157210 0 0 0 0 0 25000 0 0 0 182210 0 0 PART I, LINE 3 THE RELATED ORGANIZATION USES APPROVAL BY A COMPENSATION COMMITTEE IN DETERMINING COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B CFO ASSISTS IN PREPARATION OF THE FORM 990. THE CEO REVIEWS THE FORM 990 PRIOR TO FILING. THE FULL BOARD IS GIVEN A COPY OF THE FORM 990 UPON COMPLETION OF PREPARATION AND FILING. FORM 990, PART VI, SECTION B, LINE 12C GRACE 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 15A THE 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 19 UPON REQUEST FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 307,468. MANAGEMENT AND GENERAL EXPENSES 74,431. FUNDRAISING EXPENSES 33,869. TOTAL EXPENSES 415,768. FORM 990, PART XI, LINE 9: GAIN/LOSS ON INTEREST RATE SWAP -164,864. FORM 990, PART XII, LINE 2C THE PROCESS FOR FOR SELECTION OF INDEPENDENT ACCOUNTANT AND OVERSIGHT OF SUCH PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. GRACE VILLAGE HEALTHCARE FACILITY INC 337 GRACE VILLAGE DRIVE WINONA LAKE IN 46590 351447417 NURSING HOME/ASSISTED LIVING FACILITY IN 501C3 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 1 0 GRACE VILLAGE HEALTHCARE FACILITY INC J 300000 GRACE VILLAGE HEALTHCARE FACILITY INC M 251318