2020-02-13T14:30:22-06:00 2019-03-31 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 462400857 990 2018-04-01 352187477 INDIANA MASONIC HOME INC INDI 3177366141 690 STATE STREET FRANKLIN IN 46131 MIKE SPENCER CEO 3177366141 2020-02-11 1 SCOTT A SCHUSTER P00019243 3175802000 2020-02-11 64.132.79.19 2020-02-11 16:56:59 ES P F428415DB86C89D69CF6427FC3106D4267BD1836 1341E3BBBC0C6DC6CCBC0E83A071D0751A065351 2018 2020-09-22 18:59:49Z MIKE SPENCER 690 STATE STREET FRANKLIN IN 46131 16406974 0 X WWW.COMPASSPARK.ORG X 2003 IN TO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA. 19 17 377 39 0 0 17970296 4970913 6661785 7612889 380994 450968 2067702 293340 27080777 13328110 0 0 0 0 6080132 6627429 0 0 0 5940189 6028491 12020321 12655920 15060456 672190 114250246 100286234 19088922 33411177 95161324 66875057 TO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA. 0 0 9011714 7612889 PROVIDE CARE FOR THE AGED. 9011714 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 268 0 1 377 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 17 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 IN X MIKE SPENCER 3173461404 690 STATE STREET FRANKLIN IN 46131 RODNEY A MANN BOARD MEMBER 1.00 0.30 X 0 0 0 CARL E CULMANN GRAND MASTER 1.00 40.00 X X 0 0 0 RICHARD J ELMAN GRAND SECRETARY 1.00 41.00 X X 0 98007 0 KENNETH ROY DEPUTY GRAND MASTER 1.00 6.00 X X 0 0 0 JEFFREY P ZARING BOARD MEMBER 1.00 40.00 X 0 110839 0 JEFFREY K SAUNDERS PRESIDENT 1.00 X X 0 0 0 LORETTA RIEHL BOARD MEMBER 1.00 X 0 0 0 DENNIS D SHEETS VICE PRESIDENT 1.00 X X 0 0 0 GARY W BRINLEY TREASURER 1.00 6.00 X X 0 0 0 RONALD L BUSKIRK BOARD MEMBER 1.00 X 0 0 0 RICHARD L LENTZ BOARD MEMBER 1.00 5.00 X 0 0 0 WILLIAM S REINERS BOARD MEMBER 1.00 X 0 0 0 ROBERT D HEUCHAN BOARD MEMBER 1.00 1.00 X 0 0 0 PAUL C ST PIERRE BOARD MEMBER 1.00 X 0 0 0 JERALD L MILLER BOARD MEMBER 1.00 X 0 0 0 WILLIAM J LUDLOW BOARD MEMBER 1.00 X 0 0 0 MICHAEL GASSER BOARD MEMBER 1.00 X 0 0 0 CRAIG WITT BOARD MEMBER 1.00 X 0 0 0 ALEX D'ETTORE BOARD MEMBER 1.00 X 0 0 0 SHERRI SCROGHAM CFO 40.00 X 111356 0 0 MIKE SPENCER CEO 40.00 X 207923 0 16800 319279 208846 16800 2 0 1 0 MEDOVA HEALTHCARE FINANCIAL GROUP LLC PO BOX 26485 OKLAHOMA CITY OK 731260485 HEALTHCARE SERVICES 1927966 DIRECT SUPPLY INC PO BOX 88201 MILWAUKEE WI 532880201 REPAIR, MAINTENANCE & SUPPLY 1057031 SHIEL SEXTON COMPANY INC 902 N CAPITAL AVENUE SUITE 200 INDIANAPOLIS IN 46204 CONSTRUCTION SERVICES 1040324 HTS IN X INC 1411 W COUNTY LINE ROAD SUITE A GREENWOOD IN 46142 THERAPY SERVICES 541146 ESCO TECHOLOGIES LLC 7320 YANKEE ROAD LIBERTY TOWNSHIP OH 45044 TELECOMMUNICATIONS CONSULTING 264194 6 555477 20250 3648604 746582 4970913 RESIDENCE SERVICES 623000 4388055 4388055 HEALTH CARE FACILITY 623000 1735974 1735974 MANAGEMENT FEES 623000 628890 628890 MANAGEMENT SERVICES 623000 470660 470660 HOME HEALTH CARE 623000 389310 389310 7612889 185775 185775 36000 0 36000 36000 36000 3302221 3037028 265193 265193 265193 37559 20250 41836 -4277 -4277 OTHER INCOME 623990 242994 242994 TAX REFUND 900099 18623 18623 261617 13328110 7612889 0 744308 320492 320492 4582563 3555872 1026691 24457 19754 4703 1340011 1001453 338558 359906 263064 96842 37603 37603 72995 72995 41558 41558 151721 2600 149121 109559 9546 100013 256371 38607 217764 110770 6451 104319 43052 26161 16891 230966 168102 62864 405553 295170 110383 493501 493501 ALLOCATION FOR FRATERNI 1107199 1107199 UTILITIES 938748 773724 165024 OUTSIDE SERVICES 604017 595201 8816 REPAIRS & MAINTENANCE 439451 345155 94296 985427 766052 219375 12655920 9011714 3644206 0 1694135 2456721 12750000 290865 491921 715646 50964 35120 2622 10195415 9537208 1283189 658207 7012585 7597878 240000 263678 90727452 88265497 114250246 100286234 2356312 3428971 4488139 4460505 10650980 24196901 1593491 1324800 19088922 33411177 X -6704304 -21400380 99682288 88275437 2183340 0 95161324 66875057 114250246 100286234 X 672190 36574 -28995031 X X 0 1 X 1 0 X 5044977 9011011 4769063 17970296 4970913 41766260 14594427 8003403 8449007 6661785 7612889 45321511 19639404 17014414 13218070 24632081 12583802 87087771 3837820 7835817 3650638 15648772 3648604 34621651 481426 1837593 2319019 3837820 7835817 3650638 16130198 5486197 36940670 50147101 207868 1688560 1876103 1951489 221775 5945795 207868 1688560 1876103 1951489 221775 5945795 303248 127416 84046 273856 261617 1050183 20150520 18830390 15178219 26857426 13067194 94083749 0.53300 0.51420 0.06320 0.05390 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 303,248. 2015 AMOUNT: $ 127,416. 2016 AMOUNT: $ 84,046. 2017 AMOUNT: $ 273,856. 2018 AMOUNT: $ 261,617. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7767526 7231061 536465 2427889 2306147 121742 658207 INTEREST IN NET ASSETS OF FOUNDATION 86041161 BENEFICIAL INTEREST IN TRUST 2200712 RECEIVABLE FROM DAVIESS COUNTY HOSPITAL 23624 88265497 RESIDENT DEPOSITS 705384 REFUNDABLE ADVANCE FEES 619416 1324800 X 13364962 36574 41836 78410 13286552 41558 41558 13328110 12656198 41836 41836 12614362 41558 41558 12655920 PART X, LINE 2: THE HOME IS EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER SECTIONS 501(C)(3) OF THE INTERNAL REVENUE CODE THOUGH IT IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE INTERNAL REVENUE CODE. IN ADDITION, THE HOME HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME TAX FOR THE YEARS ENDED MARCH 31, 2019 AND 2018. THE HOME FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION RETURNS. IT IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR FISCAL YEARS BEFORE 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SPECIAL EVENT 41,836. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SPECIAL EVENT 41,836. GOLF OUTING 57809 20250 37559 41836 57809 20250 37559 41836 41836 -4277 X 0 0 0 0 0 0 0 0 0 MIKE SPENCER CEO 207923 0 0 0 0 0 0 0 16800 0 224723 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT WILL REVIEW THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C CEO SOLICITS INFORMATION ANNUALLY ON POTENTIAL CONFLICTS OF INTEREST. INFORMATION IS REVIEWED BY CEO AND PRESIDENT OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS APPROVED BY THE BOARD AND DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. ANNUAL STATE DISCLOSURE STATEMENT IS AVAILABLE TO ALL POTENTIAL NEW RESIDENTS. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS -3,648,604. CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION 2,078,961. CHANGE IN BENEFICIAL INTEREST IN TRUST -20,548. TRANSFER OF ASSETS TO INDIANA MASONIC HOME, INC. -27,404,840. FORM 990, PART XII, LINE 2C THE PROCESS HAD NOT CHANGED. FORM 990, PART VI, SECTION B, LINE 14 RECORD RETENTION AND DESTRUCTION POLICY MEDICAL RECORDS OF THE ORGANIZATION ARE GOVERNED BY A RETENTION AND STORAGE POLICY, AS WELL AS A CLOSED CHART POLICY. INDIANA MASONIC HOME FOUNDATION INC 525 N ILLINOIS ST INDIANAPOLIS IN 46204 351091997 PROVIDE SUPPORT TO THE INDIANA MASONIC HOME IN 501(C)(3) LINE 12D, III-O N/A 0 IMH REALTY INC 690 STATE STREET FRANKLIN IN 46131 364513246 PROVIDE PROPERTY TO ENSURE THE RESIDENTIAL AND MEDICAL CARE FOR THE ELDERLY IN 501(C)(2) N/A 0 GRAND LODGE FREE AND ACCEPTED MASONS OF THE STATE OF INDIANA 525 N ILLINOIS ST INDIANAPOLIS IN 46204 350300010 FRATERNAL ORGANIZATION IN 501(C)(8) & (C)(10) N/A 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 IMH REALTY I 27404840 FAIR MARKET VALUE INDIANA MASONIC HOME FOUNDATION C 3648604 CASH