2020-07-15T10:44:58-05:00 2019-08-31 410746749 CLIFTONLARSONALLEN LLP 1 BRONZE POINTE BELLEVILLE IL 62226 990 2018-09-01 370794402 COMMUNITY RETIREMENT INC COMM 2175432103 423 S EBERHARDT DRIVE ARTHUR IL 619111224 RICK WEGER PRESIDENT 2175432103 2020-07-15 1 JEFF PARKER P00970069 6182331200 2020-07-15 67.137.57.251 2020-07-15 08:33:15 CD P 05EFB997E327CD6BF4CE43E24B4C22289AFA48CE 09B458923962BDC3F648E71E9A05B76033A94988 2018 2021-01-29 14:40:06Z THE ARTHUR HOME RICK WEGER 423 S EBERHARDT DRIVE ARTHUR IL 619111224 4383288 0 X EBERHARDTSENIORCOMMUNITY.COM X 1962 IL TO PROVIDE SKILLED NURSING CARE AND INTERMEDIATE MEDICAL CARE TO ELDERLY 7 6 165 40 0 0 44240 118947 3817365 4165221 244152 189 77298 97320 4183055 4381677 0 0 0 0 2285840 2461303 0 0 0 1827032 2016100 4112872 4477403 70183 -95726 7110404 6875713 3558960 3438091 3551444 3437622 X TO PROVIDE SKILLED NURSING CARE AND INTERMEDIATE RESIDENT CARE TO THE ELDERLY. 0 0 3917427 4165221 COMMUNITY RETIREMENT INC OPERATES THE ARTHUR HOME, A NURSING HOME WHICH PROVIDES LICENSED SKILLED AND INTERMEDIATE MEDICAL CARE, PRIMARILY TO ELDERLY PATIENTS.THE ARTHUR HOME RECOGNIZES THAT EVERYONE'S NEEDS ARE DIFFERENT AND HAVE BEEN PROVIDING AN INDIVIDUALIZED PLAN OF CARE THAT ADDRESSES BOTH THE PHYSICAL AND EMOTIONAL WELL-BEING OF EACH SENIOR FOR OVER 50 YEARS. WHETHER YOU ARE HAVING JOINT REPLACEMENT SURGERY OR CAN NO LONGER CARE FOR YOURSELF AND NEED MEDICAL AND PERSONAL ASSISTANCE, WE CAN PROVIDE CARE FOR BOTH. WE UNDERSTAND THE OVERWHELMING CHALLENGES THAT FAMILY MEMBERS FACE WHEN CARING FOR AN AGING LOVED ONE ON THEIR OWN. THE ARTHUR HOME STAFF WILL WORK WITH THE SENIOR AND FAMILY TO DETERMINE THE BEST PLAN OF CARE FOR EACH GIVEN SITUATION. 3917427 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 22 0 165 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X LASHELLE PLANK 2175432103 423 EBERHARDT DRIVE ARTHUR IL 61911 RICK WEGER PRESIDENT 15.00 15.00 X X 0 0 0 JOHN STEWART VICE PRESIDENT 2.00 2.00 X X 0 0 0 FRED HELMUTH BOARD MEMBER 0.50 0.50 X 0 0 0 SUE STOUT SECRETARY/TREASURER 0.50 0.50 X X 0 0 0 SAM PETERSHEIM BOARD MEMBER (TERM ENDED 11/18) 0.50 0.50 X 0 0 0 DANNY POWELL BOARD MEMBER 0.50 0.50 X 0 0 0 WILLIS KUHNS BOARD MEMBER 0.50 0.50 X 0 0 0 DENNIS PLANK BOARD MEMBER 0.50 0.50 X 0 0 0 TOM STEPHENSON ADMINISTRATOR 20.00 20.00 X 93267 0 0 93267 0 0 0 0 0 0 ONR INC 1101 S CAPITAL OF TEXAS HWY BLDG G AUSTIN TX 78746 THERAPY SERVICES 600324 1 118947 10662 118947 NET SERVICE REVENUE 623000 4009221 4009221 RENT 623000 156000 156000 4165221 36047 0 36047 36047 36047 1800 1611 189 189 189 MISCELLANEOUS INCOME 623000 27321 27321 PROPERTY TAX REFUND 623000 21409 21409 TRANSPORTATION INCOME 623000 8806 8806 3737 3737 61273 4381677 4165221 0 97509 X 97729 97729 2080998 1947811 133187 18343 16399 1944 90919 81283 9636 173314 154945 18369 116561 116561 662182 662182 946 946 159095 132710 26385 84167 1620 82547 83950 73269 10681 7867 5569 2298 5479 5479 109809 109809 92155 92155 52539 52539 BAD DEBT EXPENSE 289465 289465 ASSESSMENT FEES/TAXES 140377 128151 12226 FOOD 116915 116915 PHARMACY 50410 50410 44183 2195 41988 4477403 3917427 559976 0 38738 49331 405910 340558 284249 266153 769952 603452 17063 16999 9192 7112 10213991 7148832 2990680 3065159 2594620 2526949 7110404 6875713 567962 579494 112489 83908 5427 2629 294019 300020 2197532 2085184 381531 386856 3558960 3438091 X 3254427 3064481 12768 43759 284249 329382 3551444 3437622 7110404 6875713 -95726 -18096 0 X X 0 1 X 1 0 X 14415 31646 1438943 44240 118947 1648191 3544827 3688253 3744791 3817365 4165221 18960457 3559242 3719899 5183734 3861605 4284168 20608648 0 1893296 2253395 1927213 2256712 2164891 10495507 1893296 2253395 1927213 2256712 2164891 10495507 10113141 2992 1412 1204 43614 36047 85269 2992 1412 1204 43614 36047 85269 8448 27062 21637 33684 61273 152104 3570682 3748373 5206575 3938903 4381488 20846021 0.48510 0.46960 0.00410 0.00250 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2014 AMOUNT: $ 759. 2017 AMOUNT: $ 20,786. 2018 AMOUNT: $ 27,321. TRANSPORTATION - 2014 AMOUNT: $ 1,113. 2015 AMOUNT: $ 17,381. 2016 AMOUNT: $ 12,664. 2017 AMOUNT: $ 6,968. 2018 AMOUNT: $ 8,806. MEALS - 2014 AMOUNT: $ 3,864. 2015 AMOUNT: $ 8,541. 2016 AMOUNT: $ 8,973. 2017 AMOUNT: $ 5,930. 2018 AMOUNT: $ 3,177. ACTIVITY - 2014 AMOUNT: $ 2,712. EQUIPMENT RENTAL - 2015 AMOUNT: $ 1,140. DAYCARE - 2018 AMOUNT: $ 560. PROPERTY TAX REFUND - 2018 AMOUNT: $ 21,409. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1213835 264084 1477919 8034076 6624157 1409919 1188 1188 0 700808 523487 177321 3065159 DUE FROM EBERHARDT VILLAGE (INTERCOMPANY) 2526949 2526949 ASSET RETIREMENT OBLIGATION 103671 REFUNDABLE ENTRANCE FEES 275843 INTERCOMPANY PAYABLE 7342 386856 PART IV, LINE 2B: THE ORGANIZATION MAINTAINS SAVINGS ACCOUNTS ON BEHALF OF CERTAIN NURSING FACILITY RESIDENTS. THE ORGANIZATION ACTS AS TRUSTEE OF THESE FUNDS WHICH ARE MAINTAINED FOR THE PERSONAL USE OF THOSE RESIDENTS. THE FUNDS ARE EXPENDED AT THE DIRECTION OF THE RESIDENTS. FRED HELMUTH BOARD MEMBER LINE OF CREDIT X 40000 40000 0 1 1 SAM PETERSHEIM FORMER BOARD MEMBER LINE OF CREDIT X 40000 40000 0 1 1 HENRY HERSHBERGER FORMER BOARD MEMBER LINE OF CREDIT X 40000 40000 0 1 1 FRED HELMUTH BOARD MEMBER LINE OF CREDIT X 150000 180020 0 1 1 300020 FORM 990, PART VI, SECTION A, LINE 6 THERE IS ONE CLASS OF MEMBERS. MEMBERS SHALL CONSIST OF THOSE PERSONS, FIRMS OR CORPORATIONS WHO HAVE MADE CONTRIBUTIONS OF AT LEAST $25. MEMBERS SHALL BE ENTITLED TO ONE VOTE FOR EACH $25 CONTRIBUTION MADE WITHIN THE PRECEDING TEN FISCAL YEARS. IN NO EVENT, HOWEVER, SHALL ANY MEMBER HAVE MORE THAN TEN VOTES. FORM 990, PART VI, SECTION A, LINE 7A DIRECTORS SHALL BE ELCTED BY MEMBERS. AN AFFIRMATIVE VOTE OF TWO-THIRDS OF THE MEMBERS PRESENT SHALL BE REQUIRED FOR ELECTION. FORM 990, PART VI, SECTION A, LINE 7B EACH MEMBER SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PRESENTED TO BOARD FOR APPROVAL BEFORE FILING FORM 990, PART VI, SECTION B, LINE 12C IN A SMALL ORGANIZATION AND VILLAGE SUCH AS OURS, ADMINISTRATION AND THE BOARD KNOW ALL OF THE PEOPLE THAT WORK FOR US AND THEIR RELATIONSHIPS WITH THOSE THAT PROVIDE AND CONTRACT SERVICES WITH US. DEALING WITH POTENTIAL: OUR POLICY DICTATES THAT ALL POTENTIAL OR ACTUAL CONFLICTS ARE BROUGHT TO THE ATTENTION OF THE BOARD PRESIDENT AS SOON AS POSSIBLE SO THAT SAFEGUARDS CAN BE ESTABLISHED TO PROTECT ALL PARTIES. THE PRESIDENT MAY BRING THEM TO ALL THE BOARD MEMBER'S ATTENTION DURING A REGULAR MONTHLY BOARD MEETING FOR FURTHER DISCUSSION. COVERED: ALL EMPLOYEES AND BOARD MEMBERS, AND CLOSE RELATIVES AND HUSBANDS AND WIFE'S OF SAME. THE LEVEL OF DETERMINATION OF WHETHER A CONFLICT EXITS ARE MADE AND REVIEWED BY THE ADMINISTRATOR AND/OR BOARD PRESIDENT. RESTRICTIONS ARE DEEMED TO BE APPROPRIATE DEPENDING ON THE PARTICULAR SITUATION. WHEN THE CONFLICT IS IN THE BEST INTERESTS OF THE ORGANIZATION, NO OR LIMITED RESTRICTIONS ARE APPLIED. WHEN THE CONFLICT IS NOT IN THE BEST INTEREST OF THE ORGANIZATION, THE RELATIONSHIP IS TERMINATED WITH THE ORGANIZATION OR PERSON IN CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 OTHER THAN THE ADMINSTRATOR, SALARIES AND WAGES FOR THE REST OF OUR EMPLOYEES ARE DETERMINED BY THE ADMINISTRATOR. THESE ARE INCLUDED IN THE ANNUAL OPERATING BUDGET WHICH IS REVIEWED AND APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 184,297. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 184,297. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 477,885. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 477,885. FORM 990, PART XII, LINE 2C: THE PROCESS IS CONSISTENT WITH PRIOR YEARS. EBERHARDT INDEPENDENT LIVING LLC 423 S EBERHARDT DRIVE ARTHUR IL 61911 823632396 INDEPENDENT LIVING IL 50109 391177 COMMUNITY RETIREMENT INC EBERHARDT VILLAGE INC 431 WEST PALMER ARTHUR IL 61911 743091143 PROVIDE ASSISTED LIVING CARE TO SENIORS IL 501(C)(3) LINE 7 N/A 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 0 0 0