NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCORPORATED: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCORPORATED (EIN 35-1282401)
Tax period
2018-07-01 to 2019-06-30
Filed
2019-11-07
IRS object ID
201943119349302619
Schema version
2018v3.1
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)
Return2019-11-07T14:30:59-06:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

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 Begin2018-07-01TaxPeriodBeginDt

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)
PersonSONDREA BERELLIPersonNm
Person TitleCFOPersonTitleTxt
Phone5743726200PhoneNum
Signature2019-11-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANGELA N CRAWFORD CPAPreparerPersonNm
PTINP00573197PTIN
Phone3176334705PhoneNum
Preparation2019-11-05PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address47.227.233.166IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-07IPDt
IP Tm14:03:56IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdB19D0506B86ED19F1A0FD2AFEEB91090E576B51FAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GRACE VILLAGE RETIREMENT COMMUNITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSONDREA BERELLIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,593,061GrossReceiptsAmt
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 Body13VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee31TotalEmployeeCnt
Total Volunteers85TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$34,431PYContributionsGrantsAmt
CY Contributions Grants$28,045CYContributionsGrantsAmt
PY Program Service Revenue$3,141,982PYProgramServiceRevenueAmt
CY Program Service Revenue$3,267,431CYProgramServiceRevenueAmt
PY Investment Income$46,501PYInvestmentIncomeAmt
CY Investment Income$69,613CYInvestmentIncomeAmt
PY Other Revenue$8,473PYOtherRevenueAmt
CY Other Revenue$5,145CYOtherRevenueAmt
PY Total Revenue$3,231,387PYTotalRevenueAmt
CY Total Revenue$3,370,234CYTotalRevenueAmt
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$999,784PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,041,776CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$31,986CYTotalFundraisingExpenseAmt
PY Other Expenses$2,520,899PYOtherExpensesAmt
CY Other Expenses$2,787,750CYOtherExpensesAmt
PY Total Expenses$3,520,683PYTotalExpensesAmt
CY Total Expenses$3,829,526CYTotalExpensesAmt
PY Revenues Less Expenses-$289,296PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$459,292CYRevenuesLessExpensesAmt
Total Assets BOY$11,484,582TotalAssetsBOYAmt
Total Assets EOY$10,666,498TotalAssetsEOYAmt
Total Liabilities BOY$11,306,173TotalLiabilitiesBOYAmt
Total Liabilities EOY$11,125,095TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$178,409NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$458,597NetAssetsOrFundBalancesEOYAmt
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$2,255,839ExpenseAmt
Revenue$3,267,431RevenueAmt
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$2,255,839TotalProgramServiceExpensesAmt
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
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
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 RequiredYes (1)ScheduleJRequiredInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
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
Employee31EmployeeCnt
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 Members13GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
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 BERELLI 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 (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
RON REDPATH
CHAIR0.500.50Yes (X)Yes (X)$0$0$0
GARY HERBRUCK
BOARD ADVISOR0.500.50Yes (X)Yes (X)$0$0$0
GARY HAMMAN
TREASURER0.500.50Yes (X)Yes (X)$0$0$0
ADAM LENON
SECRETARY & TREASURER0.500.50Yes (X)Yes (X)$0$0$0
JESSICA BRICKER
BOARD MEMBER0.500.50Yes (X)$0$0$0
DENNIS DUNCAN
BOARD MEMBER0.500.50Yes (X)$0$0$0
PASTOR MATT ELLIOTT
BOARD MEMBER0.500.50Yes (X)$0$0$0
CHAD HUMMEL
BOARD MEMBER - TERM BEGAN JAN '190.500.50Yes (X)$0$0$0
CHUCK JOSEY
BOARD MEMBER0.500.50Yes (X)$0$0$0
DAVID KOONTZ
BOARD MEMBER0.500.50Yes (X)$0$0$0
MARK MCCOLLOM
BOARD MEMBER0.500.50Yes (X)$0$0$0
NATHAN MUELLER
BOARD MEMBER - TERM BEGAN JAN '190.500.50Yes (X)$0$0$0
MATTHEW TEEVAN
BOARD MEMBER0.500.50Yes (X)$0$0$0
RONALD HENRY
SECRETARY - TERM ENDED DEC '180.500.50Yes (X)Yes (X)$0$0$0
JEFFRY CARROLL
CEO12.0028.00Yes (X)$0$171,529$38,742
SONDREA BERELLI
CFO12.0028.00Yes (X)$91,831$0$16,865
FieldValueIRS element (for citing)
Total Reportable Comp From Org$91,831TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$171,529TotReportableCompRltdOrgAmt
Total Other Compensation$55,607TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$28,045AllOtherContributionsAmt
Total Contributions$28,045TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT AND RESIDE623000$2,359,750$2,359,750
DEFERRED LIFE LEASE623000$607,681$607,681
RENT INCOME FROM GRACE623000$300,000$300,000
FieldValueIRS element (for citing)
Total Program Service Revenue$3,267,431TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,351TotalRevenueColumnAmt
Exclusion$21,351ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$271,089SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$220,135SecuritiesAmt
Other$2,692OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$50,954SecuritiesAmt
Other-$2,692OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$48,262TotalRevenueColumnAmt
Exclusion$48,262ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,145TotalRevenueColumnAmt
Exclusion$5,145ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,145OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,370,234TotalRevenueColumnAmt
Related Or Exempt Func Income$3,267,431RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$74,758ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$113,641TotalAmt
Management And General$113,641ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$615,131TotalAmt
Program Services$377,107ProgramServicesAmt
Management And General$238,024ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$313,004TotalAmt
Program Services$185,317ProgramServicesAmt
Management And General$127,687ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$28,768TotalAmt
Program Services$20,510ProgramServicesAmt
Management And General$5,778ManagementAndGeneralAmt
Fundraising$2,480FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$19,673TotalAmt
Program Services$14,026ProgramServicesAmt
Management And General$3,951ManagementAndGeneralAmt
Fundraising$1,696FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$55,501TotalAmt
Management And General$55,501ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$69,508TotalAmt
Program Services$61,350ProgramServicesAmt
Management And General$8,158ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$441,529TotalAmt
Program Services$386,487ProgramServicesAmt
Management And General$55,042ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,410TotalAmt
Program Services$99ProgramServicesAmt
Management And General$3,311ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$575TotalAmt
Program Services$17ProgramServicesAmt
Management And General$558ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$196,411TotalAmt
Program Services$176,770ProgramServicesAmt
Management And General$19,641ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$813,863TotalAmt
Program Services$732,477ProgramServicesAmt
Management And General$81,386ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$88,674TotalAmt
Program Services$2,574ProgramServicesAmt
Management And General$86,100ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmt
BAD DEBT$691,583$691,583
ALLOCATED EXPENSE$322,546$294,736$27,810
DUES & SUBSCRIPTIONS$11,393$11,062$331

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$44,316TotalAmt
Program Services$4,038ProgramServicesAmt
Management And General$40,278ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,829,526TotalAmt
Program Services$2,255,839ProgramServicesAmt
Management And General$1,541,701ManagementAndGeneralAmt
Fundraising$31,986FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$116,027BOYAmt
EOY-$52,377EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,468BOYAmt
EOY$21,972EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$22,000BOYAmt
EOY$19,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,826BOYAmt
EOY$26,269EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$20,600BOYAmt
EOY$17,650EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$51,061BOYAmt
EOY$15,189EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$24,712,635LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$14,914,810LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$10,348,098BOYAmt
EOY$9,797,825EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$678,057BOYAmt
EOY$569,695EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$229,445BOYAmt
EOY$251,275EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,484,582BOYAmt
EOY$10,666,498EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$222,448BOYAmt
EOY$181,855EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$7,074,375BOYAmt
EOY$6,637,250EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,875,690BOYAmt
EOY$3,845,320EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$133,660BOYAmt
EOY$460,670EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,306,173BOYAmt
EOY$11,125,095EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$178,409BOYAmt
EOY-$462,490EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
EOY$3,893EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$178,409BOYAmt
EOY-$458,597EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,484,582BOYAmt
EOY$10,666,498EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$459,292ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$24,276NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$153,438OtherChangesInNetAssetsAmt
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$108,019CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$78,029CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$125,311CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,431CurrentTaxYearMinus1YearAmt
Current Tax Year$28,045CurrentTaxYearAmt
Total$373,835TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,648,346CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,725,873CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,851,823CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,141,982CurrentTaxYearMinus1YearAmt
Current Tax Year$3,267,431CurrentTaxYearAmt
Total$14,635,455TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,756,365CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,803,902CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,977,134CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,176,413CurrentTaxYearMinus1YearAmt
Current Tax Year$3,295,476CurrentTaxYearAmt
Total$15,009,290TotalAmt

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$15,009,290PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$334,851CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$334,803CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,721CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,108CurrentTaxYearMinus1YearAmt
Current Tax Year$21,351CurrentTaxYearAmt
Total$755,834TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$334,851CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$334,803CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$32,721CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,108CurrentTaxYearMinus1YearAmt
Current Tax Year$21,351CurrentTaxYearAmt
Total$755,834TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$6,626CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,473CurrentTaxYearMinus1YearAmt
Current Tax Year$5,145CurrentTaxYearAmt
Total$20,244TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,091,216CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,138,705CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,016,481CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,216,994CurrentTaxYearMinus1YearAmt
Current Tax Year$3,321,972CurrentTaxYearAmt
Total$15,785,368TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.95080PublicSupportCY509Pct
Public Support PY5090.93060PublicSupportPY509Pct
Investment Income CY0.04790InvestmentIncomeCYPct
Investment Income PY0.06840InvestmentIncomePYPct
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$193,948OtherCostOrOtherBasisAmt
Book Value$193,948BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,449,333OtherCostOrOtherBasisAmt
Depreciation$13,436,052DepreciationAmt
Book Value$9,013,281BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,055,887OtherCostOrOtherBasisAmt
Depreciation$1,478,758DepreciationAmt
Book Value$577,129BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,467OtherCostOrOtherBasisAmt
Book Value$13,467BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,797,825TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
SCHWAB - LIFE LEASE ACCOUNT$362,059C
SCHWAB - GENERAL INVESTMENT ACCOUNT$7,636C
LCB FREEDOM CD$200,000C
FieldValueIRS element (for citing)
Total Book Value Securities$569,695TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
DEPOSITS$27,865
RENT CREDITS$293,775
INTEREST RATE SWAP LIABILITY$153,438
LOAN INSURANCE COSTS-$14,408
FieldValueIRS element (for citing)
Total Liability$460,670TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$3,161,654TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$55,142NetUnrealizedGainsInvstAmt
Other Revenue-$153,438OtherRevenueAmt
Revenue Not Reported-$208,580RevenueNotReportedAmt
Revenue Subtotal$3,370,234RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$3,370,234TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,798,660TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$30,866OtherExpensesIncludedAmt
Expenses Not Reported-$30,866ExpensesNotReportedAmt
Expenses Subtotal$3,829,526ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$3,829,526TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 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, 2019 AND 2018, 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 -153,438.
PART XII, LINE 2D - OTHER ADJUSTMENTS:GAIN ON LIFE INSURANCE POLICIES -30,866.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonJEFFRY CARROLLPersonNm
TitleCEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$171,529CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$24,500DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$14,242NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$210,271TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE RELATED ORGANIZATION USES APPROVAL BY A COMPENSATION COMMITTEE IN DETERMINING COMPENSATION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BCFO 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 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 -153,438.
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$751,583

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