2019-11-07T14:30:59-06:00 2019-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2018-07-01 351282401 NATIONAL FELLOWSHIP BRETHREN RETIREMENT NATI 5743726200 337 GRACE VILLAGE DR WINONA LAKE IN 46590 SONDREA BERELLI CFO 5743726200 2019-11-07 1 ANGELA N CRAWFORD CPA P00573197 3176334705 2019-11-05 47.227.233.166 2019-11-07 14:03:56 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B19D0506B86ED19F1A0FD2AFEEB91090E576B51F 2018 2020-03-31 21:24:44Z GRACE VILLAGE RETIREMENT COMMUNITY SONDREA BERELLI 337 GRACE VILLAGE DR WINONA LAKE IN 46590 3593061 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. 13 12 31 85 0 0 34431 28045 3141982 3267431 46501 69613 8473 5145 3231387 3370234 0 0 0 0 999784 1041776 0 0 31986 2520899 2787750 3520683 3829526 -289296 -459292 11484582 10666498 11306173 11125095 178409 -458597 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 2255839 3267431 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. 2255839 1 1 0 0 0 0 0 0 0 0 1 1 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 31 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 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 RON REDPATH CHAIR 0.50 0.50 X X 0 0 0 GARY HERBRUCK BOARD ADVISOR 0.50 0.50 X X 0 0 0 GARY HAMMAN TREASURER 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 - TERM BEGAN JAN '19 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 - TERM BEGAN JAN '19 0.50 0.50 X 0 0 0 MATTHEW TEEVAN BOARD MEMBER 0.50 0.50 X 0 0 0 RONALD HENRY SECRETARY - TERM ENDED DEC '18 0.50 0.50 X X 0 0 0 JEFFRY CARROLL CEO 12.00 28.00 X 0 171529 38742 SONDREA BERELLI CFO 12.00 28.00 X 91831 0 16865 91831 171529 55607 0 0 1 0 0 28045 28045 NET PATIENT AND RESIDE 623000 2359750 2359750 DEFERRED LIFE LEASE 623000 607681 607681 RENT INCOME FROM GRACE 623000 300000 300000 3267431 21351 21351 271089 220135 2692 50954 -2692 48262 48262 5145 5145 5145 3370234 3267431 0 74758 113641 113641 615131 377107 238024 313004 185317 127687 28768 20510 5778 2480 19673 14026 3951 1696 55501 55501 69508 61350 8158 441529 386487 55042 3410 99 3311 575 17 558 196411 176770 19641 813863 732477 81386 88674 2574 86100 BAD DEBT 691583 691583 ALLOCATED EXPENSE 322546 294736 27810 DUES & SUBSCRIPTIONS 11393 331 11062 44316 4038 40278 3829526 2255839 1541701 31986 116027 -52377 6468 21972 22000 19000 12826 26269 20600 17650 51061 15189 24712635 14914810 10348098 9797825 678057 569695 229445 251275 11484582 10666498 222448 181855 7074375 6637250 3875690 3845320 133660 460670 11306173 11125095 X 178409 -462490 3893 178409 -458597 11484582 10666498 X -459292 -24276 -153438 X X 0 1 X 1 0 X 108019 78029 125311 34431 28045 373835 2648346 2725873 2851823 3141982 3267431 14635455 2756365 2803902 2977134 3176413 3295476 15009290 0 0 0 15009290 334851 334803 32721 32108 21351 755834 334851 334803 32721 32108 21351 755834 6626 8473 5145 20244 3091216 3138705 3016481 3216994 3321972 15785368 0.95080 0.93060 0.04790 0.06840 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 193948 193948 22449333 13436052 9013281 2055887 1478758 577129 13467 13467 9797825 SCHWAB - LIFE LEASE ACCOUNT 362059 C SCHWAB - GENERAL INVESTMENT ACCOUNT 7636 C LCB FREEDOM CD 200000 C 569695 DEPOSITS 27865 RENT CREDITS 293775 INTEREST RATE SWAP LIABILITY 153438 LOAN INSURANCE COSTS -14408 460670 X 3161654 -55142 -153438 -208580 3370234 0 3370234 3798660 -30866 -30866 3829526 0 3829526 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. 0 0 0 0 0 0 0 0 0 JEFFRY CARROLL CEO 0 171529 0 0 0 0 0 24500 0 14242 0 210271 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 XI, LINE 9: GAIN/LOSS ON INTEREST RATE SWAP -153,438. 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 751583