2019-11-13T09:12:04-06:00 2018-12-31 381357951 PLANTE & MORAN PLLC 27400 NORTHWESTERN HIGHWAY SOUTHFIELD MI 48034 990 2018-01-01 351163961 GOLDEN YEARS HOMESTEAD INC GOLD 2607499655 3136 GOEGLEIN ROAD FORT WAYNE IN 46815 STEVE SCHAAF VP OF OPERATIONS 2607499655 2019-11-11 1 DAVID LOWENTHAL P00378651 2483522500 2019-11-04 67.59.56.31 2019-11-11 07:38:27 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D1A42FCEE5CBCA1835161BC59C75369F1B7E9248 2018 2020-01-14 16:20:31Z STEVE SCHAAF 3136 GOEGLEIN ROAD FORT WAYNE IN 46815 11907583 0 X WWW.GOLDENYEARSHOME.ORG X 1967 IN GOLDEN YEARS HOMESTEAD INC IS A RETIREMENT & HEALTH CARE CENTER. OUR NON-FOR-PROFIT, CHRISTIAN COMMITMENT HAS ALLOWED US TO HOLD OUR AGING IN REVERENCE BY PROVIDING MULTIPLE CARE OPTIONS FROM INDEPENDENT LIVING AND SHORT-TERM REHABILITATION STAYS TO LONG TERM CARE. 11 11 381 17 0 0 37328 20642 9556353 10060084 376828 156067 261964 282813 10232473 10519606 659 470 0 0 6781318 6330391 0 0 0 2590593 3107668 9372570 9438529 859903 1081077 31405376 33048108 17459009 17036235 13946367 16011873 X GOLDEN YEARS HOMESTEAD INC IS A RETIREMENT & HEALTH CARE CENTER. OUR NON-FOR-PROFIT, CHRISTIAN COMMITMENT HAS ALLOWED US TO HOLD OUR AGING IN REVERENCE BY PROVIDING MULTIPLE CARE OPTIONS FROM INDEPENDENT LIVING AND SHORT-TERM REHABILITATION STAYS TO LONG TERM CARE. 0 0 7949731 470 10334278 THE ORGANIZATION PROVIDES NURSING CARE IN A HOME AS WELL AS IN INDEPENDENT LIVING UNITS FOR THE ELDERLY. OUR NURSING FACILITY CONTAINS 111 COMPREHENSIVE CARE BEDS. RESIDENTS MAY CHOOSE BETWEEN PRIVATE AND SEMI-PRIVATE ROOMS. EIGHTY-FIVE OF THE 111 BEDS ARE MEDICAL, AND THE REMAINING 26 ARE SECURE CARE. SECURE CARE HAS BEEN DESIGNED WITH THE SPECIAL NEEDS OF ALZHEIMER'S RESIDENTS IN MIND. THIRTEEN BEDS ARE UTILIZED FOR SHORT-TERM PHYSICAL REHAB (LESS THAN 100 DAYS) WITHIN THE FACILITY. WE OFFER 44 ASSISTED LIVING ROOMS WITH 24-HOUR CARE. INDEPENDENT LIVING CONSISTS OF 68 VILLAS IN OUR FORT WAYNE, IN CAMPUS.OVER 10% OF TOTAL REVENUE WAS USED TO PROVIDE COMMUNITY BENEFITS, WHICH INCLUDE THE FOLLOWING AMOUNTS; INDIGENT CARE/CHARITY CARE $1,103,781, MEDICARE WRITE-OFFS $224,631. 7949731 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 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 0 0 1 1 0 0 0 1 13 0 1 381 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IN X SCOTT MARTIN 5745374000 1721 GREENCROFT BLVD GOSHEN IN 46526 X RAY MCINTOSH CHAIRMAN 1.00 1.00 X X 0 0 0 CYNDY ELICK VICE CHAIRMAN 1.00 1.00 X X 0 0 0 MICHAEL CARPENTER BOARD MEMBER 1.00 1.00 X 0 0 0 DALE D DEAN BOARD MEMBER 1.00 1.00 X 0 0 0 DR GEORGE BULLION BOARD MEMBER 1.00 1.00 X 0 0 0 DON SCHMIDT BOARD MEMBER 1.00 1.00 X 0 0 0 LYNETTE JOHNSON BOARD MEMBER 1.00 1.00 X 0 0 0 KENT CRANE BOARD MEMBER 1.00 1.00 X 0 0 0 KAREN WATSON BOARD MEMBER 1.00 1.00 X 0 0 0 JOE HEINS BOARD MEMBER 1.00 1.00 X 0 0 0 ANDREA VAN WYNGARDEN BOARD MEMBER 1.00 1.00 X 0 0 0 STEVE SCHAAF VP OF OPERATIONS/PRESIDENT 45.00 5.00 X 0 0 0 DALE SHENK ASSISTANT TREASURER 1.00 0.50 X 0 0 0 RACHEL APPLEGATE SECRETARY - PART YEAR 0.10 0.10 X 0 0 0 KATHY BREWTON SECRETARY 0.10 0.10 X 0 0 0 SCOTT MARTIN TREASURER 1.00 0.50 X 0 0 0 0 0 0 0 0 0 0 GREENCROFT RETIREMENT COMMUNITIES PO BOX 819 GOSHEN IN 46527 MANAGEMENT FEES 425744 IMPACT INTERIORS GROUP 13355 10TH AVE N SUITE 108 PLYMOUTH MN 55441 INTERIOR DESIGN 345003 HEALTHCARE THERAPY SERVICES 1411 WEST COUNTRY LINE RD SUITE A GREENWOOD IN 46142 THERAPY SERVICES 213129 KEVIN STEURY MANAGEMENT 8526 UNION CHAPEL ROAD FORT WAYNE IN 46845 CONSTRUCTION SERVICES 181055 K2M DESIGN INC PO BOX 72336 CLEVELAND OH 44192 ARCHITECTS 162462 7 20642 20642 CONTRACT LABOR 561000 5758823 5758823 BUILDING USE 531390 2476204 2476204 MANAGEMENT FEES 541610 1783313 1783313 RESIDENT SERVICES 623000 41744 41744 10060084 183004 183004 180000 180000 2750 0 2750 2750 2750 1361040 1387977 -26937 -26937 -26937 INCOME FROM SAMARITAN ALLIANCE 900099 46413 46413 GUEST MEALS/VENDING 722513 40334 40334 BEAUTY/BARBER SHOP INCOME 623990 7447 7447 5869 5869 100063 10519606 10334278 0 164686 470 470 5374903 5137926 236977 144258 144258 432388 432388 378842 378842 425744 425744 88456 88456 4250 4250 90655 54619 36036 59138 59138 95740 51860 43880 171554 171554 9424 9424 660056 660056 882590 679594 202996 41404 41404 TERMINATION WAIVER FEE 400000 400000 REPAIRS & MAINTENANCE 98672 62513 36159 EMPLOYEE EDUCATION 27790 27790 GIFT AND SNACK SHOP 18959 18959 33236 18936 14300 9438529 7949731 1488798 0 1093992 809084 791462 5178 635627 1030084 7256 22815 29957556 8376659 20452983 21580897 8289569 9439535 60373 71746 74114 88769 31405376 33048108 682842 1157822 157615 190712 14193282 13582291 2425270 2105410 17459009 17036235 X 13946367 16011873 13946367 16011873 31405376 33048108 X 1081077 -633043 1617472 X X 0 1 X 1 0 X 46894 39923 35897 37328 20642 180684 8199458 8646040 9104777 9810081 10334278 46094634 8246352 8685963 9140674 9847409 10354920 46275318 0 177202 224820 402022 177202 224820 402022 45873296 155219 142222 85863 199024 185754 768082 155219 142222 85863 199024 185754 768082 42223 53484 32737 5486 5869 139799 8443794 8881669 9259274 10051919 10546543 47183199 0.97220 0.97480 0.01630 0.01720 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME 1927388 1927388 25611701 7305233 18306468 1574797 1071426 503371 843670 843670 21580897 INTEREST RATE SWAP 1746175 REFUNDABLE DEPOSITS - TENANTS 7000 REFUNDABLE ENTRANCE FEES 352235 2105410 A INDIANA FINANCE AUTHORITY 351602316 2014-10-17 22800000 REFUNDING 2010 BOND ISSUANCE 0 0 0 A 9049972 22800000 209630 22590370 2014 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 1 0 0 0 0 A 0 SCHEDULE K, PART I: THE ORGANIZATION DID NOT HAVE WRITTEN POLICIES AND PROCEDURES IN PLACE GOVERNING POST-ISSUANCE COMPLIANCE FOR ITS TAX-EXEMPT BONDS FOR THE 2018 YEAR. FORM 990, PART VI, SECTION A, LINE 1 ALL COMMITTEE MEMBERS ARE BOARD MEMBERS. THE EXECUTIVE COMMITTEE INTERVIEWS NEW BOARD MEMBERS, HAS THE AUTHORITY TO MAKE EMERGENCY DECISIONS WHEN THE FULL BOARD CANNOT MEET, AND THEY MAKE RECOMMENDATIONS TO THE BOARD. OTHER COMMITTEES CAN MAKE RECOMMENDATIONS TO THE BOARD BUT DO NOT HAVE THE AUTHORITY TO ACT ON THEIR OWN. FORM 990, PART VI, SECTION A, LINE 3 GREENCROFT COMMUNITIES PROVIDES EXECUTIVE SUPPORT FOR THE BOARD GOVERNANCE FUNCTIONS, THE SERVICES OF CEO AND CFO, AND PROVIDES THE SERVICES OF THE VP OF HUMAN RESOURCES, MARKETING, INFORMATION SERVICES AND CORPORATE COMPLIANCE. THE FOLLOWING OFFICERS LISTED ON PART VII WERE COMPENSATED BY GREENCROFT COMMUNITIES. THE PRORATED PORTION OF COMPENSATION FOR SERVICES PROVIDED TO THIS ORGANIZATION IS AS FOLLOWS: STEVE SCHAAF, VP OF OPERATIONS - $169,833 DALE SHENK, ASSISTANT TREASURER - $4,245 SCOTT MARTIN, TREASURER - $34 RACHEL APPLEGATE, SECRETARY - $610 FORM 990, PART VI, SECTION A, LINE 6 CHRISTIAN MINISTRIES, INC SHALL BE THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE ORGANIZATION SHALL SELECT AND APPOINT THE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B VACANCIES IN THE BOARD MEMBERSHIP BY DEATH, RESIGNATION, OR REMOVAL, SHALL BE FILLED BY APPOINTMENT BY THE SOLE MEMBER, BASED ON NOMINATIONS FROM THE CORPORATION. NO AMENDMENT OF THE BYLAWS SHALL TAKE EFFECT UNTIL APPROVED BY THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B A FULL COPY OF THE FORM 990 WILL BE PROVIDED TO THE FINANCE (AUDIT) COMMITTEE AND REVIEWED BEFORE THE FILING OF THE RETURN. THE REMAINDER OF THE BOARD WILL BE PROVIDED A COPY OF FORM 990 TO REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE GOVERNING BODY MAINTAINS RECORDS OF INTEREST THAT MIGHT CAUSE CONFLICTS AND UPDATES THIS AT EACH QUARTERLY MEETING. IN ORDER TO AVOID CONFLICT OF INTEREST, MEMBERS OF OUR BOARD OF DIRECTORS WHO HAVE A BUSINESS RELATIONSHIP WITH THE CORPORATION WILL BE EXCUSED FROM THE MEETING DURING ANY DISCUSSION OR VOTE REGARDING THE DIRECTOR'S BUSINESS RELATIONSHIP WITH THE CORPORATION. CONFLICT OF INTEREST QUESTIONNAIRES ARE SENT OUT ANNUALLY TO ALL BOARD MEMBERS AND OFFICERS. THE QUESTIONNAIRES WERE REVIEWED BY MANAGEMENT FOR POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A: COMPENSATION FOR THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS PAID BY THE MANAGEMENT COMPANY THEREFORE, THE FORM 990 INSTRUCTIONS REQUIRE THIS TO BE ANSWERED "NO". LINE 15B: COMPENSATION FOR THE ORGANIZATION'S OTHER OFFICERS ARE PAID BY THE MANAGEMENT COMPANY THEREFORE, THE FORM 990 INSTRUCTIONS REQUIRE THIS TO BE ANSWERED "NO". FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENTS 371,482. GAIN ON CONTRACT TERMINATION 1,245,990. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. GREAT LAKES CHRISTIAN HOMES 3136 GOEGLEIN ROAD FORT WAYNE IN 46815 510139244 INDEPENDENT LIVING CENTER MI 501(C)(3) LINE 10 CHRISTIAN MINISTRIES INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0