2019-04-24T16:52:49-05:00 2018-06-30 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2017-07-01 363582046 MONTGOMERY PLACE MONT 7737534100 5550 SOUTH SHORE DRIVE CHICAGO IL 60637 DEBORAH E HART PRESIDENT AND CEO 7737534100 2019-04-05 1 DAVID LOWENTHAL P00378651 3122071040 2019-03-21 67.59.56.31 2019-04-05 11:39:28 CD P 75C7EC6AC54A61BA087900A4F9B91D17BA572CD0 A606C39FB7BC7A08A0F8C0639BFEC96E12422869 2017 2019-02-21 02:37:17Z DEBORAH E HART 5550 SOUTH SHORE DRIVE CHICAGO IL 60637 17560854 0 X WWW.MONTGOMERYPLACE.ORG X 1987 IL THE MISSION OF MONTGOMERY PLACE IS TO ENHANCE THE QUALITY OF LIFE FOR SENIOR ADULTS BY PROVIDING RETIREMENT HOUSING AND HEALTH SERVICES IN A NURTURING ENVIRONMENT THAT SUPPORTS EACH RESIDENT. 12 12 384 312 25616 0 3713 71375 15728640 16758568 94091 334901 128473 246039 15954917 17410883 0 0 0 0 8436653 9070942 0 0 0 10347059 9924884 18783712 18995826 -2828795 -1584943 40796843 39885293 61883881 62610683 -21087038 -22725390 X THE MISSION OF MONTGOMERY PLACE IS TO ENHANCE THE QUALITY OF LIFE FOR SENIOR ADULTS BY PROVIDING RETIREMENT HOUSING AND HEALTH SERVICES IN A NURTURING ENVIRONMENT THAT SUPPORTS EACH RESIDENT. 0 0 3441438 6885502 MONTGOMERY PLACE IS A LIFE PLAN CONTINUING CARE RETIREMENT COMMUNITY. RESIDENTS ARE OFFERED MULTIPLE OPTIONS IN INDEPENDENT LIVING APARTMENT SELECTION (VIEWS AND PRICES), VARYING MEAL PLANS, RESIDENT-DRIVEN DAILY ACTIVITIES AND OUTINGS. APARTMENTS INCLUDE FULL KITCHENS AND APPLIANCES, INCLUDING IN-UNIT WASHER/DRYERS. COMMON LIVING SPACES (BOTH IN THE BUILDING AND THE PARK-LIKE OUTDOORS SPACE) ENCOURAGE COMPANIONSHIP AND SATISFACTION OF PHYSICAL, INTELLECTUAL AND PSYCHOLOGICAL NEEDS. NOTABLE SERVICES AND AMENITIES INCLUDE COMPLIMENTARY WELLNESS SERVICES, BASIC PHONE, CABLE AND INTERNET, LIGHT HOUSEKEEPING/LINEN, ENTERTAINMENT AND TRANSPORTATION SERVICES, 24-HOUR LIVE SECURITY, CALL SYSTEM IN EACH UNIT, AND ON-SITE CHAPLAIN SERVICES. 8943809 5517243 THE MONTGOMERY PLACE CCRC CAMPUS INCLUDES A 40-BED, MEDICARE-CERTIFIED SKILLED NURSING FACILITY THAT OFFERS SHORT-TERM REHABILITATION, LONG-TERM CARE WITH MEMORY CARE OPTIONS. IT IS A 5-STAR FACILITY BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AND RECOGNIZED AS ONE OF THE TOP PERFORMING FACILITIES IN THE NATION. RECOGNIZED FOR ITS SHORT-TERM REHAB OUTCOMES, IT HAS AFFILIATION WITH TWO MAJOR HOSPITAL NETWORKS IN CHICAGO. 2257067 2793952 LIFE CARE AT HOME, LLC IS A PRIVATE-DUTY HOME CARE AND HOME NURSING AGENCY PROVIDING SERVICES TO PRIVATE-PAY, FEE-FOR-SERVICE CLIENTS IN THEIR HOMES IN THE CHICAGO AREA. IT IS A NON-TAXABLE LLC, MANAGED BY ITS SOLE MEMBER MONTGOMERY PLACE. FLEXIBLY DESIGNED SERVICE PLANS MEET THE INDIVIDUAL NEEDS AND PREFERENCES OF CLIENTS. THE COMPANY ALSO PROVIDES CONTRACTED WELLNESS SERVICES TO MONTGOMERY PLACE. 1246932 1561871 AS PART OF THE LIFE PLAN COMMUNITY, ASSISTED LIVING PROGRAMS PROVIDE FOR RESIDENTS TO LIVE LIFE WITH PHYSICAL AND MEMORY SUPPORT IN THEIR OWN PRIVATE APARTMENTS WHEN THEY CAN NO LONGER LIVE INDEPENDENTLY. PROGRAMS ARE RESIDENT CENTERED AND OFFER CHOICE IN PROGRAM PARTICIPATION. 1246932 1561871 15889246 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 84 0 1 384 1 1 1 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X ARTHUR CARR CFO 7737534100 5550 SOUTH SHORE DRIVE CHICAGO IL 60637 MICHAEL M MCGARRY PRESIDENT 7.00 0.00 X X 0 0 0 GREGORY L GLEASON VICE PRESIDENT (BEG. 1/2018) 2.00 1.00 X X 0 0 0 DR CONSTANCE BONBREST VICE PRESIDENT (THRU 12/2017) 2.00 1.00 X X 0 0 0 JOHN JUROE TREASURER (THRU 12/18) 3.00 1.00 X X 0 0 0 DEBORAH C FRANCZEK SECRETARY (BEG. 1/2018) 2.00 0.00 X X 0 0 0 HELEN M JOHNSON SECRETARY (THRU 8/2017) 1.00 1.00 X X 0 0 0 MARGO BROOKS-PUGH BOARD MEMBER 2.00 0.00 X 0 0 0 SUZANNE DUTCHER BOARD MEMBER 2.00 1.00 X 0 0 0 DOUG HOFFMAN BOARD MEMBER 2.00 1.00 X 0 0 0 SUSAN LEVY BOARD MEMBER 2.00 0.00 X 0 0 0 DR CYNTHIA LINDER BOARD MEMBER (THRU 12/2017) 1.00 1.00 X 0 0 0 DR BRYON ROSNER BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN SEGAL BOARD MEMBER 3.00 1.00 X 0 0 0 SCOTT WILLIAMSON BOARD MEMBER 2.00 1.00 X 0 0 0 DEBORAH HART CEO 40.00 0.00 X 252391 0 13306 FRED SAVIANO CFO (THRU 12/2017) 40.00 0.00 X 130496 0 4524 ARTHUR CARR CFO (BEG 2/2018) 40.00 0.00 X 0 0 0 382887 0 17830 2 0 1 0 HEALTHPRO REHABILITATION 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY SERVICES 826446 SHEILA KING MARKETING & PUBLIC RELATIONS PO BOX 10425 CHICAGO IL 60610 MARKETING AND PUBLIC RELATIONS 304477 GREENBERG TRAURIG LLP 77 W WACKER DR SUITE 3100 CHICAGO IL 60601 LEGAL SERVICES 296824 SB&A 207 WEST FRANKLIN STREET RICHMOND VA 23220 MARKETING SERVICES 113753 CROWE LLP 225 W WACKER DR SUITE 2600 CHICAGO IL 60606 ACCOUNTING SERVICES 103130 5 71375 71375 INDEPENDENT LIVING 623000 6524055 6524055 HEALTH CARE 623000 5517243 5517243 HOME CARE 623000 2793952 2793952 ASSISTED LIVING 623000 1561871 1561871 AMORTIZED ENTRANCE FEES 900099 361447 361447 16758568 353953 353953 227029 130919 96110 96110 25616 70494 19052 -19052 -19052 -19052 RESIDENT GARAGE 900099 70865 70865 CAFE LIBRARY 900099 30201 30201 MANAGEMENT FEE 900099 18000 18000 30863 30863 149929 17410883 16758568 25616 555324 439859 439859 7012849 5976227 1036622 846101 673212 172889 772133 638873 133260 251942 251942 121697 121697 327473 224884 102589 341409 341409 240309 185381 54928 527275 447465 79810 73570 14640 58930 1684110 1684110 2266997 2233524 33473 237225 162014 75211 FOOD 1103264 1016555 86709 ANCILLARY 1072955 1072955 REPAIRS & MAINTENANCE 464738 411681 53057 SUPPLIES 212652 171567 41085 999268 976158 23110 18995826 15889246 3106580 0 422955 684791 518409 264109 1430390 1005865 234411 177263 56148056 35075187 22056382 21072869 8860133 8951455 109375 118750 6551416 6404960 613372 1205231 40796843 39885293 1533564 1692577 1666741 2144273 29959049 29604002 28724527 29169831 61883881 62610683 X -21147195 -22725390 60157 0 -21087038 -22725390 40796843 39885293 -1584943 -53409 0 X 0 1 X 1 0 X 850 6273 7521 3713 71375 89732 13765753 13758196 13908056 15728640 16758568 73919213 13766603 13764469 13915577 15732353 16829943 74008945 55823 3250 1150 60223 0 55823 3250 1150 60223 73948722 137457 184919 639252 305346 580982 1847956 137457 184919 639252 305346 580982 1847956 107401 107376 69917 32014 149929 466637 14011461 14056764 14624746 16069713 17560854 76323538 0.96890 0.97320 0.02420 0.01920 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2013 AMOUNT: $ 39,888. 2014 AMOUNT: $ 46,729. 2015 AMOUNT: $ 8,181. 2016 AMOUNT: $ 14,014. 2017 AMOUNT: $ 131,929. MANAGEMENT FEE - 2013 AMOUNT: $ 36,000. 2014 AMOUNT: $ 36,000. 2015 AMOUNT: $ 36,000. 2016 AMOUNT: $ 18,000. 2017 AMOUNT: $ 18,000. GUEST APARTMENT - 2013 AMOUNT: $ 31,057. 2014 AMOUNT: $ 23,257. 2015 AMOUNT: $ 25,736. VENDING REVENUE - 2013 AMOUNT: $ 456. 2014 AMOUNT: $ 1,390. X 0 3253612 3253612 21083131 19054404 2028727 27849368 13413788 14435580 3391608 2434280 957328 570337 172715 397622 21072869 INTEREST FUND - BONDS 142814 F BOND SINKING FUND 42181 F DEBT SERVICE RESERVE FUND 2055265 F BOND COVENANT 4164700 F 6404960 DUE TO AFFILATE 2684706 INDEPENDENT LIVING SECURITY DEPOSITS 499266 ENTRANCE FEES DEPOSITS 44000 ENTRANCE FEES REFUNDABLE 25343703 HEALTH CARE SECURITY DEPOSITS 379586 LCAH SECURITY DEPOSITS 218570 29169831 PART III, LINE 4: THE ORGANIZATION'S COLLECTIONS CONSIST PRIMARILY OF DONATED WORKS OF ART THAT ARE ON DISPLAY IN PUBLIC THROUGHOUT THE RETIREMENT COMMUNITY. THESE WORKS OF ART ARE USED TO PROVIDE A WELCOMING ENVIRONMENT TO RESIDENTS AND FAMILIES IN FURTHERANCE OF THE ORGANIZATION'S MISSION OF ENHANCING THE QUALITY OF LIFE FOR SENIOR ADULTS. X X X 0 0 0 0 0 0 0 1 0 DEBORAH HART CEO 215491 0 36900 0 0 0 0 0 13306 0 265697 0 0 0 PART I, LINE 7 THE ORGANIZATION PROVIDES NON-FIXED PAYMENTS TO THE ADMINISTRATOR, CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER ON AN ANNUAL BASIS. THE AMOUNT PROVIDED TO EACH INDIVIDUAL IS DETERMINED BY THE BOARD AND IS DISCRETIONARY IN NATURE. THE NON-FIXED PAYMENTS ARE REPORTED AS BONUS/INCENTIVE COMPENSATION IN PART II OF SCHEDULE J. A ILLINOIS FINANCE AUTHORITY 861091967 45204ETE8 2017-05-04 31085000 REFINANCE OF SERIES 2006 BONDS 0 0 0 A 410000 30765910 2038970 206814 615318 27904808 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 0 A 1 SCHEDULE K, PART III, LINE 2: A PORTION OF THE PARKING GARAGE IS OFFERED TO NON-RESIDENTS: THIS IS THE ONLY AREA THAT HAS PRIVATE USE. THE AVAILABILITY IS ONLY WHEN RESIDENTS DO NOT WANT TO RENT AND WHEN A RESIDENT DOES REQUEST A SPACE, THE NEWEST NON-RESIDENT RENTER IS REMOVED. THIS WAS DONE UPON INITIAL OPENING; THE ORGANIZATION DOES NOT USE THE FACILITY IN ANY WAY THAT IS NOT CONSISTENT WITH THE MISSION. FORM 990, PART III, LINE 4D - DESCRIPTION OF OTHER PROGRAM SERVICES AS PART OF THE LIFE PLAN COMMUNITY, ASSISTED LIVING PROGRAMS PROVIDE FOR RESIDENTS TO LIVE LIFE WITH PHYSICAL AND MEMORY SUPPORT IN THEIR OWN PRIVATE APARTMENTS WHEN THEY CAN NO LONGER LIVE INDEPENDENTLY. PROGRAMS ARE RESIDENT CENTERED AND OFFER CHOICE IN PROGRAM PARTICIPATION. FORM 990, PART VI, SECTION B, LINE 11B THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS REVIEWED BY THE ORGANIZATION'S MANAGEMENT AND MEMBERS OF THE FINANCE COMMITTEE OF THE MONTGOMERY PLACE BOARD OF DIRECTORS. SUBSEQUENT TO THIS REVIEW, A COPY OF THE FINAL FORM 990 IS DISTRIBUTED TO EACH MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES (INTERESTED PERSONS). THE BOARD ANNUALLY REVIEWS THE POLICY ON CONFLICTS OF INTEREST AND ASKS ALL INTERESTED PERSONS TO DISCLOSE ANY CONFLICTS THAT MIGHT EXIST. IF IT IS DETERMINED THAT AN INTERESTED PERSON HAS A CONFLICT OF INTEREST WITH THE ORGANIZATION, THE INTERESTED PERSON WILL BE ASKED TO EXCUSE THEMSELVES FROM THE DISCUSSIONS AND DECISIONS THAT ARE MADE IN REGARDS TO THE TRANSACTION WHERE A CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 THE HR COMMITTEE EVALUATES THE PERFORMANCE OF THE CEO BASED ON PRE-ESTABLISHED GOALS AND OBJECTIVES. COMPENSATION IS COMPARED TO INDUSTRY DATA FOR SIMILAR POSITIONS. THE HR COMMITTEE PREPARES FINAL RECOMMENDATION TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL. THE LAST REVIEW DATE WAS 12/31/17. THE CEO EVALUATES THE PERFORMANCE OF THE CFO AND ADMINISTRATOR BASED ON PRE-ESTABLISHED GOALS AND OBJECTIVES. COMPENSATION IS COMPARED TO INDUSTRY DATA FOR SIMILAR POSITIONS. RECOMMENDATION IS PRESENTED TO THE HR COMMITTEE FOR FINAL APPROVAL. THE LAST REVIEW DATE WAS 12/31/17. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. LIFE CARE AT HOME 5550 SOUTH SHORE DRIVE CHICAGO IL 60637 203179902 HOME CARE AND HOME NURSING SERVICES IL 2793952 684420 MONTGOMERY PLACE THE CHURCH HOME 5550 SOUTH SHORE DRIVE CHICAGO IL 60637 360915453 PASTORAL CARE IL 501(C)(3) LINE 12B, II MONTGOMERY PLACE 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0