2019-10-04T16:44:28-05:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2018-01-01 371017284 CLARK-LINDSEY VILLAGE INC CLAR 2173442144 101 WEST WINDSOR ROAD URBANA IL 61802 TIMOTHY F MAST CFO 2173442144 2019-10-04 1 JEFF PARKER P00970069 3149254300 67.137.57.251 2019-10-04 14:01:03 CD P C295692FC755D544774FE10B7A8A39D33D425111 971A8EAD25932F411DD256B5E237B6EBEA5F4AEB 2018 2020-01-14 16:20:31Z DEBRA S REARDANZ 101 WEST WINDSOR ROAD URBANA IL 61802 25913436 0 X WWW.CLARK-LINDSEY.COM X 1970 IL TO PROVIDE HOUSING AND HEALTHCARE FACILITIES/SERVICES FOR ELDERLY PERSONS 11 11 387 500 0 0 192272 419230 17752597 19456546 371987 445342 353267 333943 18670123 20655061 59476 66124 0 0 9395652 10371647 0 0 0 8828225 9505400 18283353 19943171 386770 711890 53234791 52662566 32570478 32208220 20664313 20454346 X TO PROVIDE HOUSING AND HEALTHCARE FACILITIES/SERVICES FOR ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN. 0 0 15587617 5000 19456546 ALL OF CLARK-LINDSEYS BUILDINGS ARE LOCATED ON A SINGLE SITE COMPRISED OF 27 ACRES ADJACENT TO MEADOWBROOK PARK AND THE UNIVERSITY OF ILLINOIS. INDEPENDENT LIVING OPTIONS FOR PEOPLE AGE 62 AND OVER INCLUDE 131 APARTMENTS AND 16 VILLA UNITS. RESIDENTS CAN PURCHASE A LIFE PLAN RESIDENCY CONTRACT, WHICH GUARANTEES THEM RESIDENCY IN THE APARTMENTS OF VILLAS AND ACCESS TO THE HEALTH CENTER FOR LIFE. ASSISTED LIVING CONSISTS OF 12 LICENSED BEDS IN A GREEN HOUSE HOME. THE 12 ROOM HOME PROVIDES FOR CARE IN A SMALLER HOME LIKE SETTING. PROFESSIONAL NURSING STAFF IS ON DUTY 24 HOURS A DAY. SKILLED CARE CONSISTS OF 105 LICENSED BEDS. 12 BEDS ARE IN A SECOND GREEN HOUSE HOME. 93 BEDS ARE IN MEADOWBROOK HEALTH CENTER. 37 BEDS ARE MEDICARE CERTIFIED. PROFESSIONAL NURSING STAFF IS ON DUTY 24 HOURS A DAY. IN ADDITION TO RESIDENCY AND IN-PATIENT SERVICES, CLARK-LINDSEY PROVIDES OUTPATIENT THERAPY INCLUDING PHYSICAL, OCCUPATIONAL AND SPEECH. 61124 THE MISSION OF CLARK-LINDSEY IS TO OFFER SENIOR ADULTS EXCEPTIONAL SERVICES AND LIVING ENVIRONMENTS DESIGNED TO ENGAGE THE MIND, SPIRIT, AND BODY IN WELLNESS AND COMMUNITY. THE MISSION IS FURTHERED AND SUSTAINED THROUGH YEARS OF CHARITABLE GIVING. GENEROUS DONORS HAVE PROVIDED FOR A FRIENDSHIP FUND TO ASSIST COMMUNITY MEMBERS WHO NO LONGER HAVE THE FINANCIAL RESOURCES TO PROVIDE FOR THEIR HOME AND HEALTH CARE COSTS. CLARK-LINDSEY PROVIDES CARE TO RESIDENTS WHO MEET CERTAIN CRITERIA UNDER ITS FRIENDSHIP FUND POLICY WITHOUT CHARGE OR AT REDUCED RATES. KEY ELEMENTS USED TO DETERMINE ELIGIBILITY INCLUDE A RESIDENTS DEMONSTRATED INABILITY TO PAY. CLARK-LINDSEY MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS FRIENDSHIP FUND POLICY, THE ESTIMATED COST OF THOSE SERVICES AND SUPPLIES, AND EQUIVALENT SERVICE STATISTICS. DURING THE YEARS ENDED DECEMBER 31, 2018 AND 2017, ONE RESIDENT RECEIVED FINANCIAL ASSISTANCE FROM THE FRIENDSHIP FUND. 15587617 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 28 0 387 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X DEBRA REARDANZ CEO 2173442144 101 WEST WINDSOR ROAD URBANA IL 61802 DAVID HOOD CHAIR 2.00 X X 0 0 0 ROLAND WHITE VICE-CHAIR 2.00 X X 0 0 0 MICHAEL LYON TREASURER & ASSISTANT SECRETARY 2.00 X X 0 0 0 KATHLEEN HOLDEN SECRETARY & ASSISTANT TREASURER 2.00 X X 0 0 0 TANYA GALLAGHER BOARD MEMBER 2.00 X 0 0 0 GENE GRANDONE BOARD MEMBER 2.00 X 0 0 0 JAMES GREEN BOARD MEMBER 2.00 X 0 0 0 WADE HAMPTON BOARD MEMBER 2.00 X 0 0 0 DAVE LINE BOARD MEMBER 2.00 X 0 0 0 WENDY BARTLO BOARD MEMBER 2.00 X 0 0 0 DENNIS BEARD BOARD MEMBER 2.00 X 0 0 0 ELIZABETH TYLER BOARD MEMBER (TERM ENDED 07/2018) 2.00 X 0 0 0 DEBRA S REARDANZ PRESIDENT / CEO 40.00 X 250257 0 35755 TIMOTHY P MAST VICE PRESIDENT OF FINANCE 40.00 X 122660 0 22014 RIKKI BRADY VICE PRESIDENT OF HEALTH SERVICES 40.00 X 117398 0 23342 RON WILCOX VP OF RESIDENTIAL SERVICES 40.00 X 104121 0 23769 594436 0 104880 4 0 1 0 HEALTHPRO HERITAGE LLC 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY SERVICES 1009948 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 15251 ENVIRONMENTAL SERVICES 989535 PETRY KUHNE COMPANY PO BOX 3757 CHAMPAIGN IL 61826 GENERAL CONTRACTOR 495086 ADVANCED COMMERCIAL ROOFING INC PO BOX 8280 CHAMPAIGN IL 61826 ROOFING CONTRACTOR 272986 MTK TECHNOLOGIES 701 DEVONSHIRE DR C-14 CHAMPAIGN IL 61820 IT SERVICES 176909 8 419230 105956 419230 RESIDENT SERVICES 623000 17593099 17593099 AMORTIZATION OF DEFERRED REVENUE 623000 1863447 1863447 19456546 290511 290511 5371441 5205208 11402 166233 -11402 154831 154831 38478 41765 -3287 -3287 MEAL REVENUE 900099 130001 130001 GUEST SUITE 900099 76190 76190 HAIR SALON SERVICES 900099 75411 75411 55628 55628 337230 20655061 19456546 0 779285 5000 5000 61124 61124 430686 430686 8252850 7150563 1102287 197938 92636 105302 818100 382877 435223 672073 314535 357538 28325 28325 57527 57527 82269 82269 1291257 1223142 68115 73234 73234 593269 497833 95436 386705 6552 380153 1403272 1272177 131095 77885 63635 14250 61114 52762 8352 405207 367352 37855 2526212 2290211 236001 153113 153113 DIETARY 993447 855955 137492 ANCILLARY 339980 339980 ADMINISTRATION 280870 280870 REPAIRS 274716 162151 112565 476998 449132 27866 19943171 15587617 4355554 0 1113867 958578 261312 723643 1016534 1099840 24968 24968 106107 200306 61138784 26689825 34476226 34448959 16235777 15206272 53234791 52662566 2063857 2040058 17472648 17581707 12743226 12293929 21073 13358 126500 126500 143174 152668 32570478 32208220 X 20111030 19941656 531197 490604 22086 22086 20664313 20454346 53234791 52662566 711890 -921857 0 X X 0 1 X 1 0 X 346245 311955 450517 192272 419230 1720219 14423044 15165427 15173741 17752597 19456546 81971355 38478 38478 14769289 15477382 15624258 17944869 19914254 83730052 0 0 0 83730052 206985 224769 245612 286388 290511 1254265 206985 224769 245612 286388 290511 1254265 349500 345265 333301 353267 337230 1718563 15325774 16047416 16203171 18584524 20541995 86702880 0.96570 0.96410 0.01450 0.01430 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2014 AMOUNT: $ 2,580. 2015 AMOUNT: $ 7,889. 2016 AMOUNT: $ 3,019. 2017 AMOUNT: $ 1,841. 2018 AMOUNT: $ 702. MEAL REVENUE - 2014 AMOUNT: $ 117,044. 2015 AMOUNT: $ 105,622. 2016 AMOUNT: $ 122,001. 2017 AMOUNT: $ 127,985. 2018 AMOUNT: $ 130,001. SALON SERVICES - 2014 AMOUNT: $ 60,949. 2015 AMOUNT: $ 58,149. 2016 AMOUNT: $ 57,230. 2017 AMOUNT: $ 65,269. 2018 AMOUNT: $ 75,411. GARAGE FEES - 2014 AMOUNT: $ 37,770. 2015 AMOUNT: $ 37,320. 2016 AMOUNT: $ 35,640. 2017 AMOUNT: $ 36,629. 2018 AMOUNT: $ 35,819. LAUNDRY INCOME - 2014 AMOUNT: $ 17,409. 2015 AMOUNT: $ 18,149. 2016 AMOUNT: $ 17,118. 2017 AMOUNT: $ 18,576. 2018 AMOUNT: $ 15,642. PERSONAL SERVICE ATTENDANT - 2014 AMOUNT: $ 4,184. 2015 AMOUNT: $ 3,385. 2016 AMOUNT: $ 3,436. 2017 AMOUNT: $ 1,569. 2018 AMOUNT: $ 3,465. GROCERY STORE - 2014 AMOUNT: $ 39,893. 2015 AMOUNT: $ 45,227. 2016 AMOUNT: $ 42,104. 2017 AMOUNT: $ 36,268. GUEST SUITE INCOME - 2014 AMOUNT: $ 69,671. 2015 AMOUNT: $ 69,524. 2016 AMOUNT: $ 52,753. 2017 AMOUNT: $ 65,130. 2018 AMOUNT: $ 76,190. 0 1 X 2595209 20370 -105405 56098 11369 2442707 2392134 25580 276536 84699 14342 2595209 2311535 21420 93413 20947 13287 2392134 2334249 33000 -12519 30206 12989 2311535 2255595 30000 64434 2514 13266 2334249 0.84270 0.15730 0.00000 0 0 225000 225000 50148272 19646427 30501845 2035365 1209633 825732 8351397 5833765 2517632 378750 378750 34448959 DEFERRED COMPENSATION 152668 152668 X 19692700 -921857 41765 -880092 20572792 82269 82269 20655061 19902667 41765 41765 19860902 82269 82269 19943171 PART IV, LINE 2B: THE RECORDS OF THREE COMMITTEES, INCLUDING THE MEADOWBROOK AUXILIARY FUND, THE RESIDENT COUNCIL FUND, AND THE LIBRARY FUND, ARE MAINTAINED BY CLARK-LINDSEY, BUT THE MONEY IS NOT CLARK-LINDSEY'S TO SPEND. IN ADDITION, MONEY IS MAINTAINED FOR HEALTH CENTER RESIDENTS IN A SEPARATE ACCOUNT, BUT THE MONEY IS NOT CLARK-LINDSEY'S TO SPEND. THESE FUNDS ARE INCLUDED IN CASH AND IN A LIABILITY CAPTIONED "FUNDS HELD FOR OTHERS". PART V, LINE 4: THE ARMSEY BEAUTIFICATION FUND IS A TERM ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT FOR CLARK-LINDSEY RESIDENT GROUNDS AND GARDENS. THE THOMPSON LIBRARY FUND IS A TERM ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF THE CLARK-LINDSEY RESIDENT LIBRARY. THE WEBBER EDUCATIONAL FUND IS A PERMANENT ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF CONTINUING EDUCATION FOR HEALTH CENTER STAFF. THE STEWART LIBRARY FUND IS A PERMANENT ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF THE CLARK-LINDSEY RESIDENT LIBRARY. THE KAULFERS FUND IS A BOARD DESIGNATED, QUASI ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT FOR QUALITY OF LIFE IMPROVEMENTS INCLUDING PROGRAMS AND FACILITIES ESPECIALLY DEVELOPED FOR SENIOR CITIZENS. PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: GROCERY STORE EXPENSES, NETTED WITH REVENUE 41,765. PART XII, LINE 2D - OTHER ADJUSTMENTS: GROCERY STORE EXPENSES, NETTED WITH REVENUE 41,765. 1 CHARITY CARE - FINANCIAL ASSISTANCE FOR HOME AND HEALTH CARE COSTS. 1 61124 PART I, LINE 2: CLARK-LINDSEY MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS FRIENDSHIP FUND POLICY, THE ESTIMATED COST OF THOSE SERVICES AND SUPPLIES, AND EQUIVALENT SERVICE STATISTICS X X X X X 0 1 0 0 0 0 0 0 0 DEBRA S REARDANZ PRESIDENT / CEO 235257 0 15000 0 0 0 15722 0 20033 0 286012 0 0 0 PART I, LINE 4B DEBRA S. REARDANZ RECEIVED AN EMPLOYEE MATCH PAYMENT OF $5,665 TO HER 457 PLAN IN 2018. ON JANUARY 1, 2017, CLARK-LINDSEY ENTERED INTO A SUPPLEMENTAL COMPENSATION AGREEMENT COVERING DEBRA S. REARDANZ WHICH PROVIDES FOR THE OFFICER TO RECEIVE, UPON TERMINATION OF EMPLOYMENT, PAYMENT IN CASH, IN FULL, WITHIN 90 DAYS. THE BENEFIT TO WHICH THE OFFICER IS ENTITLED TO RECEIVE BECOMES FULLY VESTED ON THE 10TH FULL CALENDAR YEAR AFTER THE GRANT DATE. IF DEATH OR DISABILITY OCCURS DURING THE PERIOD COVERED BY THE AGREEMENT, THE BALANCE OF THE ACCOUNT BECOMES 100% VESTED WITH THE BENEFIT PAYMENTS MADE TO THE BENEFICIARY. CLARK-LINDSEY'S FUNDING OF THIS BENEFIT IS BEING RECOGNIZED AS COMPENSATION COST ON AN ANNUAL BASIS AND INTENDS TO USE CASH FROM OPERATIONS TO FUND THIS OBLIGATION. AT DECEMBER 31, 2018, CLARK-LINDSEY HAS RECORDED A DESIGNATED INVESTMENT BALANCE AND A DEFERRED COMPENSATION LIABILITY OF APPROXIMATELY $18,000. PART I, LINE 7 BONUSES ARE PROVIDED BASED UPON THE ORGANIZATION'S FINANCIAL OUTCOME. A CITY OF URBANA CHAMPAIGN COUNTY ILLINOIS 376000524 NONEAVAIL 2004-05-20 5000000 IMPROVEMENTS TO HEALTHCARE FACILITY 0 0 0 B CITY OF URBANA CHAMPAIGN COUNTY ILLINOIS 376000524 NONEAVAIL 2015-12-30 10000000 IMPROVEMENTS AND ADDITIONS TO HEALTHCARE FACILITY 0 0 0 A 2319428 5000000 97185 4902815 2005 0 0 1 1 B 262273 9986267 135458 9850809 2017 0 0 1 1 A 0 1 0 0 0.00080 0.00000 0.00080 0 0 1 B 0 1 0 0 0.00080 0.00000 0.00080 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF URBANA, CHAMPAIGN COUNTY, ILLINOIS DATE THE REBATE COMPUTATION WAS PERFORMED: 03/30/2015 SCHEDULE K, PAGE 1 - ISSUE PRICE VS. TOTAL PROCEEDS OF ISSUE THERE IS A DIFFERENCE IN THE ISSUE PRICE VS. THE TOTAL PROCEEDS OF ISSUE IN THE AMOUNT OF $13,733. SARA COOK DAUGHTER OF BOARD OF DIRECTOR DAVE LINE 40556 GROSS WAGES 0 X 1 105956 SALES PROCEEDS 0 1 0 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD DIRECTS THAT AT LEAST ONE BOARD MEMBER, WHO SERVES ON THE FINANCE COMMITTEE, CONDUCT THE ANNUAL REVIEW OF THE FORM 990 AND PRESENT IT TO THE FULL BOARD PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD DIRECTS THAT OFFICERS, DIRECTOR, AND KEY EMPLOYEES ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR PREPARING QUARTERLY REPORTS TO THE BOARD FINANCE COMMITTEE THAT DISCLOSES ACTUAL, POTENTIAL OR PERCEIVED CONFLICTS OF INTEREST. IN THE EVENT THAT A CONFLICT EXISTS, THE PERSON IS REQUIRED TO RECUSE HIMSELF OR HERSELF FROM PARTICIPATING IN THE DECISION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD DIRECTS THAT THE PERSONNEL & POLICY COMMITTEE (P&PC) CONDUCT THE PRESIDENT'S ANNUAL PERFORMANCE REVIEW AND DEVELOP SALARY AND COMPENSATION RECOMMENDATIONS FOR FULL BOARD APPROVAL. A COMPARATIVE ANALYSIS OF THE PRESIDENT'S ANNUAL COMPENSATION IS REVIEWED BY THE P&PC USING SOURCES SUCH AS INDEPENDENT SALARY SURVEYS, REVIEW OF FORM 990S AND OTHER INFORMATION AS IT IS AVAILABLE. TO ENSURE THE INDEPENDENCE AND OBJECTIVITY OF THE COMPARATIVE REVIEW, THE DATA AND ANALYSIS IS PREPARED BY SOMEONE OTHER THAN THE PRESIDENT. IN REGARDS TO OTHER OFFICERS AND KEY EMPLOYEES, THE PRESIDENT PERFORMS A SIMILAR PROCESS USING INDEPENDENT SALARY SURVEY DATA TO DETERMINE COMPENSATION. THESE PROCESSES WERE LAST UNDERTAKEN IN 2018. FORM 990, PART VI, SECTION C, LINE 19 CLARK-LINDSEY VILLAGE, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. FORM 990, PART XII, LINE 2C THE PROCESS FOR REVIEW AND OVERSIGHT OF THE AUDIT PROCESS IS CONSISTENT WITH PRIOR YEARS.