2018-11-15T13:18:42-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 1 BRONZE POINTE BELLEVILLE IL 62226 990 2017-01-01 455475166 CHRISTIAN LIVING COMMUNITIES CHRI 7209743555 7000 E BELLEVIEW AVENUE NO 150 GREENWOOD VILLAGE CO 80111 BRYON CHILDS CFO 7209743555 2018-11-15 1 JEFF PARKER P00970069 6182331200 2018-11-15 67.137.57.251 2018-11-15 12:08:36 CS P 22B95CEE0D9897181ECB15AC345961CB2AA02439 0FD4EF385CD5022A6BCA3F6D48F1B56E012374BF 2017 2019-02-21 02:37:17Z GREG TERRY 7000 E BELLEVIEW AVENUE NO 150 GREENWOOD VILLAGE CO 80111 7491087 0 X WWW.CHRISTIANLIVINGCOMMUNITIES.ORG X 2014 CO CHRISTIAN LIVING COMMUNITIES MINISTERS TO SENIOR ADULTS THROUGH A CONTINUUM OF SERVICES AND CARE THAT REFLECTS CHRISTIAN LOVE, RESPECT AND COMPASSION, AND THAT ENRICHES THE QUALITY AND DIGNITY OF LIFE FOR EACH INDIVIDUAL. 16 15 94 17 0 0 0 770429 4576124 6472116 0 20447 128909 171895 4705033 7434887 0 0 0 0 3553474 4370197 0 0 0 1319064 2704698 4872538 7074895 -167505 359992 6550930 9169367 816339 1610163 5734591 7559204 X CHRISTIAN LIVING COMMUNITIES, EMBRACING OUR CHRISTIAN HERITAGE AND USING OUR EXPERTISE AND EXPERIENCE, ENRICHES THE QUALITY AND LIVING EXPERIENCES FOR SENIORS AND THEIR FAMILIES THROUGH OVERSIGHT OF OUR RETIREMENT COMMUNITIES, THROUGH AFFILIATED BUSINESS OPERATIONS AND SERVICES, THROUGH OFFERING SENIORS ACCESS TO HOUSING THEY CAN AFFORD, AND THROUGH INFORMATION AND EDUCATIONAL OPPORTUNITIES FOR SENIORS AND THEIR SERVICE PROVIDERS. 0 0 4237859 4624552 CHRISTIAN LIVING COMMUNITIES (CLC) PROVIDES ADMINISTRATIVE SERVICES FOR THE OTHER ENTITIES. 1812592 1847564 CLC DAYSPRING VILLA, LLC PROVIDES ASSISTED LIVING SERVIES TO SENIOR ADULTS 6050451 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 1 235 0 94 1 0 0 0 0 0 1 1 0 0 0 0 X 16 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X BRYON CHILDS 7209743555 7000 EAST BELLEVIEW AVE STE 150 GREENWOOD VILLAGE CO 80111 GREG TERRY TRUSTEE - BOARD CHAIR 1.00 X X 0 0 0 WILLIAM PICHE TRUSTEE - VICE CHAIR 1.00 X X 0 0 0 ERIN COOK TRUSTEE 1.00 X 0 0 0 GENE DEKRUIF TRUSTEE 1.00 X 0 0 0 KAREN MEYER TRUSTEE 1.00 X 0 0 0 DAVID SAMSON TRUSTEE 1.00 X 0 0 0 ED SCHANS TRUSTEE 1.00 X 0 0 0 PEGGY FURGASON TRUSTEE 1.00 X 0 0 0 GREG HAM TRUSTEE 1.00 X 0 0 0 JOE VANDE GRIEND TRUSTEE 1.00 X 0 0 0 PAUL JOHNSON TRUSTEE 1.00 X 0 0 0 ERIC KEESEN TRUSTEE 1.00 X 0 0 0 SUE KEESEN TRUSTEE 1.00 1.00 X 0 0 0 MARK WOLF TRUSTEE 1.00 X 0 0 0 DIANNE MCCALLISTER TRUSTEE 1.00 X 0 0 0 TERENCE ROGERS CEO 20.00 20.00 X X 403179 0 14057 BRYON CHILDS CFO 20.00 20.00 X 192084 0 22648 CAMILLE BURKE CAPPELLA PRESIDENT 40.00 X 198834 0 17611 JILL VITALE-AUSSEM VP OF OPERATION CLS 40.00 X 172844 0 11 JEFFREY TROUT VP OF FINANCE CLS 40.00 X 142778 0 22658 JAN ROTH ED HUMAN RESOURCES 40.00 X 155185 0 9805 PAMELA SULLIVAN VP OF ENGAGMENT 40.00 X 155625 0 0 BRADLEE BOATRIGHT CCRC EXECUTIVE DIRECTOR 40.00 X 152993 0 7005 THEODORE AHLEM ED OF ETHICS AND COMPLIANCE 40.00 X 137080 0 18221 1710602 0 112016 10 0 1 0 BATEMAN COMMUNITY LIVING PO BOX 102289 ATLANTA GA 30368 FOOD SERVICES 7008705 PINKARD CONSTRUCTION 9195 S 6TH AVE LAKEWOOD CO 80125 CONSTRUCTION 2098781 KAISER PERMANENTE DEPT 1697 DENVER CO 80274 HEALTHCARE SERVICES 1595586 PREMIERE REHAB PO BOX 5700 PORTLAND OR 97228 HEALTHCARE SERVICES 1471069 PINNACOL ASSURANCE PO BOX 561434 DENVER CO 80256 WORKER COMP 347373 36 153225 617204 770429 MANAGEMENT FEES 541610 3913546 3913546 RESIDENT AND CLIENT SE 623000 1847564 1847564 REIMBURSED EXPENSES CL 623000 711006 711006 6472116 8897 8897 41923 0 41923 41923 41923 11550 0 11550 11550 11550 33750 153225 56200 -22450 -22450 MISC INCOME 623000 68858 68858 PHONE INCOME 623000 68839 68839 GUEST & EMPLOYEE MEALS 623000 14725 14725 152422 7434887 6472116 0 192342 1078956 922723 156233 2484588 2124820 359768 259821 222199 37622 300234 256760 43474 246598 210891 35707 273793 234148 39645 26514 22675 3839 26750 22877 3873 471601 403313 68288 112489 96201 16288 197991 169322 28669 402400 344132 58268 153128 130955 22173 16274 13918 2356 13457 11508 1949 63358 54184 9174 MISC ADMIN EXPENSES 603600 516199 87401 DIETARY 205958 176135 29823 DUES 52565 44954 7611 OTHER EXPENSES 17453 14926 2527 67367 57611 9756 7074895 6050451 1024444 0 5655183 6838395 89893 189357 16530 241200 95196 13882 3900 81314 26741 856678 785424 935682 6550930 9169367 791400 1511377 24939 98786 816339 1610163 X 5734591 7339042 220162 5734591 7559204 6550930 9169367 X 359992 27598 1437023 X X 0 1 X 1 0 X 770429 770429 4576124 6472116 11048240 4576124 7242545 11818669 8000 8000 0 8000 8000 11810669 46905 50820 97725 46905 50820 97725 82004 152422 234426 4705033 7445787 12150820 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISC INCOME - 2016 AMOUNT: $ 63,877. 2017 AMOUNT: $ 68,858. GUEST MEALS - 2016 AMOUNT: $ 18,127. 2017 AMOUNT: $ 14,725. PHONE INCOME - 2017 AMOUNT: $ 68,839. 9519 9519 85677 13882 71795 81314 INVESTMENT IN AFFILIATES 199226 C INVESTMENTS - OTHER 657452 C 856678 DUE FROM AFFILIATES 361137 BOARD DESIGNATED FUNDS 512977 CONSTRUCTION IN PROGRESS 61568 935682 SECURITY DEPOSITS 33249 INTERCOMPANY PAYABLES 65537 98786 X PART X, LINE 2: CHRISTIAN LIVING COMMUNITIES AND CHRISTIAN LIVING NEIGHBORHOODS ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION FOR STATE LAW. HOWEVER, THE CHRISTIAN LIVING COMMUNITIES AND CHRISTIAN LIVING NEIGHBORHOODS ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THESE ORGANIZATIONS ARE NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. AGED TO PERFECTIO 69200 59450 9750 11000 350 11250 EARTHNE VESSEL DINNER 117775 93775 24000 28800 4800 186975 153225 33750 39800 350 16050 56200 -22450 X X X X 0 1 0 0 0 0 0 0 0 TERENCE ROGERS CEO 298438 0 28388 0 76353 0 0 0 14057 0 417236 0 0 0 BRYON CHILDS CFO 155168 0 31286 0 5630 0 0 0 22648 0 214732 0 0 0 CAMILLE BURKE CAPPELLA PRESIDENT 165305 0 27078 0 6451 0 0 0 17611 0 216445 0 0 0 JILL VITALE-AUSSEM VP OF OPERATION CLS 149544 0 17422 0 5878 0 0 0 11 0 172855 0 0 0 JEFFREY TROUT VP OF FINANCE CLS 122002 0 15752 0 5024 0 0 0 22658 0 165436 0 0 0 JAN ROTH ED HUMAN RESOURCES 126955 0 23069 0 5161 0 0 0 9805 0 164990 0 0 0 PAMELA SULLIVAN VP OF ENGAGMENT 128777 0 22148 0 4700 0 0 0 0 0 155625 0 0 0 BRADLEE BOATRIGHT CCRC EXECUTIVE DIRECTOR 136870 0 16069 0 54 0 0 0 7005 0 159998 0 0 0 THEODORE AHLEM ED OF ETHICS AND COMPLIANCE 90140 0 16388 0 30552 0 3706 0 14515 0 155301 0 0 0 PART I, LINE 4B TERENCE ROGERS - $21,298 JAN ROTH - $3,909 PAMELA SULLIVAN - $3,820 BRYON CHILDS - $5,002 JILL VITALE-AUSSEM - $4,375 CAMILLE BURKE - $5,223 JEFFREY TROUT - $3,844 GREG HAM BOARD MEMBER / OWNER OF INSURANCE AGENCY 320000 INSURANCE SERVICES 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 GOES THROUGH AN INTERNAL REVIEW BY THE CFO. A COPY OF THE RETURN WILL BE PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS FOR COMMENTS AND CLARIFICATION. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, EACH DIRECTOR AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS REVIEWS AND SIGNS A STATEMENTS WHICH AFFIRMS THAT THEY A) HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, B) HAVE READ AND UNDERSTAND THE POLICY, C) HAVE AGREED TO COMPLY WITH THE POLICY, AND D) UNDERSTAND THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT INORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S CEO'S COMPENSATION WAS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IN 2016 DERIVED FROM COMPARABILITY DATA PUT TOGETHER FROM VARIOUS THIRD-PARTY SOURCES PURCHASED BY THE ORGANIZATION. OTHER OFFICERS AND KEY EMPLOYEES SALARIES WERE DETERMINED BY THE PRESIDENT/CEO WITH INFORMATION PUT TOGETHER FROM VARIOUS THIRD-PARTY SOURCES PURCHASED BY THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS AND FORM 990 RETURNS ARE MADE AVAILABLE ONLINE AND UPON REQUEST. THE ORGANIZATION HAS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES AVAILABLE TO THE PUBLIC AT ITS EXECUTIVE OFFICE. FORM 990, PART XI, LINE 9: EQUITY TRANSFER 1,437,023. FORM 990, PART XII, LINE 2C: THE PROCESS IS CONSISTENT WITH PRIOR YEARS. CLC DAYSPRING VILLA LLC 7000 E BELLEVIEW AVENUE STE 150 GREENWOOD VILLAGE CO 80111 384008133 ASSISTED LIVING CO 1864711 276967 CHRISTIAN LIVING COMMUNITIES CHRISTIAN LIVING NEIGHBORHOODS 7000 E BELLEVIEW AVE STE 150 GREENWOOD VILAGE CO 80111 841176989 RETIRMENT COMMUNITY CO 501(C)(3) LINE 11 CHRISTIAN LIVING COMMUNITIES 1 CHRISTIAN LIVING SERVICES 7000 E BELLEVIEW AVE STE 150 GREENWOOD VILLAGE CO 80111 371753293 CONSULTING FOR SENIOR LIVING CO CHRISTIAN LIVING COMMUNITIES C 1337855 1788918 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 CHRISTIAN LIVING NEIGHBORHOODS L 140605 DONATION RECEIVED AT PARENT LEVEL CHRISTIAN LIVING NEIGHBORHOODS R 800000 EQUITY TRANSFER AMOUNT CHRISTIAN LIVING NEIGHBORHOODS S 2400000 EQUITY TRANSFER AMOUNT CHRISTIAN LIVING NEIGHBORHOODS Q 37725503 A/P TRANSFER LEDGER