2018-07-25T15:04:36-05:00 2017-12-31 480958002 MILLER HAVILAND KETTER PC PA 1901 W 47TH PLACE SUITE 204 WESTWOOD KS 66205 990 2017-01-01 431084953 BEAUTIFUL SAVIOR HOME BEAU 8163310781 1003 S CEDAR STREET BELTON MO 64012 BRENDA BUFORD ADMINISTRATOR 8163310781 2018-07-25 1 JAMES P KETTER P00165162 9134322727 2017 2022-09-23 18:48:47Z BRENDA BUFORD 1003 S CEDAR STREET BELTON MO 64012 8434339 0 X WWW.BEAUTIFULSAVIORLUTHERANHOME.ORG X 1978 MO TO PROVIDE QUALITY CARE FOR SENIOR CITIZENS AND OTHERS IN NEED OF SUPERVISION AND TO IMPROVE EACH RESIDENT'S QUALITY OF LIFE. 9 9 243 5 0 0 0 0 8867560 8434339 0 0 0 0 8867560 8434339 0 0 0 0 4095368 4191055 0 0 0 4196270 4042222 8291638 8233277 575922 201062 5520149 5639852 2252813 2171455 3267336 3468397 TO PROVIDE QUALITY CARE FOR SENIOR CITIZENS AND OTHERS IN NEED OF SUPERVISION AND TO IMPROVE EACH RESIDENT'S QUALITY OF LIFE. 0 0 6272803 8434339 OPERATION OF 126-BED LONG-TERM CARE AND 50-BED RESIDENTIAL CARE NURSING HOME FOR PRIVATE PAY INDIVIDUALS AND FOR MEDICAID RECIPIENTS AT RATES DETERMINED BY THE STATE OF MISSOURI. 6272803 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 18 0 1 243 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X BRENDA BUFORD 8163310781 1003 S CEDAR STREET BELTON MO 64012 ROBERT MUELLER DIRECTOR / PRESIDENT 1.00 X X 0 0 0 TOM FITZGERALD DIRECTOR 1.00 X 0 0 0 CAROL BEHM DIRECTOR / ASSISTANT SECRE 1.00 X X 0 0 0 RICHARD NOLTE DIRECTOR / SECRETARY 1.00 X X 0 0 0 PEGGY POE DIRECTOR 1.00 X 0 0 0 DALE HEIL DIRECTOR / VICE PRESIDENT 1.00 X X 0 0 0 PEGGY NOAH DIRECTOR 1.00 X 0 0 0 BRENDA BUFORD ADMINISTRATOR 40.00 X X 137811 0 0 PASTOR DAVID M ROLF DIRECTOR 1.00 X 0 0 0 137811 0 0 1 0 0 0 AEGIS PO BOX 8103 FORT SMITH AR 72902 THERAPY 539801 GRACETEAM LLC 10713 W 128TH CT OVERLAND PARK KS 66213 MANAGEMENT 393137 HEALTHCARE SERVICES GROUP 3220 TILLMAN DRIVE STE 300 BENSALEM PA 19020 LAUNDRY & HOUSEKEEPING 223984 3 PATIENT REVENUES 623000 8434339 8434339 8434339 8434339 8434339 0 0 X 147300 147300 3552889 2874435 678454 26209 22278 3931 180644 153547 27097 284013 241411 42602 403329 403329 11652 11652 25621 25621 1023667 865050 158617 44171 44171 13798 13798 279872 237891 41981 23915 23915 60528 51449 9079 196722 167214 29508 144422 122759 21663 SUPPLIES 823020 697888 125132 MISSOURI BED TAX 528430 528430 BAD DEBT EXPENSE 242820 242820 REPAIRS & MAINTENANCE 118734 118734 101521 67631 33890 8233277 6272803 1960474 0 2293785 1955879 1027791 1323643 12700 13636 44874 17996 7222250 4893552 2133303 2328698 7696 5520149 5639852 663921 602823 1490806 1410109 98086 158523 2252813 2171455 X 3267336 3468397 3267336 3468397 5520149 5639852 201062 0 X X 0 0 0 X 7746086 8566557 8585982 8867560 8434339 42200524 7746086 8566557 8585982 8867560 8434339 42200524 0 0 0 42200524 8112 8112 7754198 8566557 8585982 8867560 8434339 42208636 0.99980 0.99970 0.00000 X 412621 412621 5550101 3932871 1617230 1259528 960681 298847 2328698 DEPOSITS 8979 PATIENT CREDIT BALANCES 149544 158523 X PART X, LINE 2: THE HOME IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW AND THEREFORE HAS MADE NO PROVISION FOR INCOME TAXES IN THE ACCOMPANYING FINANCIAL STATEMENTS; IT IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. INCOME TAX RETURNS FILED BY THE HOME ON FORM 990 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) FOR THREE YEARS AFTER THE DATE FILED, WITH THE RESULT THAT YEARS 2016, 2015, 2014 AND 2013 REMAIN OPEN AS OF NOVEMBER 15, 2017, ALTHOUGH NO RETURNS HAVE BEEN SELECTED FOR EXAMINATION BY THE IRS. MANAGEMENT HAS EVALUATED TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE HOME'S TAX RETURNS WITH ASSISTANCE FROM THE HOME'S TAX PREPARER TO DETERMINE WHETHER ITS TAX POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED BY APPLICABLE TAXING AUTHORITIES; LIKELY TAX POSITIONS ARE REPORTED IN THESE FINANCIAL STATEMENTS, AND MANAGEMENT IS NOT AWARE OF ANY UNLIKELY TAX POSITIONS, WITH THE RESULT THAT NO UNLIKELY TAX POSITIONS ARE REPORTED. FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT SERVICES FOR BEAUTIFUL SAVIOR HOME WERE PROVIDED DURING 2017 BY GRACETEAM LLC UNDER THE TERMS OF A MANAGEMENT AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11B AN OUTSIDE INDEPENDENT CPA FIRM PREPARES AND REVIEWS THE FORM 990. PRIOR TO FILING, THE FORM 990 IS ALSO REVIEWED BY THE ADMINISTRATOR AND IS PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW AND COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. ANY CONFLICTS ARE EVALUATED BY THE BOARD. WHEN THERE IS A CONFLICT OF INTEREST: THE DIRECTOR OR OFFICER THAT HAS A CONFLICT WILL EXCUSE THEMSELVES FROM THE MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS REVIEWS THE EXECUTIVE DIRECTORS COMPENSATION USING COMPARABLE DATA AND DOCUMENTS THEIR DECISION PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE BEAUTIFUL SAVIOR HOME MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 865,050. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 865,050. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 97,141. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 97,141. DATA PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 61,476. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 61,476. FORM 990, PART XII, LINE 2C: EACH YEAR THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE REVIEW OF FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. FORM 990 ELECTION SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION BEAUTIFUL SAVIOR HOME 1003 S. CEDAR STREET BELTON, MO 64012 EMPLOYER IDENTIFICATION NUMBER: 43-1084953 FOR THE YEAR ENDING DECEMBER 31, 2017 BEAUTIFUL SAVIOR HOME IS MAKING THE DE MINIMIS SAFE HARBOR ELECTION UNDER REG. SEC. 1.263(A)-1(F).