2018-09-14T18:53:43-05:00 2018-04-30 381357951 PLANTE & MORAN PLLC 750 TRADE CENTRE WAY STE 300 PORTAGE MI 49002 990 2017-05-01 381366932 CLARK RETIREMENT COMMUNITY INC CLAR 6164521568 1551 FRANKLIN SE GRAND RAPIDS MI 495063331 BRIAN PANGLE PRESIDENT/CEO 6164521568 2018-09-13 1 CAROL LALONDE CPA P00181637 2695674500 2018-09-07 67.59.56.31 2018-09-13 08:40:59 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 58F74DC53CB874483B207ADF23CD6921384352E9 2017 2018-06-14 16:35:46Z BRIAN PANGLE 1551 FRANKLIN SE GRAND RAPIDS MI 495063331 24284650 0 X CLARKRETIREMENT.ORG X 1906 MI TO PROVIDE RETIREMENT HOUSING, HEALTHCARE, AND RELATED SERVICES TO RESIDENTS AND CLIENTS. 14 12 455 802 0 0 1748266 1934952 25069265 21786339 -60476 -27450 601983 541419 27359038 24235260 0 0 0 0 13877844 9690025 0 0 241379 14897391 14206845 28775235 23896870 -1416197 338390 47677863 48442215 32947337 32596249 14730526 15845966 X TO CREATE A COMMUNITY OF DIGNITY, COMPASSION AND RESPECT CENTERED ON THE LIVES OF OLDER ADULTS AND THOSE WHO CARE FOR THEM. 0 1 17877171 21786339 CLARK RETIREMENT COMMUNITY IS THE FIRST ORGANIZATION IN THE UNITED STATES TO RECEIVE ACCREDITATION FOR DEMENTIA SERVICES BY THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES - CONTINUING CARE ACCREDITATION COMMITTEE (CARF-CCAC).IN FISCAL YEAR 2018, CLARK PROVIDED OVER$1,498,098IN BENEVOLENT CARE GRANTS TO RESIDENTS WHO HAVE OUTLIVED THEIR PERSONAL FINANCIAL RESOURCES.DURING FISCAL YEAR 2018, CLARK RECEIVED SEVERAL NOTABLE AWARDS AND RECOGNITION FOR ITS PROGRAM SERVICES. CLARK WAS VOTED AS ONE OF THE 101 MOST SUSTAINABLE COMPANIES IN WEST MICHIGAN. 17877171 1 1 0 1 0 0 0 0 0 1 1 1 0 1 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 1 0 0 0 0 0 1 1 1 1 0 0 1 32 0 1 455 1 0 0 0 0 0 0 0 0 0 0 X 14 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 MI X CRAIG COURTS 6164521568 1551 FRANKLIN ST SE GRAND RAPIDS MI 49506 STEVE FINNEY PRESIDENT 1.00 1.00 X X 0 0 0 BOB GILLETTE VICE PRESIDENT 1.00 0.00 X X 0 0 0 BETH KELLY SECRETARY 1.00 0.00 X X 0 0 0 GREGG RICHARDSON TREASURER 1.00 0.00 X X 0 0 0 BRIAN PANGLE CEO 40.00 1.00 X X 280972 0 24667 CYNTHIA MCCURREN PRESIDENT - PART YEAR 1.00 1.00 X X 0 0 0 ANA RAMIREZ-SAENZ SECRETARY - PART YEAR 1.00 0.00 X X 0 0 0 DAN LAMORE TREASURER - PART YEAR 1.00 0.00 X X 0 0 0 SUZEANNE BENET BOARD MEMBER 1.00 0.00 X 0 0 0 SPENCER BROWN BOARD MEMBER 1.00 0.00 X 0 0 0 MIKE CRETE BOARD MEMBER 1.00 1.00 X 0 0 0 JAYNE COURTS BOARD MEMBER 1.00 0.00 X 0 0 0 DALE GROGAN BOARD MEMBER 1.00 0.00 X 0 0 0 WILLIAM HAGGARD BOARD MEMBER 1.00 0.00 X 0 0 0 KATHY HOLT BOARD MEMBER 1.00 0.00 X 0 0 0 CHARLES HOMEYER BOARD MEMBER 1.00 0.00 X 0 0 0 CAROL ANN YOUELLS BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN BERGSTROM BOARD MEMBER - PART YEAR 1.00 1.00 X 0 0 0 MARK ERBES BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 DAVE GOMBERT BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 MARCIA HAAS BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 DICK SELLECK BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 TOM WERKMAN BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 DICK YOUELLS BOARD MEMBER - PART YEAR 1.00 0.00 X 0 0 0 CRAIG COURTS CFO/COO 40.00 0.00 X 185846 0 19911 TIM HOCK COO - PART YEAR 40.00 0.00 X 202574 0 3202 669392 0 47780 3 0 1 0 UNIDINE 1000 WASHINGTON ST STE 510 BOSTON MA 02118 DINING SERVICES 3522052 QCI HEALTHCARE 2805 COIT NE GRAND RAPIDS MI 49505 CLINICAL STAFFING 405801 PROGRESSIVE AE 1811 - 4 MILE ROAD NE GRAND RAPIDS MI 49525 ENGINEERING 371049 CREATING RESULTS INC 14000 CROWN COURT STE 211 WOODBRIDGE VA 22193 MARKETING SERVICES 344338 MODERN ROOFING INC 4741 - 24TH STREET DORR MI 49323 ROOFING 296230 14 1934952 1934952 RESIDENT SERVICES 623000 21786246 21786246 HOME PERSONAL SERVICES 621610 93 93 21786339 21940 21940 19303 0 19303 19303 19303 49390 -49390 -49390 -49390 PROPERTY TAX REVENUE 900099 159937 159937 BARBER SHOP REVENUE 900099 121480 121480 GUEST MEALS 900099 47433 47433 193266 193266 522116 24235260 21786339 0 513969 X 686481 686481 7566779 5703404 1625136 238239 17989 20006 -2017 832724 731160 101564 586052 586052 48388 48388 52920 52920 1765 1765 24582 24582 5771503 4921073 850330 100 173395 116274 57121 94625 94625 728582 728582 60101 60101 49590 1270 48320 1084776 1084776 2283193 2267612 15581 246155 246155 NURSING HOME SUPPLIES 1705335 1705335 MEDICAID TAXES 745145 745145 MINOR EQUIPMENT 498352 148752 349600 BAD DEBTS 376175 376175 262263 325321 -66098 3040 23896870 17877171 5778320 241379 -9363 0 875536 512840 94960 91403 529805 527759 65856671 32137234 33882867 33719437 10171870 10749675 96765 0 2035423 2841101 47677863 48442215 3255855 3188337 11374158 11076471 11469772 11485352 5576168 5228697 1271384 1617392 32947337 32596249 X 14730526 15845966 14730526 15845966 47677863 48442215 X 338390 18987 758063 X X 0 1 X 1 0 X 2123325 5609788 2189699 1748266 1934952 13606030 25099602 25405528 25690787 25069265 21786339 123051521 27222927 31015316 27880486 26817531 23721291 136657551 0 0 0 136657551 17368 104251 49980 27669 6678 205946 17368 104251 49980 27669 6678 205946 302575 535083 524874 582281 522116 2466929 27542870 31654650 28455340 27427481 24250085 139330426 0.98080 0.98130 0.00150 0.00170 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2013 AMOUNT: $ 302,575. 2014 AMOUNT: $ 535,083. 2015 AMOUNT: $ 524,874. 2016 AMOUNT: $ 582,281. 2017 AMOUNT: $ 522,116. 0 0 0 0 0 0 0 0 1 1765 1765 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO LEADING AGE MICHIGAN AND LEADING AGE NATIONAL ARE ALLOCATED TO LOBBYING ACTIVITIES. 1575336 145567 1720903 1507611 67725 1575336 1507611 1507611 1507611 1507611 1507611 1507611 1.00000 0 1 1 4714933 4714933 55686178 28785707 26900471 4544936 3351527 1193409 910624 910624 33719437 BENEFICIAL INTEREST IN NET ASSETS OF CLARK RETIREMENT COMMUNITY FOUNDATION 10749675 F 10749675 ASSETS LIMITED AS TO USE 2048121 DEFERRED FINANCING COSTS 124648 DUE FROM AFFILIATES 668332 2841101 BANK LINE OF CREDIT 1617392 1617392 X X X X 1 0 0 0 0 0 0 0 0 BRIAN PANGLE CEO 280972 0 0 0 0 0 4794 0 19873 0 305639 0 0 0 CRAIG COURTS CFO/COO 185846 0 0 0 0 0 3202 0 16709 0 205757 0 0 0 TIM HOCK COO - PART YEAR 138536 0 0 0 64038 0 3202 0 0 0 205776 0 0 0 PART I, LINE 4A TIM HOCK - $64,038 A MICHIGAN STRATEGIC FUND 521417332 594698AQ5 2006-06-09 11539859 SEE PART VI 0 0 0 A 11539853 1161000 13793 230797 5104 2008 1 1 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MICHIGAN STRATEGIC FUND DATE THE REBATE COMPUTATION WAS PERFORMED: 06/09/2011 PART I, LINE A, COLUMN F ADVANCE REFUND PORTION OF 1998 BONDS (ISSUED 9/10/1998) AND CURRENTLY REFUND ALL OF 2001 BONDS (ISSUED 6/28/2001). JAYNE COURTS BOARD MEMBER 205757 COMPENSATION OF FAMILY MEMBER - CRAIG COURTS, CFO/COO 0 FORM 990, PART III, LINE 3 REDUCTION IN REHAB CARE UNITS SO IN FY19 WE CAN REMODEL THESE UNITS FOR INDEPENDENT LIVING APARTMENTS. FORM 990, PART VI, SECTION A, LINE 2 JAYNE COURTS, BOARD MEMBER, HAS A FAMILY RELATIONSHIP WITH CRAIG COURTS, CFO/COO OF CLARK RETIREMENT COMMUNITY, INC. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS REVIEWED BY THE FINANCE COMMITTEE PRIOR TO FILING THE RETURN. ONCE THE FINANCE COMMITTEE APPROVES THE RETURN, THE BOARD WILL RECEIVE A COPY OF THE RETURN FOR REVIEW BEFORE FILING. THE OFFICERS OF THE ORGANIZATION ALSO REVIEW THE 990 PRIOR TO FILING. A COPY OF THE 990 WILL BE MADE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, THE BOARD IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST DOCUMENT. THESE DOCUMENTS ARE REVIEWED ANNUALLY TO ENSURE COMPLIANCE. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, THE INDIVIDUAL WITH THE CONFLICT OF INTEREST WITH CLARK RETIREMENT COMMUNITY CANNOT INFLUENCE IN ANY WAY AND MUST ABSTAIN FROM VOTING ON ANY OUTCOME RELATED TO THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 AN ANNUAL REVIEW IS CONDUCTED BY THE EMPLOYERS ASSOCIATION ALONG WITH HR GENERATING COMPARISONS TO LOCAL, REGIONAL AND NATIONAL INDUSTRY DATA. A COPY OF THE REVIEW IS PROVIDED TO THE BOARD FOR APPROVAL. THE MOST RECENT YEAR THIS PROCESS WAS UNDERTAKEN WAS IN FISCAL YEAR 2018. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY, PORTIONS OF THE FINANCIAL STATEMENTS ARE INCLUDED IN THE ANNUAL DISCLOSURE STATEMENT. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 4,921,073. MANAGEMENT AND GENERAL EXPENSES 850,330. FUNDRAISING EXPENSES 100. TOTAL EXPENSES 5,771,503. FORM 990, PART XI, LINE 9: UNREALIZED GAIN ON INVESTMENT IN RELATED ORG 847,158. GAIN ON INTEREST RATE SWAP AGREEMENT 180,258. ADJUSTED UNREALIZED LOSS ON INVESTMENTS -269,353. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE IN PROCESS FROM THE PRIOR YEAR. CLARK AT HOME HEALTH SERVICES LLC 1551 FRANKLIN SE GRAND RAPIDS MI 495063331 381366932 HOME CARE SERVICES MI 1173297 565 CLARK RETIREMENT COMMUNITY INC CLARK AT HOME PERSONAL SERVICES LLC 1551 FRANKLIN SE GRAND RAPIDS MI 495063331 381366932 HOME CARE SERVICES MI 82389 0 CLARK RETIREMENT COMMUNITY INC CLARK RETIREMENT COMMUNITY FOUNDATION 1551 FRANKLIN SE GRAND RAPIDS MI 495063331 383236052 SUPPORTING ORGANIZATION MI 501(C)(3) LINE 12A, I CLARK RETIREMENT COMMUNITY INC 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 CLARK RETIREMENT COMMUNITY FOUNDATION C 1934952 CASH CLARK RETIREMENT COMMUNITY FOUNDATION A 6600 ACTUAL RENT