2018-02-23T13:54:02-06:00 2017-06-30 381357951 PLANTE & MORAN PLLC 10 S Riverside Plaza 9th Floor Chicago IL 60606 990 2016-07-01 510173104 LEWIS MEMORIAL CHRISTIAN VILLAGE LEWI 3145877903 622 EMERSON ROAD No 310 ST LOUIS MO 63141 CHUCK SCHMITZ CFO 3145877903 2018-02-19 1 David Lowenthal P00378651 3122071040 2018-02-19 67.59.56.30 2018-02-19 18:05:53 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 75C7EC6AC54A61BA087900A4F9B91D17BA572CD0 2016 2021-01-29 14:40:06Z CHUCK SCHMITZ 622 EMERSON ROAD No 310 ST LOUIS MO 63141 17419030 0 X https://christianhorizonsliving.org X 1975 IL We exist to honor God by providing a continuum of excellent care and support services, primarily for older adults. 16 16 384 106 0 0 242814 86899 14375877 16696935 414566 553608 27667 81588 15060924 17419030 0 0 0 0 7793746 8292556 0 0 0 6946783 8158992 14740529 16451548 320395 967482 41440619 41978010 17355922 16870863 24084697 25107147 X THE MISSION OF LEWIS MEMORIAL CHRISTIAN VILLAGE IS TO CREATE AN EXCITING LIFESTYLE AND TO PROVIDE HIGH QUALITY CARE FOR SENIORS ON A CONTINUUM OF CARE. CAMPUS PROVIDING CARE IN A CHRISTIAN ENVIRONMENT PROVIDES A UNIQUE OPPORTUNITY TO MEET THE NEEDS OF SENIORS PHYSICALLY, MENTALLY, AND SPIRITUALLY. OUR COMMITMENT TO EXCELLENCE IS MOTIVATED BY OUR CHRISTIAN BELIEF THAT ALL ARE PRECIOUS IN THE SIGHT OF GOD. 0 0 13892367 0 16696935 LEWIS MEMORIAL CHRISTIAN VILLAGE PROVIDES QUALITY CARE TO SENIORS IN A CHRISTIAN ENVIRONMENT. THE OPERATIONS INCLUDE SKILLED NURSING CARE, INDEPENDENT LIVING APARTMENTS, AND ASSISTED LIVING SHARED HOMES. THE SKILLED NURSING CARE FACILITY PROVIDED 56,065 PATIENT DAYS OF SERVICE, THE INDEPENDENT LIVING APARTMENTS SERVED APPROXIMATELY 41 RESIDENTS AND THE SHARED HOME AVERAGED 19 RESIDENTS. THE WELLNESS CENTER AT LEWIS MEMORIAL CHRISTIAN VILLAGE IS AN EXERCISE FACILITY AND POOL FOR THE INDEPENDENT LIVING RESIDENTS ON THE CAMPUS, AS WELL AS OTHER RETIREMENT AGE PEOPLE IN THE COMMUNITY. 13892367 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 384 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X CHUCK SCHMITZ 3145877903 622 EMERSON ROAD SUITE 310 ST LOUIS MO 63141 RON SEWELL BOARD MEMBER - CHAIRMAN 0.30 2.00 X X 0 1000 0 NICK FILING BOARD MEMBER - VICE CHAIRMAN 0.30 2.00 X X 0 750 0 BILLY CARTER BOARD MEMBER - TREASURER 0.30 2.00 X X 0 1000 0 TERRY GOODNER BOARD MEMBER - SECRETARY 0.30 2.00 X X 0 1000 0 Bill Lash board member (part year) 0.30 2.00 X 0 0 0 Debra vincent board member (part year) 0.30 2.00 X 0 0 0 DON FITZGERALD BOARD MEMBER 0.30 2.00 X 0 750 0 DOUG WILEY BOARD MEMBER 0.30 2.00 X 0 0 0 JIM FRASURE BOARD MEMBER 0.30 2.00 X 0 1000 0 MARK BEHRENDS BOARD MEMBER 0.30 2.00 X 0 1000 0 MIKE DUNAWAY BOARD MEMBER 0.30 2.00 X 0 0 0 RANDY CLARK BOARD MEMBER 0.30 2.00 X 0 750 0 ROBERT CROSBY BOARD MEMBER 0.30 2.00 X 0 750 0 SCOTT WILLIAMS BOARD MEMBER 0.30 2.00 X 0 1000 0 STEVE GNUSE BOARD MEMBER 0.30 2.00 X 0 1000 0 THOMAS KERINS BOARD MEMBER 0.30 2.00 X 0 1000 0 TIMOTHY BURRELL BOARD MEMBER 0.30 2.00 X 0 750 0 TIMOTHY PHILLIPPE CEO 2.00 38.00 X 0 424467 36780 CHUCK SCHMITZ CFO (Beg. Oct. 2016) 2.00 38.00 X 0 47137 1180 SUSAN MCGHEE CFO (through Mar. 2017) 2.00 38.00 X 0 277088 14080 DONALD BELL COO 2.00 38.00 X 0 46938 5055 JENELLE BERTOLINO-ISHMAEL COO OF HCBS 2.00 38.00 X 0 263828 14080 SHERRY GUTERMUTH VICE PRESIDENT OF OPERATION 2.00 38.00 X 0 251154 11720 John P Rupkey Pharmacy Manager 0.40 39.60 X 0 203057 5500 Kathryn J Abel Regional VP of Operation 2.00 38.00 X 0 177983 13080 Elizabeth A Huck VP of Sales 2.00 38.00 X 0 169744 10080 Michael W Smar Pharmacist 0.40 39.60 X 0 154458 0 Cynthia A Schaaf Executive Director 2.00 38.00 X 154050 0 0 154050 2027604 111555 1 0 1 0 0 86899 86899 NURSING HOME OPERATIONS 623000 15327499 15327499 senior living units 623990 1369436 1369436 16696935 553608 553608 BEAUTY shop 900099 38329 38329 membership fees 900099 23728 23728 meal revenue 900099 8454 8454 11077 11077 81588 17419030 16696935 0 635196 X 7106420 6417886 688534 10501 9484 1017 672837 607646 65191 502798 454082 48716 976530 976530 43927 43927 2505839 2505510 329 51140 5281 45859 47283 27867 19416 47936 47936 926098 762321 163777 27834 20030 7804 2445 2227 218 704382 695876 8506 1355084 1355084 179075 179075 RAW FOOD (DIETARY) 487160 487160 medicare participation 383861 383861 BAD DEBT 362834 362834 LICENSES, DUES, AND SUB 49292 49292 8272 4 8268 16451548 13892367 2559181 0 10631 500 90385 89213 2032626 2873185 13554 13576 37680 41037 29128537 13022455 16989431 16106082 10790995 11405717 183175 0 11292142 11448700 41440619 41978010 848792 616554 1380462 1248433 13093597 13970918 33000 38898 268049 0 1732022 996060 17355922 16870863 X 24069121 25085833 15576 21314 24084697 25107147 41440619 41978010 967482 54968 0 X 0 1 X 1 0 X 295456 81949 150996 242814 86899 858114 14275750 14694535 14702138 14379477 16696935 74748835 14571206 14776484 14853134 14622291 16783834 75606949 0 0 0 75606949 282669 354571 293824 258011 553608 1742683 282669 354571 293824 258011 553608 1742683 39642 400833 104452 27667 81588 654182 14893517 15531888 15251410 14907969 17419030 78003814 0.96930 0.97220 0.02230 0.01970 X Schedule A, Part III, Line 12, Explanation of Other Income: MISCELLANEOUS - 2012 Amount: $ 3,169. 2013 Amount: $ 12,800. 2014 Amount: $ 2,532. 2015 Amount: $ 8,040. 2016 Amount: $ 1,886. beautyshop - 2012 Amount: $ 35,857. 2013 Amount: $ 39,939. 2014 Amount: $ 33,278. 2015 Amount: $ 25,385. 2016 Amount: $ 38,329. meal revenue - 2012 Amount: $ 616. 2013 Amount: $ 15,887. 2014 Amount: $ 10,736. 2015 Amount: $ 11,104. 2016 Amount: $ 8,454. DISCOUNTS - 2012 Amount: $ 0. 2013 Amount: $ 0. 2014 Amount: $ 0. 2015 Amount: $ 0. 2016 Amount: $ 4,877. INSURANCE GAIN - 2013 Amount: $ 332,207. 2014 Amount: $ 57,906. 2015 Amount: $ 26,400. 2016 Amount: $ 4,314. DEBT EXTINGUISHMENT - 2012 Amount: $ 0. 2013 Amount: $ 0. 2014 Amount: $ 0. 2015 Amount: $ -46,862. 2016 Amount: $ 0. SITTER FEES - 2012 Amount: $ 0. 2013 Amount: $ 0. 2014 Amount: $ 0. 2015 Amount: $ 3,600. 2016 Amount: $ 0. membership fees - 2012 Amount: $ 0. 2013 Amount: $ 0. 2014 Amount: $ 0. 2015 Amount: $ 0. 2016 Amount: $ 23,728. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 911742 48364 960106 872461 39281 911742 796029 76432 872461 742223 53806 796029 705292 36931 742223 1.00000 0.00000 0.00000 0 0 308762 308762 22118433 8938428 13180005 4004196 2243760 1760436 2692724 1840267 852457 4422 4422 16106082 ACCRUED INTEREST 30502 bond funds 820079 INTERCOMPANY RECEIVABLE 10598119 11448700 DUE TO AUXILIARY 11611 REFUNDABLE ENTRANCE FEES 984449 996060 Part IV, Line 2b: RESIDENT FUNDS ARE AGENCY FUNDS HELD LOCALLY AT THE COMMUNITIES FOR INDIVIDUAL RESIDENTS' PERSONAL USE, RESIDENT SECURITY DEPOSITS, AND OTHER MISCELLANEOUS DEPOSITS. Part V, Line 4: ORGANIZATION HOLDS FUNDS IN ENDOWMENT DESIGNATED BY THE BOARD OF DIRECTORS TO BE USED FOR RESIDENT CARE. 0 0 0 0 0 0 0 0 0 TIMOTHY PHILLIPPE CEO 0 342688 0 78106 0 3673 0 15500 0 21280 0 461247 0 0 SUSAN MCGHEE CFO (through Mar. 2017) 0 239088 0 38000 0 0 0 7000 0 7080 0 291168 0 0 JENELLE BERTOLINO-ISHMAEL COO OF HCBS 0 234828 0 29000 0 0 0 7000 0 7080 0 277908 0 0 SHERRY GUTERMUTH VICE PRESIDENT OF OPERATION 0 215154 0 36000 0 0 0 7000 0 4720 0 262874 0 0 John P Rupkey Pharmacy Manager 0 160220 0 30500 0 12337 0 5500 0 0 0 208557 0 0 Kathryn J Abel Regional VP of Operation 0 154543 0 20400 0 3040 0 6000 0 7080 0 191063 0 0 Elizabeth A Huck VP of Sales 0 149959 0 19000 0 785 0 3000 0 7080 0 179824 0 0 Michael W Smar Pharmacist 0 154458 0 0 0 0 0 0 0 0 0 154458 0 0 Cynthia A Schaaf Executive Director 154050 0 0 0 0 0 0 0 0 0 154050 0 0 0 Part I, Line 3 COMPENSATION OF THE ORGANIZATION'S CEO IS ESTABLISHED BY A RELATED ORGANIZATION, CHRISTIAN HOMES, INC. CHRISTIAN HOMES, INC. USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. Form 990, Part VI, Section A, line 3 THE ORGANIZATION DELEGATES MANAGEMENT DUTIES INCLUDING SUPERVISING PERSONNEL, OPERATIONS, AND BUDGETING TO MIDWEST CHRISTIAN VILLAGES, A MANAGEMENT COMPANY AND RELATED EXEMPT ORGANIZATION. Form 990, Part VI, Section B, line 11b THE BOARD IS PROVIDED A COPY OF FORM 990 PRIOR TO ITS FILING. Form 990, Part VI, Section B, line 12c THE CONFLICT OF INTEREST STATEMENT IS INCLUDED IN THE EMPLOYEE HANDBOOK, WHICH EVERY EMPLOYEE IS GIVEN A COPY OF AND SIGNS AN ACKNOWLEDGEMENT FOR ON THEIR FIRST DAY OF EMPLOYMENT. IF A VIOLATION OCCURS, EMPLOYEES CAN REPORT DIRECTLY TO THEIR SUPERVISOR OR USE THE 800 NUMBERS WHICH ARE POSTED AT EACH LOCATION. VIOLATIONS ARE INVESTIGATED BY INDIVIDUALS AT THE VICE PRESIDENT LEVEL AND AT LEAST TWO INDIVIDUALS WOULD MAKE THE FINAL DETERMINATION AS TO THE APPROPRIATE ACTION TO BE TAKEN. THE BOARD OF DIRECTORS HAS ADOPTED A CONFLICT OF INTEREST POLICY. ANNUALLY EVERY BOARD MEMBER COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM AND IDENTIFIES ANY POTENTIAL CONFLICTS. THEY ALSO CERTIFY THAT THEY HAVE REVIEWED AND AGREE TO ABIDE BY THE CURRENT POLICY IN PLACE. IF A POTENTIAL CONFLICT ARISES IT IS REVIEWED BY THE BOARD OF DIRECTORS AND DISCUSSED AND VOTED ON. Form 990, Part VI, Section B, line 15 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, OFFICERS AND KEY EMPLOYEES IS DETERMINED BY A RELATED ORGANIZATION, CHRISTIAN HOMES, INC. OFFICERS ARE NOT PRESENT AT ANY MEETING DISCUSSING THEIR COMPENSATION. THE COMPENSATION COMMITTEE DOCUMENTS ITS FINDINGS IN WRITING. CHRISTIAN HOMES, INC. PARTICIPATES IN SEVERAL (MINIMUM OF 3) INDUSTRY SPECIFIC, EXECUTIVE SALARY SURVEYS EACH YEAR TO HELP DETERMINE COMPETITIVENESS OF THE ORGANIZATION'S EXECUTIVE AND SENIOR MANAGEMENT POSITIONS. THE SALARIES ARE DISCUSSED AND REVIEWED BY THE PRESIDENT AND VICE PRESIDENT OF HUMAN RESOURCES. IF A NEW HIRE IS BEING CONSIDERED FOR AN EXECUTIVE LEVEL POSITION, IT MAY ALSO BE DISCUSSED WITH THE BOARD. IN 2010, THE ORGANIZATION ESTABLISHED A COMPENSATION COMMITTEE OF THE BOARD HEADED BY A PERSON WHOSE ENTIRE CAREER WAS IN HUMAN RESOURCES AND INCLUDES THE ORGANIZATION'S VICE PRESIDENT OF HUMAN RESOURCES AS WELL AS A FEW OTHER BOARD MEMBERS. OTHER OFFICERS AND KEY EMPLOYEES SALARIES ARE DETERMINED BASED ON A REVIEW AND PARTICIPATION IN SEVERAL INDUSTRY SPECIFIC SALARY SURVEYS WHICH PROVIDE DATA ON OTHER EXECUTIVES. THE ORGANIZATION REVIEWS THE COMPENSATION REVIEW THROUGH A BOARD COMMITTEE. THE VP OF HR IS ALSO ON THIS COMMITTEE. THEY REVIEW THE EXECUTIVE TEAM COMPENSATION ON AN ANNUAL BASIS AND THEY USE SALARY SURVEYS FROM EXTERNAL SOURCES THAT RELATE TO THE ORGANIZATION'S INDUSTRY. AT THE MARCH 2017 BOARD MEETING THE CFO AND CEO SALARIES WERE REVIEWED. THE ITEMS THAT ARE DISCUSSED DURING THE COMPENSATION MEETING ARE SUMMARIZED IN THE FULL BOARD MEETING, WHERE MINUTES ARE TAKEN. Form 990, Part VI, Section C, line 19 THE ORGANIZATION POSTS ITS MONTHLY FINANCIAL STATEMENTS ON ITS WEBSITE. MONTHLY FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE ALSO AVAILABLE UPON REQUEST. Form 990, Part IX, line 11g PROFESSIONAL FEES/CONSULTANTS: Program service expenses 2,505,510. Management and general expenses 329. Fundraising expenses 0. Total expenses 2,505,839. CHRISTIAN HOMES INC 200 N POSTVILLE DRIVE LINCOLN IL 62656 370841562 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(c)(3) Line 10 N/A 0 FAIR HAVENS CHRISTIAN HOMES 1790 S FAIRVIEW AVENUE DECATUR IL 62521 370987659 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(c)(3) Line 10 N/A 0 HOOSIER CHRISTIAN VILLAGE 621 S SUGAR STREET BROWNSTOWN IN 47220 237423749 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(c)(3) Line 10 N/A 0 SPRING RIVER CHRISTIAN VILLAGE 201 S NORTHPARK LANE JOPLIN MO 64801 431341462 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS MO 501(c)(3) Line 10 N/A 0 CROWN POINT CHRISTIAN VILLAGE 6685 E 117TH ST CROWN POINT IN 46307 311114614 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(c)(3) Line 10 N/A 0 RISEN SON CHRISTIAN VILLAGE 3000 RISEN SON BLVD COUNCIL BLUFFS IA 51503 421279738 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IA 501(c)(3) Line 10 N/A 0 MIDWEST SENIOR MINISTRIES 622 EMERSON ROAD ST LOUIS MO 63141 201053401 PHARMACY SERVICES IL 501(c)(3) Line 10 N/A 0 MIDWEST CHRISTIAN VILLAGES 200 N POSTVILLE DRIVE LINCOLN IL 62656 260275009 MGMT NURSING AND RETIREMENT IL 501(c)(3) Line 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0