2017-11-13T07:11:24-06:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2016-01-01 431207154 VILLAGE NORTH INC VILL 3148001955 11160 VILLAGE NORTH DRIVE SAINT LOUIS MO 63136 ROGER BYRNE CHAIRPERSON 3148001955 2017-11-09 1 JEFF PARKER P00970069 3149254300 67.137.57.251 2017-11-09 16:15:08 CS P 2FD9AEF635F49284691F87E9FE125090855B27AB CEFDC36D6FB2C918DCE6F6AD347ED2F4EF281456 2016 2018-03-14 21:41:22Z ROGER BYRNE 11160 VILLAGE NORTH DRIVE SAINT LOUIS MO 63136 6815708 0 X WWW.BETHESDAHEALTH.ORG/COMMUNITIES/10/VILLAGE-NOR X 1980 MO VILLAGE NORTH, INC.'S PRIMARY PURPOSE IS TO PROVIDE A VARIETY OF QUALITY HEALTHCARE SERVICES AND LIVING OPTIONS FOR THE SENIOR POPULATION IN ST. LOUIS ON ITS CAMPUS LOCATED IN NORTH ST. LOUIS COUNTY. THESE SERVICES ARE PROVIDED IN VNI'S INDEPENDENT LIVING APARTMENTS AS WELL AS IN THEIR SKILLED NURSING FACILITY. 4 4 100 4 0 0 3392 8203 6588744 6741568 36745 24664 55856 41273 6684737 6815708 0 0 0 0 3316097 3458171 0 0 0 4647375 5414416 7963472 8872587 -1278735 -2056879 6548071 6280379 4174071 4019143 2374000 2261236 X TO BE THE PREMIER PROVIDER OF CARE AND SERVICES FOR SENIORS IN THE ST. LOUIS REGION WHILE MAINTAINING FINANCIAL STRENGTH AND PROVIDING FULFULLING CAREER OPPORTUNITIES. 0 0 6337356 6741568 VILLAGE NORTH OPERATES A LIFE-CARE, RESIDENTIAL CARE FACILITY FOR ELDERLY PERSONS, REGARDLESS OF THEIR ABILITY TO PAY. THE FACILITY IS COMPRISED OF 153 APARTMENT UNITS FOR INDEPENDENT LIVING; AN ACTIVITIES ADMINISTRATION BUILDING WHICH WILL BE CONNECTED TO THE APARTMENTS BY COVERED, ENCLOSED WALKWAYS; A 40-BED SKILLED NURSING AND REHABILITATION CARE FACILITY; AND WITHIN THE SKILLED NURSING AND REHABILITATION FACILITY, THERE ARE 20 BEDS DEDICATED TO LONG TERM RESIDENCY OF LOCAL COMMUNITY MEMBERS WHO ARE NO LONGER ABLE TO LIVE INDEPENDENTLY AND REQUIRE A HIGHER LEVEL OF CARE TO LIVE. THE SKILLED NURSING AND REHABILITATION FACILITY AT VILLAGE NORTH OPERATES AS AN OUTPATIENT FACILITY, FOR CONVALESCENCE FOLLOWING HOSPITALIZATION OR FOR PROLONGED PERIODS OF TIME AS NEEDED AND IS STAFFED BY LICENSED HEALTH PROFESSIONALS 24/7. VILLAGE NORTH PARTICIPATES IN FEDERAL MEDICARE AND MEDICAID PROGRAMS FOR PATIENTS. 6337356 1 0 0 0 0 0 0 0 1 0 1 0 0 0 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 0 1 X 55 0 100 1 0 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X THE ORGANIZATION 3148001983 11160 VILLAGE NORTH DRIVE SAINT LOUIS MO 63136 X X DANIEL J ROTHERY VICE CHAIRPERSON 2.00 X X 0 0 0 ROGER T BYRNE CHAIRPERSON 2.00 X X 0 0 0 JOSEPH J BRINKER SECRETARY 2.00 X X 0 0 0 RONALD B MCMULLEN TREASURER (TERM 6/2016) 2.00 X X 0 0 0 RICK STEVENS TREASURER 2.00 X X 0 0 0 REBECCA PENNICK ADMINISTRATOR 40.00 X 0 0 0 GWEN CABE GENERAL MANAGER 40.00 X 0 0 0 DENNIS GRINDEL GENERAL MANAGER 40.00 X 0 0 0 LASHONDA HILL DIRECTOR OF NURSING 40.00 X 0 0 0 PEGGY PAYNE DIRECTOR OF NURSING 40.00 X 0 0 0 ANDREW LANE DIRECTOR OF NURSING 40.00 X 0 0 0 0 0 0 0 0 0 0 REHAB CARE PO BOX 503534 ST LOUIS MO 63150 THERAPY 632889 PARIC PO BOX 790100 ST LOUIS MO 63179 CAPITAL ADDITIONS 616525 BARTELS-MISSEY INC 3486 TELEGRAPH RD ARNOLD MO 63010 CAPITAL ADDITIONS 367997 BETHESDA HEALTH GROUP INC 1630 DES PERES RD SUITE 200 ST LOUIS MO 63131 MANAGEMENT SERVICES 356181 OMINCARE PHARMACY PO BOX 78000 DETROIT MI 48278 PHARMACY SERVICES 342034 13 8203 8203 RESIDENT/PATIENT REVEN 623000 6741568 6741568 6741568 24664 24664 MEALS REVENUE 623000 35437 35437 BARBER & BEAUTY SHOP R 623000 5836 5836 41273 6815708 6741568 0 65937 X 3028639 2364338 664301 35788 27939 7849 178347 139420 38927 215397 168152 47245 356181 356181 15167 15167 676 676 2038374 1710850 327524 34272 34272 1219633 1036047 183586 149425 149425 401716 282321 119395 61164 22991 38173 462984 462984 56524 56524 BAD DEBT EXPENSE 246012 246012 TAXES AND LICENSES 225114 225114 OTHER MISCELLANEOUS 119153 119153 EDUCATION AND TRAINING 14758 2154 12604 13263 1007 12256 8872587 6337356 2535231 0 300707 36608 1006824 1122399 16918 23592 3015 19428995 14334230 4348233 5094765 874586 803 0 6548071 6280379 3923234 3856196 2231 10184 109300 139306 152763 4174071 4019143 X 2374000 2261236 2374000 2261236 6548071 6280379 X -2056879 1944115 X 0 0 0 X 3392 8203 11595 6588744 6741568 13330312 6592136 6749771 13341907 0 181066 253050 434116 181066 253050 434116 12907791 36745 24664 61409 36745 24664 61409 55856 41273 97129 6684737 6815708 13500445 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MEALS REVENUE - 2015 AMOUNT: $ 40,397. 2016 AMOUNT: $ 35,437. BARBER BEAUTY SHOP - 2015 AMOUNT: $ 6,523. 2016 AMOUNT: $ 5,836. TRANSPORTATION REVENUE - 2015 AMOUNT: $ 8,936. 0 1 X 184755 184755 8422650 6229007 2193643 1027532 586102 441430 9733124 7510011 2223113 60934 9110 51824 5094765 DEPOSITS 152763 152763 PART IV, LINE 2B: THE ORGANIZATION HOLDS CASH FUNDS ON BEHALF OF RESIDENTS. USE OF THESE FUNDS IS AT THE DISCRETION OF THE RESIDENT. FORM 990, PART V, LINE 2A AND FORM 990, PART IX, LINE 7 VILLAGE NORTH DOES NOT ISSUE W-2S. THE MANAGEMENT COMPANY, BETHESDA HEALTH GROUP INC, ISSUES THE W-2S FOR THIS ENTITY. THE AMOUNT LISTED ON FORM 990, PART IX, LINE 7 REPRESENTS THE WAGES THAT BETHESDA HAS PAID TO ITS EMPLOYEES WHO WORK SPECIFICALLY AT THE VILLAGE NORTH COMMUNITY. FORM 990, PART VI, SECTION A, LINE 3 VNI HAS ENTERED INTO AN AGREEMENT WITH BETHESDA HEALTH GROUP, INC., WHO IS ONE OF THE JOINT MEMBERS OF VNI, TO PROVIDE MANAGEMENT SERVICES FOR THE DAY-TO-DAY OPERATIONS OF VNI. THE MANAGEMENT SERVICES TO BE PROVIDED BY BETHESDA HEALTH GROUP, INC. INCLUDE, WITHOUT LIMITATION, THE FOLLOWING: GENERAL PLANNING SERVICES; BUDGETS; CONTRACT NEGOTIATION; BILLING AND COLLECTION SERVICES; BUSINESS OFFICE SERVICES; PRICING; HUMAN RESOURCE SERVICES; INFORMATION SYSTEMS; ADVERTISING & MARKETING SERVICES; ACCOUNTING SERVICES; REPAIRS & MAINTENANCE; CAPITAL IMPROVEMENTS; ADMISSION & DISCHARGE SERVICES; INSURANCE; RECORD MAINTENANCE; QUALITY CONTROL; RISK MANAGEMENT; POLICIES & COMPLIANCE SERVICES; AND OTHER MANAGEMENT ACTIVITIES. DURING THE 2016 CALENDAR YEAR BETHESDA HEALTH GROUP, INC. COMPENSATED THE FOLLOWING INDIVIDUALS IN TOTAL WAGES: REBECCA PENNICK $86,410 FOR SERVING AS VNI'S ADMINSITRATOR; GWEN CABE $60,200 FOR SERVING AS VNI'S GENERAL MANAGER; DENNIS GRINDEL $22,210 FOR SERVING AS VNI'S GENERAL MANAGER; LASHONDA HILL $5,846 FOR SERVING AS VNI'S DIRECTOR OF NURSING; PEGGY PAYNE $9,808 FOR SERVING AS VNI'S DIRECTOR OF NURSING; AND ANDREW LANE $4,985 FOR SERVING AS VNI'S DIRECTOR OF NURSING. FORM 990, PART VI, SECTION A, LINE 6 BETHESDA HEALTH GROUP, INC. AND CHRISTIAN HEALTH SERVICES DEVELOPMENT CORPORATION, TWO UNRELATED CHARITABLE TAX-EXEMPT ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3), ARE VNI'S TWO MEMBERS, WITH EACH HAVING 50% CONTROL OF ITS BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A EACH OF THE ORGANIZATION'S TWO MEMBERS, BETHESDA HEALTH GROUP, INC. AND CHRISTIAN HEALTH SERVICES DEVELOPMENT CORPORATION, HAVE THE POWER TO APPOINT TWO MEMBERS TO VNI'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS FOR REVIEW, COMMENT AND APPROVAL PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C VNI HAS ADOPTED A WRITTEN CONFLICT OF INTEREST POLICY (POLICY) THAT REQUIRES OFFICERS, DIRECTORS, KEY EMPLOYEES, AND OTHER COVERED INDIVIDUALS TO DISCLOSE BUSINESS OR OTHER INTERESTS THAT MAY GIVE RISE TO CONFLICTS. VNI REGULARLY AND CONSISTENTLY MONITORS COMPLIANCE WITH THE POLICY BY ISSUING ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE REMINDING COVERED INDIVIDUALS OF THEIR OBLIGATION TO DISCLOSE POTENTIAL CONFLICTS AND REQUIRES THE INDIVIDUAL TO ATTEST TO THEIR CONTINUING OBLIGATION TO DISCLOSE SAID CONFLICTS SHOULD THE NEED ARISE. THE RESULTS OF THE CONFLICTS QUESTIONNAIRE ARE REVIEWED BY A CENTRALIZED COMPLIANCE DEPARTMENT AND APPROPRIATE ACTION IS TAKEN AS NECESSARY. IN ACCORDANCE WITH THE POLICY, INDIVIDUALS DISCLOSING SUCH CONFLICTS RECUSE THEMSELVES FROM ANY AND ALL DISCUSSIONS RELATED TO SUCH BUSINESS TRANSACTIONS. SUCH RELATIONSHIPS ARE REVIEWED TO ENSURE THAT ANY PAYMENTS RECEIVED OR AMOUNTS PAID DO NOT EXCEED THE FAIR MARKET VALUE OF THE GOODS AND SERVICES RECEIVED BY VNI. FORM 990, PART VI, SECTION B, LINE 15 PER POLICIES OF THE MANAGEMENT SERVICES PROVIDER, BETHESDA HEALTH GROUP, AN INDEPENDENT COMPENSATION CONSULTANT IS REGULARLY ENGAGED TO REVIEW AND ANALYZE THE COMPENSATION AND BENEFITS OF OUR EXECUTIVES COMPARED TO THEIR PEERS IN THE BUSINESS COMMUNITY. THE RESULTS ARE REVIEWED AND APPROVED, WHEN APPROPRIATE, BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 PER THE POLICIES OF THE MANAGEMENT SERVICES PROVIDER, THE ORGANIZATION DOES NOT MAKE COPIES OF IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION B AND PART IX ALTHOUGH THE ORGANIZATION PAID BETHESDA APPROXIMATELY $700,000 FOR THE CALENDAR YEAR, ONLY $356,181 OF THAT IS CONSIDERED TO BE MANAGEMENT FEES. THE OTHER $343,819 IS REIMBURSEMENT FOR MISCELLANEOUS FEES AND TECHNOLOGY INCURRED BY THE MANAGEMENT COMPANY. THESE AMOUNTS ARE SPLIT BETWEEN THE APPROPRIATE CATEGORIES ON REPORTED ACCORDINGLY ON PAGE 10. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 809,070. MANAGEMENT AND GENERAL EXPENSES 143,062. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 952,132. TEMP AGENCIES: PROGRAM SERVICE EXPENSES 800,439. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 800,439. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 101,341. MANAGEMENT AND GENERAL EXPENSES 184,462. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 285,803. FORM 990, PART XI, LINE 9: ADDITIONAL PAID IN CAPITAL BY MEMBERS 1,944,115. SCHEDULE R SCHEDULE R HAS BEEN REMOVED FOR THIS TAX FILING AS IT WAS DETERMINED THAT NEITHER MEMBER (BETHESDA NOR CHRISTIAN HEALTH) HAVE CONTROL OVER THE BOARD AS BOTH MEMBERS CONTROL EXACTLY 50% OF THE BOARD.