NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCORPORATED: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCORPORATED (EIN 35-1282401)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-11-14
IRS object ID
202543189349304464
Schema version
2024v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-11-14T10:05:44-06:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351509921PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SWARTZ RETSON & CO PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1235 E 86TH AVENUEAddressLine1Txt
CityMERRILLVILLECityNm
State AbbreviationINStateAbbreviationCd
ZIP46410ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351282401EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NATIONAL FELLOWSHIP BRETHREN RETIREMENTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNATIBusinessNameControlTxt
Phone5743726498PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK SCHWOBPersonNm
Person TitleDIRECTOR OF FINANCEPersonTitleTxt
Phone5743726498PhoneNum
Signature2025-11-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGREGORY R WARDPreparerPersonNm
PTINP01991555PTIN
Phone2197693616PhoneNum
Preparation2025-11-11PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GRACE VILLAGE RETIREMENT COMMUNITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJUSTIN KIMBRELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,098,595GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressGRACEVILLAGE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1974FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionGRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECUITY OF A CHRISTIAN COMMUNITY. GRACE VILLAGE OFFERS INDEPENDENT LIVING OPTIONS THAT INCLUDE MEALS AND NURSING SERVICES WHEN NEEDED.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee28TotalEmployeeCnt
Total Volunteers96TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$67,690PYContributionsGrantsAmt
CY Contributions Grants$44,314CYContributionsGrantsAmt
PY Program Service Revenue$3,904,123PYProgramServiceRevenueAmt
CY Program Service Revenue$3,720,870CYProgramServiceRevenueAmt
PY Investment Income-$2,917PYInvestmentIncomeAmt
CY Investment Income$185,088CYInvestmentIncomeAmt
PY Other Revenue$6,118PYOtherRevenueAmt
CY Other Revenue$2,500CYOtherRevenueAmt
PY Total Revenue$3,975,014PYTotalRevenueAmt
CY Total Revenue$3,952,772CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$777,700PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$901,528CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,213,122PYOtherExpensesAmt
CY Other Expenses$2,827,115CYOtherExpensesAmt
PY Total Expenses$2,990,822PYTotalExpensesAmt
CY Total Expenses$3,728,643CYTotalExpensesAmt
PY Revenues Less Expenses$984,192PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$224,129CYRevenuesLessExpensesAmt
Total Assets BOY$13,463,802TotalAssetsBOYAmt
Total Assets EOY$13,604,053TotalAssetsEOYAmt
Total Liabilities BOY$9,996,227TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,391,041TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,467,575NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,213,012NetAssetsOrFundBalancesEOYAmt
MissionGRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECUITY OF A CHRISTIAN COMMUNITY. GRACE VILLAGE OFFERS INDEPENDENT LIVING OPTIONS THAT INCLUDE MEALS AND NURSING SERVICES WHEN NEEDED.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,148,850ExpenseAmt
Revenue$3,952,772RevenueAmt
DescGRACE VILLAGE OFFERS INDEPENDENT LIVING OPTIONS THAT INCLUDE MEALS AND NURSING SERVICES WHEN NEEDED. GRACE VILLAGE ALSO OFFERS THERAPY SERVICES AND IN HOME NON-MEDICAL SERVICES AS NEEDED.Desc
Total Program Service Expenses$3,148,850TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee28EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARK SCHWOBPersonNm
Phone5743726290PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
GLENN HALL
BOARD MEMBER0.500.50Yes (X)$0$0$0
CHAD HUMMEL
CHAIR0.500.50Yes (X)$0$0$0Yes (X)
CHECK JOSEY
BOARD MEMBER0.500.50Yes (X)$0$0$0
DAVID KOONTZ
BOARD MEMBER0.500.50Yes (X)$0$0$0
ADAM LENON
SECRETARY & TREASURER0.500.50Yes (X)$0$0$0Yes (X)
MARK MCCOLLOM
BOARD MEMBER0.500.50Yes (X)$0$0$0
MIKE MCKINNIS
BOARD MEMBER0.500.50Yes (X)$0$0$0
JENNIFER PIERCE
BOARD MEMBER0.500.50Yes (X)$0$0$0
WILLIAM STOCKDALE
BOARD MEMBER0.500.50Yes (X)$0$0$0
DALE ROBBINS
BOARD MEMBER0.500.50Yes (X)$0$0$0
ROGER WEIDEMAN
BOARD MEMBER0.500.50Yes (X)$0$0$0
JUSTIN KIMBRELL
CEO12.0028.00$0$189,708$32,211Yes (X)
MARK SCHWOB
DIRECTOR OF FINANCE12.0028.00$82,031$0$22,957Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$82,031TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$189,708TotReportableCompRltdOrgAmt
Total Other Compensation$55,168TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MASTER BUILD LLC
11531 CR 30GOSHENIN46528RESTORATION SERVICES$365,283
HASKINS UNDERGROUND INC
8111 9B RDPLYMOUTHIN46563RESTORATION SERVICES$296,899
SERVICE MASTER BY CROSS ROADS
2851 N WEBSTER AVEINDIANAPOLISIN46219RESTORATION SERVICES$271,774
AUXIANT
PO BOX 75008CEDAR RAPIDSMI52407MEDICAL CONTRACT$186,421
WINONA IT LLC
1037 MARINERS DRIVEWARSAWIN46580INFORMATION TECHNOLOGY$108,698
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$44,314AllOtherContributionsAmt
Total Contributions$44,314TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT AND RESIDE623000$2,844,151$2,844,151
DEFERRED LEASES623000$876,719$876,719
FieldValueIRS element (for citing)
Total Program Service Revenue$3,720,870TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$171,081TotalRevenueColumnAmt
Exclusion$171,081ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$159,830SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$145,823SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$14,007SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,007TotalRevenueColumnAmt
Exclusion$14,007ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISC INCOMEDesc
Business900099BusinessCd
Total Revenue Column$2,500TotalRevenueColumnAmt
Related Or Exempt Func Income$2,500RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,500OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,952,772TotalRevenueColumnAmt
Related Or Exempt Func Income$3,723,370RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$185,088ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$104,989TotalAmt
Program Services$82,941ProgramServicesAmt
Management And General$22,048ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$651,622TotalAmt
Program Services$514,781ProgramServicesAmt
Management And General$136,841ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$13,551TotalAmt
Program Services$10,705ProgramServicesAmt
Management And General$2,846ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$67,291TotalAmt
Program Services$53,160ProgramServicesAmt
Management And General$14,131ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$64,075TotalAmt
Program Services$50,619ProgramServicesAmt
Management And General$13,456ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$52,110TotalAmt
Program Services$41,167ProgramServicesAmt
Management And General$10,943ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$966,257TotalAmt
Program Services$966,257ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$12,763TotalAmt
Program Services$10,083ProgramServicesAmt
Management And General$2,680ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$56,213TotalAmt
Program Services$44,408ProgramServicesAmt
Management And General$11,805ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$585,913TotalAmt
Program Services$462,871ProgramServicesAmt
Management And General$123,042ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$228,309TotalAmt
Program Services$180,364ProgramServicesAmt
Management And General$47,945ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$754,338TotalAmt
Program Services$595,927ProgramServicesAmt
Management And General$158,411ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$128,253TotalAmt
Program Services$101,320ProgramServicesAmt
Management And General$26,933ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MISC$13,065$10,321$2,744
FOOD & ENTERTAINMENT$8,844$6,987$1,857
GIFTS ANNUITY PAYMENTS$6,265$4,949$1,316
DUES AND SUBSCRIPTIONS$5,111$4,038$1,073

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$9,674TotalAmt
Program Services$7,952ProgramServicesAmt
Management And General$1,722ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,728,643TotalAmt
Program Services$3,148,850ProgramServicesAmt
Management And General$579,793ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,514,953BOYAmt
EOY$264,199EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$3,663,646EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$299,529BOYAmt
EOY$17,947EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$15,413BOYAmt
EOY$11,448EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$58,842BOYAmt
EOY$58,770EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$26,823,231LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$18,323,791LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,007,847BOYAmt
EOY$8,499,440EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,529,327BOYAmt
EOY$1,088,603EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$37,891BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,463,802BOYAmt
EOY$13,604,053EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$256,545BOYAmt
EOY$102,606EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,531,169BOYAmt
EOY$6,160,412EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,176,704BOYAmt
EOY$3,069,712EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$31,809BOYAmt
EOY$58,311EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,996,227BOYAmt
EOY$9,391,041EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,456,405BOYAmt
EOY$4,192,009EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,170BOYAmt
EOY$21,003EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,467,575BOYAmt
EOY$4,213,012EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,463,802BOYAmt
EOY$13,604,053EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$224,129ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$31,055NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$300,000DonatedServicesAndUseFcltsAmt
Prior Period Adjustments$233,806PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$43,553OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$80,937CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$301,122CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$34,557CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$67,690CurrentTaxYearMinus1YearAmt
Current Tax Year$44,314CurrentTaxYearAmt
Total$528,620TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,008,832CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,365,601CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,805,527CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,904,123CurrentTaxYearMinus1YearAmt
Current Tax Year$3,720,870CurrentTaxYearAmt
Total$15,804,953TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,089,769CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,666,723CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,840,084CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,971,813CurrentTaxYearMinus1YearAmt
Current Tax Year$3,765,184CurrentTaxYearAmt
Total$16,333,573TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$16,333,573PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,195CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,543CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$21,960CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$79,139CurrentTaxYearMinus1YearAmt
Current Tax Year$171,080CurrentTaxYearAmt
Total$299,917TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,195CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19,543CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$21,960CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$79,139CurrentTaxYearMinus1YearAmt
Current Tax Year$171,080CurrentTaxYearAmt
Total$299,917TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$192,718CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,660CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,000CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,118CurrentTaxYearMinus1YearAmt
Current Tax Year$2,500CurrentTaxYearAmt
Total$210,996TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,290,682CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,691,926CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,866,044CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,057,070CurrentTaxYearMinus1YearAmt
Current Tax Year$3,938,764CurrentTaxYearAmt
Total$16,844,486TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.96970PublicSupportCY509Pct
Public Support PY5090.97770PublicSupportPY509Pct
Investment Income CY0.01780InvestmentIncomeCYPct
Investment Income PY0.00920InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$219,548OtherCostOrOtherBasisAmt
Book Value$219,548BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,324,414OtherCostOrOtherBasisAmt
Depreciation$17,145,736DepreciationAmt
Book Value$6,178,678BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,252,145OtherCostOrOtherBasisAmt
Depreciation$1,178,055DepreciationAmt
Book Value$1,074,090BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,027,124OtherCostOrOtherBasisAmt
Book Value$1,027,124BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,499,440TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
SCHWAB- LIFE LEASE ACCOUNT$75,041F
SCHWAB- GENERAL INVESTMENT ACCOUNT$1,013,562F
FieldValueIRS element (for citing)
Total Book Value Securities$1,088,603TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ANNUTIES PAYABLE$7,224
RESIDENT DEPOSITS$6,995
DEFERRED COMPENSATION PLAN OBLIGATIONS$44,092
FieldValueIRS element (for citing)
Total Liability$58,311TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$4,238,882TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$31,055NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$300,000DonatedServicesAndUseFcltsAmt
Revenue Not Reported$331,055RevenueNotReportedAmt
Revenue Subtotal$3,907,827RevenueSubtotalAmt
Investment Expenses Not Incld$1,392InvestmentExpensesNotIncldAmt
Other Revenues Not Included$43,553OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$44,945RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$3,952,772TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,727,249TotExpnsEtcAuditedFinclStmtAmt
Prior Year Adjustments-$2PriorYearAdjustmentsAmt
Expenses Not Reported-$2ExpensesNotReportedAmt
Expenses Subtotal$3,727,251ExpensesSubtotalAmt
Investment Expenses Not Incld2$1,392InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$1,392ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$3,728,643TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:WHEN UNCERTAIN TAX POSITIONS ARE TAKEN BY THE ORGANIZATION, CHANGES IN BENEFITS ARISING FROM CURRENT AND PRIOR TAX POSITIONS TAKEN BY THE ORGANIZATION ARE RECOGNIZED IN THE PERIOD IN WHICH THE CHANGE OCCURS. CHANGES RESULTING FROM SETTLEMENTS WITH TAXING AUTHORITIES ARE RECOGNIZED IN THE PERIOD THAT SETTLEMENT OCCURS. REDUCTIONS IN UNRECOGNIZED TAX BENEFITS AS A RESULT OF A LAPSE OF THE APPLICABLE STATUTE OF LIMITATIONS ARE RECOGNIZED IN THE PERIOD THE STATUTE LAPSES. PROJECTED PENALTIES AND INTEREST RECOGNIZED ON TAX POSITIONS WHERE IT IS REASONABLY POSSIBLE THAT THE ORGANIZATION'S TAX POSITION WILL NOT PREVAIL IN A REVIEW BY TAXING AUTHORITIES ARE RECOGNIZED AS PART OF CURRENT PERIOD INCOME TAX EXPENSE.
PART XI, LINE 4B - OTHER ADJUSTMENTS:ADJUSTMENT FOR CONNECTION TO GRACE VILLAGE

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonJUSTIN KIMBRELLPersonNm
TitleCEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$189,708CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$32,211DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$221,919TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE DIRECTOR OF FINANCE ASSISTS THE INDEPENDENT ACCOUNTING FIRM IN PREPARATION OF THE FORM 990 BEFORE IT IS FILED. THE DIRECTOR OF FINANCE REVIEWS THE FORM 990 BEFORE IT IS FILED. INDEPENDENT ACCOUNTING FIRM FILES FORM 990 ONCE FINAL APPROVAL IS RECEIVED FROM THE DIRECTOR OF FINANCE. THE DIRECTOR OF FINANCE AND FULL BOARD ARE GIVEN COPIES OF THE FORM 990 UPON COMPLETION OF THE PREPARATION AND FILING.
FORM 990, PART VI, SECTION B, LINE 12CGRACE VILLAGE TRIES TO AVOID SITUATIONS THAT COULD POTENIALLY BE SEEN AS CONFLICTS OF INTEREST. IF A CONFLICT IS FOUND, IT IS DEALT WITH ON A CASE BY CASE, AND THE BOARD OF DIRECTORS MAKES A DECISION AS TO MATERIALITY OF THE CONFLICT, AND WHETHER TO TERMINATE TRANSACTIONS WITH PARTIES THAT HAVE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST ARE MONITORED AND DEALT WITH AT EVERY LEVEL OF THE ORGANIZATION, FORM HOURLY EMPLOYEES, TO SALARIED EMPLOYEES, TO BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 15ATHE CEO'S SALARY IS PAID BY A RELATED ORGANIZATION AND IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS OF THAT ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST
FORM 990, PART IX, LINE 11GINVESTMENT FEES: PROGRAM SERVICE EXPENSES 1,392. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,392. OTHER CONSULTING FEES: PROGRAM SERVICE EXPENSES 964,865. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 964,865.
FORM 990, PART XI, LINE 9:ADJUSTMENT WITH CONNECTION TO GRACE VILLAGE -43,553.
FORM 990, PART XII, LINE 2C:THE PROCESS FOR SELECTION OF INDEPENDENT ACCOUNTANT AND OVERSIGHT OF SUCH PROCESS HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1GRACE VILLAGE HEALTHCARE FACILITY INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONACityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd
FieldValueIRS element (for citing)
EIN351447417EIN
Primary ActivitiesNURSING HOME/ASSISTED LIVING FACILITYPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 10PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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