2016-11-15T15:27:20-06:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2015-01-01 431207154 VILLAGE NORTH INC VILL 3148001955 11160 VILLAGE NORTH DRIVE SAINT LOUIS MO 63136 ROGER BYRNE VICE CHAIRPERSON 3148001955 2016-11-15 1 JEFF PARKER P00970069 3149254300 2015 2017-02-10 21:41:12Z X DANIEL ROTHERY 11160 VILLAGE NORTH DRIVE SAINT LOUIS MO 63136 6684737 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 2 0 4 0 0 3392 6588744 36745 55856 6684737 0 0 3316097 0 0 4647375 7963472 -1278735 6548071 4174071 2374000 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. 1 0 5668503 6588744 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. 5668503 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 14 0 0 0 0 0 0 0 0 0 0 0 0 X 4 2 1 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 DANIEL J ROTHERY CHAIRPERSON 2.00 X X 0 0 0 ROGER T BYRNE VICE CHAIRPERSON 2.00 38.00 X X 0 286111 16808 JOSEPH J BRINKER TREASURER 2.00 38.00 X X 0 460829 15429 RONALD B MCMULLEN SECRETARY 2.00 X X 0 0 0 0 746940 32237 0 0 1 0 PARIC PO BOX 790100 ST LOUIS MO 63179 CAPITAL ADDITIONS 577107 REHAB CARE PO BOX 503534 ST LOUIS MO 63150 THERAPY 412115 BETHESDA HEALTH GROUP INC 1630 DES PERES RD SUITE 200 ST LOUIS MO 63131 MANAGEMENT SERVICES 370222 APF PO BOX 823461 PHILADELPHIA PA 19182 TEMP STAFFING 224670 PROFESSIONAL THERAPY SERVICE 1909 N MORTON AVE MORTON IL 61550 THERAPY 194709 15 3392 3392 RESIDENT/PATIENT REVEN 623000 6588744 6588744 6588744 36745 36745 MEALS REVENUE 623000 40397 40397 TRANSPORTATION REVENUE 623000 8936 8936 BARBER & BEAUTY SHOP R 623000 6523 6523 55856 6684737 6588744 0 92601 X 2931661 2220856 710805 40713 30842 9871 121040 91693 29347 222683 168692 53991 370222 370222 1731423 1606209 125214 37244 37244 1189010 910085 278925 132513 132513 370778 269467 101311 22435 22435 366310 366310 35281 35281 BAD DEBT EXPENSE 198694 198694 TAXES AND LICENSES 177426 452 176974 DUES AND SUBSCRIPTIONS 11012 829 10183 OTHER MISCELLANEOUS 3068 3068 1959 1959 7963472 5668503 2294969 0 300707 1006824 16918 18219479 13871246 0 4348233 874586 0 803 0 6548071 2283226 2231 109300 0 1779314 0 4174071 X 2374000 0 2374000 0 6548071 X -1278735 3652735 X 0 0 0 X 3392 3392 6588744 6588744 6592136 6592136 0 181066 181066 181066 181066 6411070 36745 36745 36745 36745 55856 55856 6684737 6684737 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MEALS REVENUE - 2015 AMOUNT: $ 40,397. BARBER BEAUTY SHOP - 2015 AMOUNT: $ 6,523. TRANSPORTATION REVENUE - 2015 AMOUNT: $ 8,936. 0 1 X 184755 184755 7416101 6031306 1384795 585392 566425 18967 8091193 7264405 826788 1942038 9110 1932928 4348233 DUE TO AFFILIATE 1640008 DEPOSITS 139306 1779314 PART IV, LINE 2B: THE ORGANIZATION HOLDS CASH FUNDS ON BEHALF OF RESIDENTS. USE OF THESE FUNDS IS AT THE DISCRETION OF THE RESIDENT. 0 0 0 0 0 0 0 0 0 ROGER T BYRNE VICE CHAIRPERSON 0 223611 0 62500 0 0 0 8390 0 8418 0 302919 0 0 JOSEPH J BRINKER TREASURER 0 360829 0 100000 0 0 0 12937 0 2492 0 476258 0 0 PART I, LINE 3 BETHESDA HEALTH GROUP INC, A RELATED ORGANIZATION AND MANAGEMENT COMPANY USES THE FOLLOWING TO ESTABLISH COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART III, LINE 2 PRIOR TO JANUARY 1, 2015, VILLAGE NORTH WAS OPERATED BY AN AFFILIATE OF BJC HEALTH SYSTEM ("BJC"). CURRENTLY, VILLAGE NORTH IS JOINTLY OWNED AND OPERATED BY BETHESDA HEALTH GROUP INC. ("BETHESDA") AND BJC, TWO HIGHLY RESPECTED NAMES IN ACUTE CARE AND RETIREMENT LIVING. BETHESDA MANAGES VILLAGE NORTH AND PROVIDES A VARIETY OF SERVICES, CONVENIENCES AND LIVING OPTIONS TO SENIOR CITIZENS IN THE COMMUNITY WITHOUT REGARD TO INCOME OR SOCIOECONOMIC STATUS, OR RESIDENT'S ABILITY TO PAY. ADJACENT TO CHRISTIAN HOSPITAL IN NORTH ST. LOUIS COUNTY, VILLAGE NORTH RESIDENTS HAVE ACCESS TO QUALITY HEALTHCARE INCLUDING REHABILITATION AND LONG-TERM CARE RIGHT ON CAMPUS. FORM 990, PART V, LINE 2A AND FORM 990, PART IX, LINE 7 VILLAGE NORTH DOES NOT ISSUE W-2S. THE MANAGEMENT COMPANY AND RELATED PARTY, 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 2 ROGER T. BYRNE AND JOSEPH J. BRINKER HAVE A BUSINESS RELATIONSHIP, AS THEY ARE BOTH OFFICERS FOR BETHESDA HEALTH GROUP, INC. 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. 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 11 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 GOODSAND 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 OVER $3.4M FOR THE CALENDAR YEAR, ONLY $370,222 OF THAT IS CONSIDERED TO BE MANAGEMENT FEES. THE OTHER $3M IS REIMBURSEMENT FOR SALARIES, BENEFITS, PAYROLL TAXES, ETC. 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 904,941. MANAGEMENT AND GENERAL EXPENSES 39,827. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 944,768. TEMP AGENCIES: PROGRAM SERVICE EXPENSES 698,954. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 698,954. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,314. MANAGEMENT AND GENERAL EXPENSES 85,387. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 87,701. FORM 990, PART XI, LINE 9: OPENING BALANCE EQUITY 3,652,735. FORM 990, PART XI, LINE 9 PRIOR TO THIS FILING, VILLAGE NORTH WAS INCLUDED AS A SUBORDINATE ORGANIZATION IN THE IRS GROUP RULING ISSUED TO BJC HEALTH SYSTEM (GEN 3844). VILLAGE NORTH RECEIVED AN INDEPENDENT DETERMINATION OF ITS TAX-EXEMPT STATUS UNDER CODE SECTION 501(C)(3) AND AS A RESULT IS NOW FILING A SEPERATE 990. BETHESDA HEALTH GROUP INC 1630 DES PERES RD ST LOUIS MO 63131 430666738 SENIOR LIVING SERVICES MO 501(C)(3) LINE 11B, II 0 CHRISTIAN HEALTH SERVICES DEVELOPMENT CORPORATION 11133 DUNN ROAD ST LOUIS MO 63136 431230583 HEALTH CARE MO 501(C)(3) LINE 3 BJC HEALTH SYSTEM 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0