2016-05-11T11:23:56-05:00 2015-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2015-01-01 371017284 CLARK-LINDSEY VILLAGE INC CLAR 2173442144 101 WEST WINDSOR ROAD URBANA IL 61802 THOMAS B BERNS CEO 2173442144 2016-04-28 1 JEFF PARKER P00970069 3149254300 2015 2016-09-27 15:27:22Z DEBRA REARDANZ 101 WEST WINDSOR ROAD URBANA IL 61802 22132837 0 X WWW.CLARK-LINDSEY.COM X 1970 IL TO PROVIDE HOUSING AND HEALTHCARE FACILITIES/SERVICES FOR ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN. 12 12 343 800 0 0 346245 311955 14423044 15165427 495366 243570 355255 345265 15619910 16066217 0 0 0 0 7343215 7784893 0 0 0 6787026 7086204 14130241 14871097 1489669 1195120 38561592 39444444 21173312 21091551 17388280 18352893 X TO PROVIDE HOUSING AND HEALTHCARE FACILITIES/SERVICES FOR ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN. 0 0 13306893 15165427 CLARK-LINDSEY VILLAGE'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE HOUSING, SERVICES, AND HEALTHCARE TO THE ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN. IN 2015, CLARK- LINDSEY VILLAGE PROVIDED HOUSING AND SERVICES TO APPROXIMATELY 515 ELDERLY PEOPLE, RESULTING IN 87,763 DAYS OF CARE. IN ADDITION, CLARK-LINDSEY PROVIDED 171,300 HOURS OF NURSING CARE, 40,075 SESSIONS OF THERAPY, AND MORE THAN 400 SENIOR PROGRAMS DESIGNED TO PROMOTE CONTINUED LEARNING AND SUCCESSFUL AGING.THE MISSION OF CLARK-LINDSEY IS TO OFFER SENIOR ADULTS EXCEPTIONAL SERVICES AND LIVING ENVIRONMENTS DESIGNED TO ENGAGE THE MIND, SPIRIT, AND BODY IN WELLNESS AND COMMUNITY. THE MISSION IS FURTHERED AND SUSTAINED THROUGH YEARS OF CHARITABLE GIVING. GENEROUS DONORS HAVE PROVIDED FOR A FRIENDSHIP FUND TO ASSIST COMMUNITY MEMBERS WHO NO LONGER HAVE THE FINANCIAL RESOURCES TO PROVIDE FOR THEIR HOME AND HEALTH CARE COSTS. CLARK-LINDSEY PROVIDES CARE TO RESIDENTS WHO MEET CERTAIN CRITERIA UNDER ITS FRIENDSHIP FUND POLICY WITHOUT CHARGE OR AT REDUCED RATES. KEY ELEMENTS USED TO DETERMINE ELIGIBILITY INCLUDE A RESIDENT'S DEMONSTRATED INABILITY TO PAY.CLARK-LINDSEY MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS FRIENDSHIP FUND POLICY, THE ESTIMATED COST OF THOSE SERVICES AND SUPPLIES, AND EQUIVALENT SERVICE STATISTICS. DURING THE YEARS ENDED DECEMBER 31, 2015 AND 2014 THERE HAVE BEEN NO RESIDENTS RECEIVING FINANCIAL ASSISTANCE FROM THE FRIENDSHIP FUND.CLARK-LINDSEY UTILIZES EARNINGS FROM CERTAIN INVESTMENTS AND CONTRIBUTIONS RECEIVED DESIGNATED FOR THE FRIENDSHIP FUND TO SUBSIDIZE THE COSTS OF PROVIDING CHARITY CARE. TOTAL EARNINGS AND CONTRIBUTIONS RECEIVED FOR FRIENDSHIP FUND ASSISTANCE WERE APPROXIMATELY $2,000 AND $1,000 FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014, RESPECTIVELY. 13306893 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 43 0 343 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X X DEBRA REARDANZ CEO 2173442144 101 WEST WINDSOR ROAD URBANA IL 61802 THOMAS B BERNS CHAIRMAN 2.00 X X 0 0 0 GLEN C PAINE VICE-CHAIRMAN 2.00 X X 0 0 0 DAVID W HOOD TREASURER 2.00 X X 892 0 0 MICHAEL W LYON SECRETARY 2.00 X X 0 0 0 JAMES D GREEN BOARD MEMBER 2.00 X 0 0 0 CAMILLE S HARMON BOARD MEMBER 2.00 X 0 0 0 KATHLEEN HOLDEN BOARD MEMBER 2.00 X 0 0 0 CHRISTOPHER MOYER BOARD MEMBER 2.00 X 419 0 0 MICHAEL B PROVENZANO BOARD MEMBER 2.00 X 0 0 0 ELIZABETH H TYLER BOARD MEMBER 2.00 X 0 0 0 ROLAND WHITE BOARD MEMBER 2.00 X 0 0 0 WADE HAMPTON BOARD MEMBER 2.00 X 606 0 0 GENE GRANDONE BOARD MEMBER 2.00 X 0 0 0 DEBRA S REARDANZ PRESIDENT / CEO 40.00 X 226303 0 31147 TIMOTHY P MAST VICE PRESIDENT OF FINANCE, CFO 40.00 X 109467 0 22957 337687 0 54104 2 0 1 0 PERKINS EASTMAN ARCHITECTS PC 115 FIFTH AVENUE NEW YORK NY 10003 ARCHITECT SERVICES 741652 REHABCARE GROUP INC 7733 FORSYTH BLVD SUITE 2300 ST LOUIS MO 63150 THERAPY SERVICES 732441 TAG RESIDENTIAL COMPANY 2805 BOULDER ROAD URBANA IL 68102 CONSTRUCTION SERVICES 431723 PETRY KUHNE COMPANY 2110 CLEARLAKE BLVD CHAMPAIGN IL 61822 CONSTRUCTION SERVICES 291698 DILLMAN BROTHERS 3509 CUNNINGHAM AVE URBANA IL 68102 CONSTRUCTION SERVICES 247914 5 311955 311955 RESIDENT SERVICES 623000 13622488 13622488 AMORTIZATION OF DEFERRED REVENUE 623000 1542939 1542939 15165427 224769 224769 6085421 6066620 18801 18801 18801 MEAL REVENUE 900099 105622 105622 GUEST SUITE 900099 69524 69524 HAIR SALON SERVICES 900099 58149 58149 111970 111970 345265 16066217 15165427 0 588835 389874 389874 6269834 5760944 508890 179237 162610 16627 453139 409414 43725 492809 435862 56947 24580 24580 43050 43050 75639 75639 753403 740053 13350 105596 105596 13240 13240 206287 178982 27305 1123515 1111350 12165 92837 37172 55665 18316 4515 13801 88125 88125 1682683 1664464 18219 253215 250473 2742 DIETARY 917876 917876 NURSING SUPPLIES & PHAR 573229 573229 MAINTENANCE AND GROUNDS 439972 435208 4764 ALL OTHER EXPENSES 221127 221127 453514 302249 151265 14871097 13306893 1564204 0 1858292 1077782 724592 1206812 679447 918786 25771 25510 138763 100285 41435590 22560031 11706564 18875559 16089186 14484225 11748 9598 7327229 2745887 38561592 39444444 1847769 1902158 13442379 15579335 3509530 3359895 26945 30766 2255500 126500 91189 92897 21173312 21091551 X 16623201 17404195 745993 926612 19086 22086 17388280 18352893 38561592 39444444 1195120 -230507 0 X X 0 1 X 1 0 X 51720 42312 49313 346245 311955 801545 13530880 14121884 14509060 14423044 15165427 71750295 13582600 14164196 14558373 14769289 15477382 72551840 0 0 0 72551840 271682 224200 195724 206985 224769 1123360 271682 224200 195724 206985 224769 1123360 222242 240414 376517 349500 345265 1533938 14076524 14628810 15130614 15325774 16047416 75209138 0.96470 0.96560 0.01490 0.01520 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2011 AMOUNT: $ 222,242. 2012 AMOUNT: $ 240,414. 2013 AMOUNT: $ 38,840. 2014 AMOUNT: $ 2,580. 2015 AMOUNT: $ 7,889. MEAL REVENUE - 2013 AMOUNT: $ 121,413. 2014 AMOUNT: $ 117,044. 2015 AMOUNT: $ 105,622. SALON SERVICES - 2013 AMOUNT: $ 54,420. 2014 AMOUNT: $ 60,949. 2015 AMOUNT: $ 58,149. GARAGE FEES - 2013 AMOUNT: $ 38,520. 2014 AMOUNT: $ 37,770. 2015 AMOUNT: $ 37,320. LAUNDRY INCOME - 2013 AMOUNT: $ 19,629. 2014 AMOUNT: $ 17,409. 2015 AMOUNT: $ 18,149. PERSONAL SERVICE ATTENDANT - 2013 AMOUNT: $ 1,738. 2014 AMOUNT: $ 4,184. 2015 AMOUNT: $ 3,385. GROCERY STORE - 2013 AMOUNT: $ 36,864. 2014 AMOUNT: $ 39,893. 2015 AMOUNT: $ 45,227. GUEST SUITE INCOME - 2013 AMOUNT: $ 65,093. 2014 AMOUNT: $ 69,671. 2015 AMOUNT: $ 69,524. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 2334249 33000 -12519 30206 12989 2311535 2255595 30000 64434 2514 13266 2334249 2060926 20000 204278 15992 13617 2255595 1895464 15000 184989 20816 13711 2060926 1975526 10000 -36476 41076 12510 1895464 0.86520 0.00960 0.12520 0 0 225000 225000 31463415 15615402 15848013 2072748 1158745 914003 7674427 5785884 1888543 18875559 CONSTRUCTION IN PROGRESS 2745887 2745887 DEFERRED COMPENSATION 92897 92897 X 15760071 -230507 -230507 15990578 75639 75639 16066217 14795458 0 14795458 75639 75639 14871097 PART IV, LINE 2B: THE RECORDS OF THREE COMMITTEES, INCLUDING THE MEADOWBROOK AUXILIARY FUND, THE RESIDENT COUNCIL FUND, AND THE LIBRARY FUND, ARE MAINTAINED BY CLARK-LINDSEY, BUT THE MONEY IS NOT CLARK-LINDSEY'S TO SPEND. IN ADDITION, MONEY IS MAINTAINED FOR HEALTH CENTER RESIDENTS IN A SEPARATE ACCOUNT, BUT THE MONEY IS NOT CLARK-LINDSEY'S TO SPEND. THESE FUNDS ARE INCLUDED IN CASH AND IN A LIABILITY CAPTIONED "FUNDS HELD FOR OTHERS". PART V, LINE 4: THE ARMSEY BEAUTIFICATION FUND IS A TERM ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT FOR CLARK-LINDSEY RESIDENT GROUNDS AND GARDENS. THE THOMPSON LIBRARY FUND IS A TERM ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF THE CLARK-LINDSEY RESIDENT LIBRARY. THE WEBBER EDUCATIONAL FUND IS A PERMANENT ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF CONTINUING EDUCATION FOR HEALTH CENTER STAFF. THE STEWART LIBRARY FUND IS A PERMANENT ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF THE CLARK-LINDSEY RESIDENT LIBRARY. THE KAULFERS FUND IS A BOARD DESIGNATED, QUASI ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT FOR QUALITY OF LIFE IMPROVEMENTS INCLUDING PROGRAMS AND FACILITIES ESPECIALLY DEVELOPED FOR SENIOR CITIZENS. PART X, LINE 2: CLARK-LINDSEY QUALIFIES AS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, CLARK-LINDSEY IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. CLARK-LINDSEY IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER THE CODE AND CONTRIBUTIONS TO CLARK-LINDSEY QUALIFY AS A CHARITABLE TAX DEDUCTION FOR THE CONTRIBUTOR. MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT FEES INCLUDED IN REVENUE 75,639. PART XII, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT FEES NET AGAINST REVENUE 75,639. X X 1 1 X X X X X 0 1 1 0 0 0 0 1 0 DEBRA S REARDANZ PRESIDENT / CEO 213603 0 12700 0 0 0 13945 0 17202 0 257450 0 0 0 PART I, LINE 1A DAVID HOOD AND WADE HAMPTON, BOARD MEMBERS, WERE PROVIDED REIMBURSEMENT FOR TRAVEL FOR COMPANIONS. THIS AMOUNT WAS INCLUDED IN EACH BOARD MEMBER'S TAXABLE COMPENSATION. CHRISTOPHER MOYER, BOARD MEMBER, WAS PROVIDED WITH REMIBURSEMENT FOR TRAVEL FOR COMPANIONS. THIS AMOUNT WAS NOT INCLUDED IN HIS TAXABLE COMPENSATION, AS THE AMOUNT WAS BELOW THE 1099-MISC REPORTING REQUIREMENT. TOM BERNS, BOARD MEMBER, WAS PROVIDED WITH FIRST-CLASS OR CHARTER TRAVEL DUE TO MEDICAL ISSUES. THIS AMOUNT WAS NOT INCLUDED IN HIS TAXABLE COMPENSATION. PART I, LINES 4B-C THE CEO HAS A BALANCE IN A 457 PLAN, BUT THERE WERE NO PAYMENTS TO THE PLAN IN 2015. PART I, LINE 7 BONUSES ARE PROVIDED BASED UPON THE ORGANIZATION'S FINANCIAL OUTCOME. A CITY OF URBANA CHAMPAIGN COUNTY ILLINOIS 376000524 NONEAVAIL 2004-05-20 5000000 IMPROVEMENTS TO HEALTHCARE FACILITY 0 0 0 A 1695105 5000000 100000 4900000 2005 0 0 1 1 A 0 1 0 0 0.00070 0.00070 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF URBANA, CHAMPAIGN COUNTY, ILLINOIS DATE THE REBATE COMPUTATION WAS PERFORMED: 06/13/2013 FORM 990, PART VI, SECTION B, LINE 11 THE BOARD DIRECTS THAT AT LEAST ONE BOARD MEMBER, WHO SERVES ON THE FINANCE COMMITTEE, CONDUCT THE ANNUAL REVIEW OF THE FORM 990 AND PRESENT IT TO THE FULL BOARD PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD DIRECTS THAT OFFICERS, DIRECTOR, AND KEY EMPLOYEES ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR PREPARING QUARTERLY REPORTS TO THE BOARD FINANCE COMMITTEE THAT DISCLOSES ACTUAL, POTENTIAL OR PERCEIVED CONFLICTS OF INTEREST. IN THE EVENT THAT A CONFLICT EXISTS, THE PERSON IS REQUIRED TO RECUSE HIMSELF OR HERSELF FROM PARTICIPATING IN THE DECISION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD DIRECTS THAT THE PERSONNEL & POLICY COMMITTEE (P&PC) CONDUCT THE PRESIDENT'S ANNUAL PERFORMANCE REVIEW AND DEVELOP SALARY AND COMPENSATION RECOMMENDATIONS FOR FULL BOARD APPROVAL. A COMPARATIVE ANALYSIS OF THE PRESIDENT'S ANNUAL COMPENSATION IS REVIEWED BY THE P&PC USING SOURCES SUCH AS INDEPENDENT SALARY SURVEYS, REVIEW OF FORM 990S AND OTHER INFORMATION AS IT IS AVAILABLE. TO ENSURE THE INDEPENDENCE AND OBJECTIVITY OF THE COMPARATIVE REVIEW, THE DATA AND ANALYSIS IS PREPARED BY SOMEONE OTHER THAN THE PRESIDENT. IN REGARDS TO OTHER OFFICERS AND KEY EMPLOYEES, THE PRESIDENT PERFORMS A SIMILAR PROCESS USING INDEPENDENT SALARY SURVEY DATA TO DETERMINE COMPENSATION. THESE PROCESSES WERE LAST UNDERTAKEN IN 2015. FORM 990, PART VI, SECTION C, LINE 19 CLARK-LINDSEY VILLAGE, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. FORM 990, PART XII, LINE 2C THE PROCESS FOR REVIEW AND OVERSIGHT OF THE AUDIT PROCESS IS CONSISTENT WITH PRIOR YEARS.