2015-05-14T11:31:34-05:00 2014-06-30 420714325 MCGLADREY LLP 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2013-07-01 371223609 COMMUNITY RESIDENTIAL CENTERS INC COMM 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 STAN SYDLOWSKI PRESIDENT 3093431550 2015-05-12 1 BEN MCMAHAN P00702421 3093428026 2013 2016-02-25 16:41:14Z STAN SYDLOWSKI 285 SOUTH FARNHAM STREET GALESBURG IL 61401 927893 0 X N/A X 1987 IL TO PROVIDE & OPERATE LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED. 4 4 323 0 0 0 25070 3878 9906456 919366 1739 -4670706 0 0 9933265 -3747462 0 0 0 0 6570058 917163 0 0 0 3245569 1068857 9815627 1986020 117638 -5733482 9633437 2276903 6741282 5118230 2892155 -2841327 X THE MISSION OF THE ORGANIZATION IS ARTICULATED IN ITS ARTICLES OF INCORPORATION AS FOLLOWS:THE CORPORATION IS ORGANIZED EXCLUSIVELY FOR CHARTIABLE PURPOSES AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN FURTHERANCE OF THOSE CHARITABLE PURPOSES, THE CORPORATION SHALL BE EMPOWERED TO BUILD, LEASE, ACQUIRE AND OTHERWISE OWN AND OPERATE RESIDENTIAL FACILITIES, NURSING FACILITIES AND OTHER RELATED FACILITIES AND SERVICES FOR THE ELDERLY, MENTALLY RETARDED, MENTALLY ILL, DEVELOPMENTALLY DISABLED AND OTHER LIKE CONDITIONS WITHOUT REGARD TO RACE, RELIGION, COLOR, SEX, CREED OR NATIONAL ORIGIN OF SAID PERSONS. THE CORPORATION WILL NOT ENGAGE IN THE PRACTICE OF MEDICINE NOR RENDER ANY LICENSED PROFESSIONAL SERVICES. 0 0 1773527 919366 ALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING LONG-TERM CARE FACILITIES AND OTHER RELATED SERVICES TO THE DEVELOPMENTALLY DISABLED AND ELDERLY. THE ORGANIZATION OPERATES ONE, 255-BED FACILITY. 1773527 1 0 0 0 0 0 0 0 0 0 1 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 1 0 0 0 0 1 1 0 1 0 1 16 0 1 323 1 0 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 IL X X RON WILSON RFMS INC 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 X GARY BRUINGTON DIRECTOR 2.00 0.00 X 3000 0 0 STAN SYDLOWSKI PRESIDENT 2.00 0.00 X X 3000 0 0 CHARLES WESTBAY SECRETARY 2.00 0.00 X X 3000 0 0 DAVID BEVERSDORF DIRECTOR 2.00 0.00 X 3000 0 0 RON WILSON RFMS INC CFO 40.00 X 0 0 0 12000 0 0 0 0 0 0 RFMS INC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 ADMINISTRATIVE SERVICES 135859 1 X 3878 3878 MEDICARE & MEDICAID 623000 731137 731137 RESIDENT PRIVATE PAY 623000 138908 138908 AID TRAINING INCOME 623000 47270 47270 SUPPORT SERVICES INCOM 623000 2051 2051 919366 4649 4649 4675355 -4675355 -4675355 -4675355 -3747462 919366 0 -4670706 4000 4000 669927 632971 36956 9833 9291 542 78646 74307 4339 154757 146220 8537 22939 17182 5757 72266 72266 24957 24957 12597 12597 865 778 87 8940 6914 2026 2717 2173 544 434541 404458 30083 8751 8649 102 62 56 6 255349 242582 12767 38961 33117 5844 MEDICAID ASSESSMENT TAX 97669 97669 SUPPLIES & SMALL EQUIP. 66962 66962 EQUIPMENT RENT & MAINT. 16547 16547 SUBSCRIPTIONS & FEES 1958 823 1135 2776 231 2545 1986020 1773527 212493 0 167925 365561 278131 454151 2634718 66519 4287876 3874034 5337391 413842 10000 10000 1138753 1033349 9633437 2276903 579020 336090 27508 4770576 4754632 1391686 0 6741282 5118230 X 2892155 -2841327 2892155 -2841327 9633437 2276903 -5733482 0 X 0 0 0 X 16802 20620 16940 25070 3878 83310 10042712 9949772 9563561 9906456 919366 40381867 10059514 9970392 9580501 9931526 923244 40465177 0 0 0 40465177 2376 171160 10206 1739 4649 190130 2376 171160 10206 1739 4649 190130 5969 2615 8584 10067859 10144167 9590707 9933265 927893 40663891 0.99510 0.99580 0.00470 0.00390 X 184000 184000 2507481 2277639 229842 950513 950513 0 405757 405757 0 240125 240125 0 413842 DEFERRED FINANCING COSTS 86023 ESCROW DEPOSITS 22619 REPLACEMENTS RESERVE 924707 1033349 LTC SUPPORT SERVICES LTC TWO DIRECTORS COMMON TO CRC & LTC: STAN SYDLOWSKI & CHARLES WESTBAY. 14280 SUPPORT SERVICES ARE PROVIDED BY LTC SUPPORT SERVICES, LLC, AS DESCRIBED IN SCHEDULE O RELATIVE TO PART VI, SECTION A, LINE 3. STAN SYDLOWSKI, WHO IS A DIRECTOR OF COMMUNITY RESIDENTIAL CENTERS, INC. AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $0 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING JUNE 30, 2014. CHARLES WESTBAY, WHO IS A DIRECTOR OF COMMUNITY RESIDENTIAL CENTERS, INC. AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $0 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING JUNE 30, 2014. 0 FORM 990, PART IV, LINE 31: THE RESIDENTIAL FACILITY USED BY COMMUNITY RESIDENTIAL CENTERS, INC. (CRC) WAS DELISTED BY THE STATE OF ILLINOIS. ALL OF THE RESIDENTS OF CRC WERE TRANSFERRED TO THE CARE OF ACHIEVEMENT UNLIMITED, INC. AND MOVED TO FACILITIES OPERATED BY THAT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION RECEIVES SUPPORT SERVICES FROM LTC SUPPORT SERVICES, LLC, AN UNRELATED COMPANY. THESE SERVICES INCLUDE OVERSIGHT, TRAINING, REGULATORY COMPLIANCE, QUALITY ASSURANCE PROGRAMS, HUMAN RESOURCE SUPPORT, MARKETING AND MAINTENANCE. COMMUNITY RESIDENTIAL CENTERS, INC., OWNS 12.5% OF LTC SUPPORT SERVICES, LLC. THE REMAINING 87.5% OF LTC SUPPORT SERVICES, LLC, IS OWNED BY UNRELATED EXEMPT ORGANIZATIONS. THE ORGANIZATION ALSO HAS A NEGOTIATED ARMS LENGTH ADMINISTRATIVE SERVICES CONTRACT WITH RFMS, INC., AN UNRELATED COMPANY, TO OBTAIN SERVICES SUCH AS CASH MANAGEMENT, ACCOUNTING AND FINANCIAL REPORTING, PAYROLL AND EMPLOYEE BENEFITS, INFORMATION TECHNOLOGY, REGULATORY MATTERS, AND OTHER GENERAL BUSINESS AND FINANCIAL MANAGEMENT SERVICES AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 11 EACH MEMBER OF THE BOARD OF DIRECTORS RECEIVES A PAPER COPY OF FORM 990 FOR THEIR REVIEW AND COMMENT PRIOR TO ITS FILING. THE BOARD ALSO REVIEWS IN DETAIL EACH FORM 990 FILED BY THE ORGANIZATION AT ITS REGULARLY SCHEDULED BOARD MEETINGS. ON AN ANNUAL BASIS, EACH BOARD MEMBER ATTENDS A TRAINING SESSION THAT PROVIDES UPDATES ON CURRENT EXEMPT ORGANIZATION TAX COMPLIANCE MATTERS. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO ATTEST TO THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. THE BOARD OF DIRECTORS REVIEWS ALL COMPLETED CONFLICT OF INTEREST STATEMENTS TO DETERMINE IF ANY CONFLICTS EXIST WHICH WOULD REQUIRE RESTRICTION ON PARTICIPATION IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN ANY TRANSACTIONS INVOLVING THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 18 A PAPER COPY OF FORM 990 IS PROVIDED UPON REQUEST. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE VIA THE GUIDESTAR.ORG WEBSITE AND THROUGH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXCEPT THROUGH PUBLIC FILING REQUIREMENTS. FORM 990, PART VII, SECTION A, COLUMN F: RON WILSON IS EMPLOYED BY RFMS, INC., AN UNRELATED ORGANIZATION WHICH HAS AN ADMINISTRATIVE SERVICES CONTRACT WITH COMMUNITY RESIDENTIAL CENTERS, INC. THE TYPE OF SERVICES PROVIDED BY RFMS, INC., ARE DETAILED IN THE SCHEDULE O EXPLANATION ABOVE RELATIVE TO FORM 990, PART VI, SECTION A, LINE 3. RON WILSON IS THE CHIEF FINANCIAL OFFICER OF RFMS, INC. HIS COMPENSATION REPORTED ON HIS RFMS, INC. FORM W-2, BOX 5 FOR CALENDAR YEAR 2013 IS $173,862. RON WILSON'S COMPENSATION AMOUNT AND HOURS HAVE NOT BEEN PRORATED BASED ON TIME SPENT FOR EACH OF THE NINETEEN ORGANIZATIONS TO WHOM SERVICES ARE PROVIDED BY RFMS, INC. FORM 990, PART VIII, LINES 7A THROUGH 7D: ESTIMATED IMPAIRMENT OF FAIR MARKET VALUE OF REAL ESTATE FORMERLY USED TO PROVIDE LONG-TERM CARE AND RESIDENCE TO THE DEVELOPMENTALLY DISABLED. CRC CHERRY STREET FACILITY LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 421578299 OWNS FACILITY OPERATED BY COMMUNITY RESIDENTIAL CENTERS, INC. IL 42 1498068 N/A RFMS INC MEDICAL BENEFIT PLAN TRUST 285 SOUTH FARNHAM STREET GALESBURG IL 61401 367042729 MEDICAL, ST DISABILITY & DEATH BENEFITS FOR ELIGIBLE EMPLOYEES IL 501(C)(9) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RFMS INC MEDICAL BENEFIT PLAN TRUST R 70176 COST OF PREMIUMS SCHEDULE R, PART II AND PART V: THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST IS A SELF-INSURED BENEFIT PROGRAM FUNDED BY THE EMPLOYERS AND PARTICIPANTS WITHIN THE PLAN. PARTICIPANTS IN THE PLAN ARE CURRENT AND FORMER EMPLOYEES OF THE FOLLOWING SPONSORS: RFMS, INC., LTC SUPPORT SERVICES, LLC, COMMUNITY RESIDENTIAL CENTERS, INC., COMMUNITY LIVING OPTIONS, INC., SMSLC, LLC, FRANCES HOUSE, INC., UNLIMITED DEVELOPMENT, INC., KENSINGTON OF GALESBURG, INC., ACHIEVEMENT UNLIMITED, INC., CONCEPTS PLUS, INC., PINNACLE OPPORTUNITIES, INC., PIONEER CONCEPTS, INC., RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., RESIDENTIAL ALTERNATIVES OF IOWA, DESERT HEALTHCARE FACILITIES, INC., FLORIDA LIVING OPTIONS, INC., AND HIGHLAND ESTATES RESORT, LLC. PLAN ASSETS ARE HELD IN A VOLUNTARY EMPLOYEES' BENEFIT ASSOCIATION (VEBA) TRUST. NO TRUSTEE FEES OR MANAGEMENT FEES ARE PAID BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST.