2015-11-23T16:08:42-06:00 2015-03-31 420714325 RSM US LLP 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2014-04-01 371223846 RESIDENTIAL ALTERNATIVES OF ILLINOISINC RESI 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 IRWIN JANN PRESIDENT 3093431550 2015-11-12 1 MICHAEL BASS P00458970 3093428026 2014 2016-03-07 17:11:31Z IRWIN JANN 285 SOUTH FARNHAM STREET GALESBURG IL 61401 84482422 0 X N/A X 1987 IL RAI PROVIDES & OPERATES NURSING AND ASSISTED LIVING FACILITIES FOR THE ELDERLY. 5 4 2067 71 0 0 12955 10763 67348572 82585832 246236 240178 0 0 67607763 82836773 14176 500 0 0 28671232 34235471 0 0 0 36152443 44232681 64837851 78468652 2769912 4368121 37392577 40565873 20807022 19441428 16585555 21124445 X THE MISSION OF THE ORGANIZATION IS ARTICULATED IN ITS ARTICLES OF INCORPORATION AS FOLLOWS:THE CORPORATION IS ORGANIZED EXCLUSIVELY FOR CHARITABLE 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 72932226 500 82585832 ALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING SKILLED NURSING FACILITIES, HEALTH CARE, ASSISTED AND SEMI-INDEPENDENT LIVING FACILITIES, AND OTHER RELATED SERVICES TO THE ELDERLY. THE ORGANIZATION OPERATES 26 FACILITIES WITH A COMBINED TOTAL OF 1,627 BEDS WITHIN THESE FACILITIES. 72932226 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 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 47 0 2067 1 0 0 0 0 0 0 0 0 0 0 X 5 4 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 IL X RON WILSON RFMS INC 3093431550 285 S FARNHAM GALESBURG IL 61401 X IRWIN JANN PRESIDENT 1.00 1.00 X X 6000 0 0 JEFFREY SHAW SECRETARY 1.00 1.00 X X 6000 0 0 DOUG BIEDERSTEDT DIRECTOR 1.00 1.00 X 4500 0 0 WILLIAM KEMPINERS DIRECTOR 1.00 1.00 X 6000 0 0 JOHN KNIERY DIRECTOR 1.00 1.00 X 6000 0 0 RON WILSON RFMS INC CFO 40.00 X 0 0 0 LISA MILLER ADMINISTRATOR 40.00 0.00 X 106984 0 5248 ANDRES BARDELAS ADMINISTRATOR 40.00 0.00 X 115924 0 5304 251408 0 10552 2 0 0 0 AEGIS THERAPIES PO BOX 8103 FORT SMITH AR 72902 THERAPY SERVICES 4029291 ONR 1101 S CAPITAL OF TEXAS HWY AUSTIN TX 78746 THERAPY SERVICES 2178633 RFMS INC 285 S FARNHAM GALESBURG IL 61401 ADMINISTRATIVE SERVICES 1650000 LTC SUPPORT SERVICES LLC 285 S FARNHAM GALESBURG IL 61401 SUPPORT SERVICES 996420 PROFESSIONAL THERAPY SERVICES 2810 FRANK SCOTT PARKWAY WEST BELLEVILLE IL 62223 THERAPY SERVICES 470590 6 10763 10763 PRIVATE PAY RESIDENT SERVICES 623000 42517500 42517500 MEDICARE & MEDICAID 623000 39689167 39689167 OTHER INCOME 623000 242245 242245 MAINTENANCE FEES 623000 136920 136920 82585832 232801 232801 1653026 1645649 7377 7377 7377 82836773 82585832 0 240178 X 500 500 28500 28500 29468175 28585673 882502 182120 176666 5454 2202890 2136919 65971 2353786 2283296 70490 2798898 1841009 957889 55037 55037 319346 319346 8592102 8592102 799269 719342 79927 519280 406983 112297 239378 191502 47876 15758078 15292152 465926 175588 173765 1823 53272 47445 5827 1956 1897 59 1175774 1116985 58789 623681 480815 142866 SUPPLIES & SMALL EQUIPM 8764774 8738481 26293 UNCOLLECTIBLE CHARGES 2117045 2117045 MEDICAID ASSESSMENT TAX 1453938 1453938 EQUIPMENT RENTAL & MAIN 653350 632082 21268 131915 60674 71241 78468652 72932226 5536426 0 1163397 1370690 3948041 3277461 10071455 11891717 224288 287468 23369322 7520110 18246740 15849212 3078656 5198667 660000 10000 0 2680658 37392577 40565873 7578092 6431394 429000 322000 12799930 12688034 20807022 19441428 X 16585555 21124445 16585555 21124445 37392577 40565873 4368121 170769 0 X X 0 1 X 1 0 X 8261 5830 9144 12955 10763 46953 58859590 62884673 63205073 67348572 82585832 334883740 58867851 62890503 63214217 67361527 82596595 334930693 0 0 0 334930693 73909 99165 58778 241351 232801 706004 73909 99165 58778 241351 232801 706004 58941760 62989668 63272995 67602878 82829396 335636697 0.99790 0.99840 0.00210 0.00160 X 0 0 72932226 72932226 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 14384 13198 14054 0 41636 250000 250000 250000 250000 1000000 1500000 273810 273810 13793249 1939047 11854202 4200911 2040677 2160234 4003042 2686062 1316980 1098310 854324 243986 15849212 FACILITY ASSETS HELD FOR SALE 2680658 2680658 RESIDENT SECURITY DEPOSITS 1278363 AMOUNTS REFUNDABLE TO RESIDENTS 242000 DUE TO RESIDENTS, TRUST ACCTS 96538 MORTGAGE NOTE PAYABLE TO FRANCES HOUSE, INC. 10117513 DUE TO THIRD PARTY PAYORS 432000 INTEREST PAYABLE TO FRANCES HOUSE, INC. 300044 RENT PAYABLE TO PEORIA MANOR COURT, LTD., NFP 151279 RENT PAYABLE TO FRANCES HOUSE, INC. 7091 RENT PAYABLE TO PERU BECKER, LTD., NFP 63206 12688034 X PART X, LINE 2: FRANCES HOUSE, INC. AND SUBSIDIARIES ARE EXEMPT FROM INCOME TAXES UNDER SECTIONS 501(C)(3) OR 501(C)(2) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2011. SCHEDULE D, PART IX: THE ORGANIZATION DETERMINED DURING THE YEAR THAT THEY WOULD SEEK A BUYER FOR ONE OF THE SKILLED NURSING FACILITIES. LTC SUPPORT SERVICES (LTC) TWO DIRECTORS COMMON TO BOTH RAI & LTC ARE JEFF SHAW & IRWIN JANN. 1103900 SUPPORT SERVICES ARE PROVIDED BY LTC SUPPORT SERVICES, LLC, AS DESCRIBED IN SCHEDULE O RELATIVE TO PART VI, SECTION A, LINE 3. JEFFREY SHAW, WHO IS A DIRECTOR OF RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $3,000 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING MARCH 31, 2015. IRWIN JANN, WHO IS A DIRECTOR OF RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $3,000 FOR THE FISCAL YEAR ENDING MARCH 31, 2015 AND COMPENSATION OF $20,000 FROM LTC SUPPORT SERVICES, LLC. 0 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. RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., OWNS 12.5% OF LTC SUPPORT SERVICES, LLC., AND FRANCES HOUSE, INC., (PARENT ORGANIZATION OF RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC.) OWNS 12.5% OF LTC SUPPORT SERVICES, LLC. THE REMAINING 75% 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 A, LINE 7A THE ORGANIZATION IS A SUBSIDIARY OF FRANCES HOUSE, INC. FRANCES HOUSE, INC., IS THE MEMBER OF THE ORGANIZATION. FRANCES HOUSE, INC., ELECTS THE GOVERNING BODY ON AN ANNUAL BASIS. 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 RESIDENTIAL ALTERNATIVES OF ILLINOIS, 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 2014 IS $173,518. THIS COMPENSATION AMOUNT HAS NOT BEEN PRORATED BASED ON TIME SPENT FOR EACH OF THE SEVENTEEN ORGANIZATIONS TO WHOM SERVICES ARE PROVIDED BY RFMS, INC. FORM 990, PART VII, SECTION A, COLUMN B: APPROXIMATELY ONE HALF OF THE AVERAGE HOURS PER WEEK ESTIMATED FOR EACH DIRECTOR IS DEVOTED TO RELATED ORGANIZATIONS LISTED ON SCHEDULE R. FORM 990, PART IX, LINE 11G CONSULTANT FEES - LAB, XRAY, THERAPY, DIETARY, RESPITORY, SPEECH, PHARMACY: PROGRAM SERVICE EXPENSES 8,592,102. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,592,102. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XII, LINE 2B: THE FINANCIAL STATEMENTS OF RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., WERE AUDITED AS PART OF THE CONSOLIDATED FINANCIAL REPORT ISSUED FOR FRANCES HOUSE, INC., AND SUBSIDIARIES. CORALVILLE MANOR LLC 2332 LIBERTY DRIVE CORALVILLE IA 52241 300233914 OPERATES WINDMILL MANOR, A SKILLED NURSING FACILITY IA 7607409 1772340 N/A FRANCES HOUSE INC 285 S FARNHAM STREET GALESBURG IL 61401 371087901 OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED. IL 501(C)(3) LINE 9 N/A 0 PINNACLE OPPORTUNITIES INC 285 S FARNHAM STREET GALESBURG IL 61401 364143605 OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED. IL 501(C)(3) LINE 9 N/A 0 PIONEER CONCEPTS INC 285 S FARNHAM STREET GALESBURG IL 61401 364143602 OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED. IL 501(C)(3) LINE 9 N/A 0 CLINTON PARK LANE LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262341666 NO ACTIVITY IL 501(C)(2) N/A 0 FREEPORT NAVAJO LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262341569 NO ACTIVITY IL 501(C)(2) N/A 0 FREEPORT MANOR COURT LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262905838 NO ACTIVITY IL 501(C)(2) N/A 0 GENESEO SOUTH CHICAGO LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262341757 NO ACTIVITY IL 501(C)(2) N/A 0 MANOR COURT OF PRINCETON LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262865939 NO ACTIVITY IL 501(C)(2) N/A 0 PEORIA MANOR COURT LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262341694 ACQUIRING & HOLDING TITLE TO PROPERTY; REMITTING ALL INCOME TO 501(C)(3) IL 501(C)(2) N/A 0 PEORIA STALWORTH LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262341610 NO ACTIVITY IL 501(C)(2) N/A 0 PERU BECKER LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262341728 ACQUIRING & HOLDING TITLE TO PROPERTY; REMITTING ALL INCOME TO 501(C)(3) IL 501(C)(2) N/A 0 STEATOR EASTWOOD LTD NFP 285 S FARNHAM STREET GALESBURG IL 61401 262341779 NO ACTIVITY IL 501(C)(2) N/A 0 RFMS INC MEDICAL BENEFIT PLAN TRUST 285 S 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 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 PERU BECKER LTD NFP K 1437206 CASH TRANSACTION BASED ON FMV PEORIA MANOR COURT LTD NFP K 972000 CASH TRANSACTION BASED ON FMV RFMS INC MEDICAL BENEFIT PLAN TRUST R 1048770 COST OF PREMIUMS SCHEDULE R, PART II: RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., IS A SUBSIDIARY OF FRANCES HOUSE, INC. PIONEER CONCEPTS, INC., AND PINNACLE OPPORTUNITIES, INC., ARE SUBSIDIARIES OF FRANCES HOUSE, INC. THE 501(C)(2) ORGANIZATIONS LISTED IN THIS SECTION ARE SUBSIDIARIES OF FRANCES HOUSE, INC. 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 LIVING OPTIONS, INC., SMSLC, LLC, FRANCES HOUSE, INC., UNLIMITED DEVELOPMENT, INC., KENSINGTON OF GALESBURG, INC., ACHIEVEMENT UNLIMITED, INC., PINNACLE OPPORTUNITIES, INC., PIONEER CONCEPTS, INC., RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., 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. THE PLAN IS SUBJECT TO THE PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA), AS AMENDED. NO TRUSTEE FEES OR MANAGEMENT FEES ARE PAID BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST. THE AMOUNT OF PREMIUMS RECEIVED BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST IS FOR THE PLAN'S FISCAL YEAR ENDING OCTOBER 31, 2014.