2015-11-16T12:49:54-06:00 2014-12-31 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2014-01-01 362382853 Rest Haven Illiana Christian Convalescent Home % WILLIAM DEYOUNG REST 7083428100 18601 North Creek Drive Tinley Park IL 60477 William DeYoung Chief Financial Officer 7083428100 2015-11-16 true Mollie P Longhouse P00294881 6142492300 2014 2016-04-25 22:37:26Z Providence Life Services Richard Schutt 18601 North Creek Drive Tinley Park IL 60477 61467033 false X www.providencelifeservices.com X 1956 IL Rest Haven's purpose is to provide services for the aged including skilled nursing ad rehab services, home health care, town home living, independent and assisted living. 15 15 1221 350 12368 260 1449177 1313214 70682235 57971086 23271088 1449987 -123677 -157998 95278823 60576289 0 0 0 0 39547950 30332536 0 0 0 42645711 28378846 82193661 58711382 13085162 1864907 103632118 107674828 68857981 70691215 34774137 36983613 X See Schedule O false false 52126017 57958718 To provide proper care for the sick and elderly. 843 beds/units with occupancy over 92% on the full continuum of care. 52126017 true true false false false false false false false false true false false true true true true false false false false false false false true false false false false true true false false false false false false false false true false false false false false true true false false false true 95 0 true 1221 true true true false false false false true true false false false false X 15 15 false false false false true true true true true false false false true true true true true true true false IL IN MI X WILLIAM DEYOUNG 7083428139 18601 NORTH CREEK DRIVE TINLEY PARK IL 60477 Norm Aardema Chair 2.0 0.0 X X 0 0 0 Lucette Bamford Director 2.0 0.0 X 0 0 0 Dr Dave Beezhold Director 2.0 0.0 X 0 0 0 Tim Breems Director 2.0 0.0 X 0 0 0 Hal Brown Director 2.0 0.0 X 0 0 0 Jean Cavanaugh Director 2.0 0.0 X 0 0 0 Sharon Clousing Vice Chair 2.0 0.0 X X 0 0 0 Al Diepstra Director 2.0 0.0 X 0 0 0 Gary Ellens Director 2.0 0.0 X 0 0 0 Howard Hoff Secretary/Treasurer 2.0 0.0 X X 0 0 0 Justin Kats Director 2.0 0.0 X 0 0 0 Ken Schoon Director 2.0 0.0 X 0 0 0 Cal Tameling Asst. Sec./Treas. 2.0 0.0 X X 0 0 0 Don Van Dyk Director 2.0 0.0 X 0 0 0 Rich Van Hattem Director 2.0 0.0 X 0 0 0 Kurt Nelson Director 2.0 0.0 X 0 0 0 Ron Porter Director 2.0 0.0 X 0 0 0 Arnold Koldenhoven Chair 2.0 0.0 X X 0 0 0 Rich Schutt CEO 45.0 0.0 X 478050 0 147668 Bill De Young CFO 45.0 0.0 X 318136 0 71199 Cheryl Widdowson Exec VP of Healthcare Services 45.0 0.0 X 285424 0 80332 Mark Trnka VP of AL/IL Operations 45.0 0.0 X 169292 0 29717 Ray Hemphill VP of Project Development 45.0 0.0 X 222027 0 42305 Barry VanderGenugten VP of Finance 45.0 0.0 X 167274 0 29284 Mary Kay Kacmarek VP Clinical Services 45.0 0.0 X 136084 0 36098 Jeffery Courtney VP Construction 45.0 0.0 X 141082 0 39670 Nancy VanDrunen Administrator 45.0 0.0 X 133321 0 29624 2050690 0 505897 52 false true false Symbria Rx Services 28100 Torch Parkway Suite 600 Warrenville IL 60555 Pharmacy 1950858 MarianJoy 13259 S Central Avenue Palos Heights IL 60463 Therapy 1750000 Gordon Food Service Inc PO Box 88029 Chicago IL 606801029 Dietary 1927416 ProviNET Solutions 18645 West Creek Drive Tinley Park IL 60477 It Services 1627990 Creative Dining Services One Royal Park Drive Suite 3 Zeeland MI 49464 Dietary 893133 37 199896 1113318 1313214 Routine Revenue 621610 52980789 52980789 Ancillary Revenue 621610 4990297 4977929 12368 57971086 1412613 1412613 0 0 0 0 0 644551 607177 37374 37374 37374 125569 199896 283567 -157998 -157998 0 0 0 60576289 57958718 12368 1291989 0 0 0 0 1410526 1410526 0 23753246 21542542 2210704 513241 302334 210907 2834275 2240593 593682 1821248 1616417 204831 0 115773 115773 329591 329591 0 0 0 3879854 3879854 0 0 691978 691978 0 1964852 1574578 390274 0 0 0 1873632 1873632 0 2561643 2539938 21705 2568339 2476523 91816 NURSING EXPENSE 2951558 2951558 FOOD & DIETARY EXPENSE 2907061 2907061 PHARMACY EXPENSE 2033208 2033208 REPAIRS & MAINTENANCE 1386968 1386968 5114389 4355447 758942 58711382 52126017 6585365 0 1620581 9218822 3263543 2573354 168782 34500 5344945 7625283 0 0 0 0 11500000 0 0 0 273080 418117 112955778 58491686 49650456 54464092 19279540 19180975 2992730 0 0 0 0 0 9538461 14159685 103632118 107674828 10686795 9117944 0 0 3954374 4609197 7837252 6730566 0 0 0 0 43517855 46691520 0 0 2861705 3541988 68857981 70691215 X 34330398 36804797 443739 178816 0 0 34774137 36983613 103632118 107674828 X 1864907 -117345 264332 197582 X false true X true true true X 1843841 1657909 741230 1449177 1313214 7005371 70618626 73255481 73371512 70682235 57958718 345886572 0 0 0 72462467 74913390 74112742 72131412 59271932 352891943 0 0 0 352891943 740596 181696 1344675 932659 1412613 4612239 0 0 0 0 12268 12268 740596 181696 1344675 932659 1424881 4624507 0 0 0 0 0 0 0 73203063 75095086 75457417 73064071 60696813 357516450 0.98706 0.99052 0.01294 0.00949 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6490782 6490782 72558904 41839212 30719692 17774938 16202630 1572308 16131154 449844 15681310 54464092 GROUND LEASE RECEIVABLES 1300660 DEFERRED FINANCING COSTS 1248051 ASSETS LIMITED TO USE 4395448 DUE FROM AFFILIATES 2869601 OTHER ASSETS 476332 LEGAL LIABILITY INS RECOVERIES 1876575 DEFERRED COMP GRANTOR TRUST 1993018 14159685 0 CHARITABLE ANNUITY CONTRACTS 254704 ACCRUED INTEREST PAYABLE 205665 RESIDENT NOTES AND DEPOSITS 638587 ASSET RETIREMENT OBLIGATION 310383 ESTIMATED SELF-INS LIABILITIES 2132649 3541988 X 33106576 -82588 -82588 33189164 27387125 27387125 60576289 36763785 36763785 21947597 21947597 58711382 ASC 740 FOOTNOTE THE CORPORATIONS ACCOUNT FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL, WHICH ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, THE CORPORATIONS MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES ON INCOME TAXES AND ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AS OF DECEMBER 31, 2014 AND 2013, THE CORPORATIONS DO NOT HAVE A LIABILITY FOR ANY UNRECOGNIZED TAX BENEFITS. Reconciliation of Revenue Part XI Line 4b Other (Revenue) Disregarded Entity Revenue 21,704,917 Providing for Related Party Bad Debt 5,123,457 Provision for uncollectable accounts 558,751 ------------ Total Line 4b 27,387,125 Reconciliation of Expenses Part XII, Line 4b Other (Expense) Disregard Entity Expenses 21,947,597 Banquet 165628 98389 67239 227692 Golf Outing 123643 75763 47880 41694 2 36194 25744 10450 14181 325465 199896 125569 283567 283567 -157998 FUNDRAISING OR GAMING ACTIVITIES FORM 990, SCHEDULE G, PART II The organization hosts events for public relations and fundraising purposes. These events are often underwritten by leadership sponsors of which their sponsorships are allocated amongst the various events. The combined gross receipts of the events totaled $325,465 for 2014. The combined costs of the events totaled $283,567. The net income to the organization for hosting all of the events was $41,898. X X true true X X X X X X false true false false false false false false false Rich Schutt CEO 418374 0 43020 0 16656 0 113894 0 33774 0 625718 0 Bill De Young CFO 277099 0 29039 0 11998 0 36422 0 34777 0 389335 0 Cheryl Widdowson Exec VP of Healthcare Services 249196 0 25903 0 10325 0 54690 0 25642 0 365756 0 Ray Hemphill VP of Project Development 176416 0 37000 0 8611 0 9055 0 33250 0 264332 0 0 Mark Trnka VP of AL/IL Operations 147569 0 13500 0 8223 0 6833 0 22884 0 199009 0 0 Barry VanderGenugten VP of Finance 149173 0 7000 0 11101 0 6625 0 22659 0 196558 0 0 Mary Kay Kacmarek VP Clinical Services 133956 0 0 2128 0 4388 0 31710 0 172182 0 0 Jeffery Courtney VP Construction 121242 0 13332 0 6508 0 5940 0 33730 0 180752 0 0 Nancy VanDrunen Administrator 117258 0 15000 0 1063 0 5702 0 23922 0 162945 0 0 Form Sch J Part I Line 1a THE ORGANIZATION PROVIDES AN ALLOWANCE FOR UP TO 10 BOARD MEMBERS TO ATTEND THE ANNUAL ASSOCIATION CONVENTION TO PROVIDE MORE IN DEPTH KNOWLEDGE OF THE SENIOR CARE INDUSTRY. THE COST OF TRAVEL FOR SPOUSES IS PERMITTED AS LONG AS THE TOTAL DOES NOT EXCEED THE ESTABLISHED ALLOWANCE AMOUNT. DOCUMENTATION OF ATTENDANCE AT THE ANNUAL CONVENTION IS REQUIRED. THE ORGANIZATION HAS ESTABLISHED A SENIOR EXECUTIVE MANAGEMENT PROGRAM WHICH ALLOWS STATED EMPLOYEES TO JOIN A FITNESS CENTER. ELIGIBLE EMPLOYEES THAT ENROLL ARE REQUIRED TO BE ACTIVELY UTILIZING THE FITNESS CENTER. Form Sch J Part I Line 4b REST HAVEN HAS ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN IN AN EFFORT TO RETAIN SELECTED OFFICERS ON A LONG TERM BASIS. THE FOLLOWING IS A SCHEDULE OF THE OFFICERS AND THE ANNUAL CONTRIBUTION TO THE PLAN: RICHARD SCHUTT $103,494 WILLIAM DEYOUNG $26,022 CHERYL WIDDOWSON $45,014 IN 2005, THE BOARD OF DIRECTORS ESTABLISHED A RETENTION INCENTIVE PLAN FOR CERTAIN OFFICERS. THIS PLAN RECOGNIZES THE HISTORIC CONTRIBUTION OF THE EXECUTIVES AND ESTABLISHES AN INCENTIVE FOR THEM TO CONTINUE THEIR EMPLOYMENT WITH THE ORGANIZATION UNTIL NORMAL RETIREMENT AGE. AMONG VARIOUS CRITERIA, IN ORDER TO QUALIFY FOR THE BENEFIT, THE EXECUTIVE WILL NEED TO BE CONTINUOUSLY EMPLOYED THRU AND UNTIL A FUTURE DATE. THE ORGANIZATION'S PAYMENTS INTO THE PLAN ARE RECORDED ON THE 990 AS DEFERRED COMPENSATION. HOWEVER, THE EXECUTIVE HAS NOT RECEIVED THESE MONIES AND WILL ONLY BE ELIGIBLE TO RECEIVE THEM BASED UPON THE ACHIEVEMENT OR SATISFACTION OF SOME FUTURE EVENTS. THE PLAN CONTRIBUTIONS ARE NOT UNDER THE CONTROL OF THE EXECUTIVE, THEY REMAIN THE ASSET OF THE ORGANIZATION, AND THE ENTIRE PLAN IS SUBJECT TO A FULL RISK OF FORFEITURE BY THE INDIVIDUAL. Form Sch J Part I Line 5a THE EXECUTIVE COMPENSATION PROGRAM HAS TWO MAJOR ELEMENTS: SALARY, OR BASE PAY, AND VARIABLE PAY. THE SALARY REFLECTS THE VALUE OF AN EXECUTIVE'S CAPABILITIES AND EXPERIENCE. THE VARIABLE PAY REFLECTS THE ORGANIZATION'S COMMITMENT TO PAY FOR SPECIFIC PERFORMANCE TOWARDS THE ORGANIZATION'S GOALS. THE VARIABLE PAY IS AWARDED BASED UPON A SPECIFIC REVIEW OF GOALS AND OBJECTIVES (INCLUDING THOSE WHICH RELATE TO MISSION, OPERATIONAL EFFICIENCY, FINANCIAL EFFECTIVENESS, AND STRATEGIC GOALS). SEMI-ANNUALLY THE COMPENSATION COMMITTEE REVIEWS, ASSESSES AND DETERMINES ANY AWARD UNDER THE VARIABLE PAY COMPONENT. EXECUTIVE EMPLOYEE BENEFITS ARE REVIEWED BY THE COMPENSATION COMMITTEE AND OUTSIDE CONSULTANTS TO INSURE THEY ARE COMPETITIVE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSITIONS IN SIMILARLY SIZED AND TYPE ORGANIZATIONS. THE COMMITTEE RECEIVES AN EXECUTIVE COMPENSATION OPINION NOTING THAT THE ORGANIZATION'S EXECUTIVE COMPENSATION FALLS WITHIN THE RANGE OF COMPARABLE POSITIONS WITHIN THE SAME INDUSTRY. THE REPORT/OPINION ALSO NOTES THAT THE STATED REQUIREMENTS OF ENSURING INDEPENDENCE OF COMPENSATION DELIBERATIONS FOR SENIOR EXECUTIVES ARE MET. A Illinois Finance Authority 861091967 2009-12-29 27689940 Refinancing false false false A 20107374 0 27689940 0 0 0 329940 0 0 0 0 0 true false true true A false false false false 0 false false false false A false false false true false false 0 false 0 false false A true Linda Schutt Spouse of CEO 92998 Employment Compensation false Allison Oleshko Daughter of CEO 39848 Employment Compensation false Bonnie Heirendt Sister of CEO 50019 Employment Compensation false Part IV The transactions reported above involving interested persons are reviewed annually by the boards compensation committee and have been deemed appropriate based on the position employed. Form 990 Part III Line 1 REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME D/B/A PROVIDENCE LIFE SERVICES (REST HAVEN) IS A NOT-FOR-PROFIT ILLINOIS CORPORATION WHOSE PURPOSE IS TO PROVIDE NURSING AND RESIDENTIAL LIVING ARRANGEMENTS FOR THE AGED INCLUDING SKILLED NURSING AND REHABILITATION SERVICES, HOME HEALTH CARE, TOWNHOME LIVING, INDEPENDENT LIVING, AND ASSISTED LIVING. Form 990 VI Line 6 Members of the Association Form 990 VI Line 7a The members elect the members of the governing body (but not if the persons on the governing body are the orginazation's only members) or their delegates. Form 990 VI Line 7b The members approve changes to the by-laws. Form 990 Part VI Line 11b A DRAFT OF THE 990 WAS PREPARED AND SENT FOR INITIAL REVIEW BY THE CONTROLLER, CFO AND CEO. UPON REVIEW AND APPROVAL, THE FINAL DRAFT IS FORWARDED TO THE EXECUTIVE COMMITTEE BEFORE SUBMISSION. A COMPLETED COPY OF THE 990 IS PROVIDED TO THE FULL BOARD AT THE SUBSEQUENT BOARD MEETING, AFTER FILING. Form 990 Part VI Line 12c THE OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT UPON BEGINNING THEIR POSITION. THEREAFTER, THE CONFLICT OF INTEREST STATEMENTS ARE UPDATED ON AN ANNUAL BASIS. ANY POTENTIAL CONFLICTS ARE REVIEWED AND ADDRESSED BY THE BOARD AS NECESSARY. Form 990 Part VI Line 15a & 15b QUESTIONS 15A & 15B: THE EXECUTIVE COMPENSATION PROGRAM'S PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIP TALENT IN ORDER TO ACHIEVE THE ORGANIZATION'S MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECUTIVE COMPENSATION RANGES THROUGH A WRITTEN POLICY AND BY COMPARING ITSELF TO ORGANIZATIONS OF SIMILAR SIZE AND TYPE - USING OBJECTIVE, THIRD-PARTY DATA. A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS RECOMMENDS, AND THE BOARD OF DIRECTORS APPROVES, THE SALARY RANGES AND REVIEWS TOTAL COMPENSATION FOR EXECUTIVES ON AN ANNUAL BASIS. THE ORGANIZATION ROUTINELY USES KNOWLEDGEABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR REASONABLENESS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. Form 990 Part VI Line 19 QUESTION 19: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990 Part XI Line 9 Change in Restricted Contributions $197,582 Providence Development Group 18601 N Creek Drive Tinley Park IL 60477 Development IL 22858 10113680 Rest Haven Park Place Realty Group 18601 N Creek Drive Tinley Park IL 60477 Real Estate IL 44930 142945 NA Providence Operations LLC 18601 N Creek Drive Tinley Park IL 60477 Operations IL 12863474 6499823 Rest Haven Providence Tenant LLC 18601 N Creek Drive Tinley Park IL 60477 Real Estate IL Rest Haven Providence Palos Heights LLC 18601 N Creek Drive Tinley Park IL 60477 Real Estate IL 300964 3741037 Rest Haven Providence Downers Grove LLC 18601 N Creek Drive Tinley Park IL 60477 Real Estate IL 349252 8409901 Rest Haven Providence Grand Rapids LLC 18601 N Creek Drive Tinley Park IL 60477 Real Estate IL 150276 2838693 Rest Haven Providence Zeeland LLC 18601 N Creek Drive Tinley Park IL 60477 Real Estate IL 474940 9032307 Rest Haven RP Lisle Managing Partner LLC 18601 N Creek Drive Tinley Park IL 60477 26737 35422 PHC Christian Healthcare Foundation 18601 N Creek Drive Tinley Park IL 60477 200722359 Research IL 501 (c )(3) 9 Rest Haven false Christian Living Campus 18601 N Creek Drive Tinley Park IL 60477 200226221 Senior Living IL 501 (c )(3) 9 Rest Haven false Haven Park 18601 N Creek Drive Tinley Park IL 60477 383026594 Healthcare MI 501 (c )(3) 9 Rest Haven false Timothy Place 18601 N Creek Drive Tinley Park IL 60477 201835089 Senior Living IL 501 (c )(3) 9 Rest Haven false Park Place of St John 18601 N Creek Drive Tinley Park IL 60477 201834903 Senior Living IL 501 (c )(3) 9 Rest Haven false Hudsonville Park Place 18601 N Creek Drive Tinley Park IL 60477 201834667 Senior Living IL 501 (c )(3) 9 Rest Haven false Providence Mgmt & Development 18601 N Creek Drive Tinley Park IL 60477 363774205 IT Services IL NA C Corp 225111 6380959 1.00000 true Home Aide Health Network 18601 N Creek Drive Tinley Park IL 60477 364167569 Home Care MI Prov Mgmt & Dev C Corp 1.00000 true Providence Housing Corporation 18601 N Creek Drive Tinley Park IL 60477 461379112 Housing IL Rest Haven C Corp 174300 405737 1.00000 true true false false true false false false false false false true false false true true true true true true PMDC p 658818 FMV Timothy Place q 483768 FMV Haven Park q 1230033 FMV Haven Park k 1303033 FMV PMDC d 3208640 FMV