2015-10-26T13:22:11-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 610 W GERMANTOWN PIKE STE 400 PLYMOUTH MEETING PA 19462 990 2014-01-01 362171730 THE ADMIRAL AT THE LAKE ADMI 7734331800 929 WEST FOSTER AVE CHICAGO IL 60640 DAN CHURCHILL CFO 7734331800 2015-10-01 1 BERNADETTE O'TOOLE CPA P00229258 2156433900 2014 2016-02-25 16:41:14Z GLENN BRICHACEK 929 WEST FOSTER AVE CHICAGO IL 60640 54196975 0 X WWW.ADMIRALATTHELAKE.COM X 1887 IL TO PROVIDE A QUALITY ENVIRONMENT FOR SENIORS THAT SUPPORTS PERSONAL INDEPENDENCE AND WELLNESS. 6 6 228 60 0 0 1088793 934645 7353973 14487742 374756 459281 311455 401979 9128977 16283647 384972 371223 0 0 5976351 7502943 0 0 0 24021238 25314067 30382561 33188233 -21253584 -16904586 205990775 200287014 275875668 298655594 -69884893 -98368580 X TO PROVIDE A QUALITY ENVIRONMENT FOR SENIORS THAT SUPPORTS PERSONAL INDEPENDENCE AND PROMOTES HEALTH AND WELLNESS. 0 0 28623143 371223 14487742 THE ADMIRAL AT THE LAKE HAS COMPLETED DEVELOPMENT OF A NEW NON-PROFIT CONTINUING CARE RETIREMENT COMMUNITY (CCRC) ON THE SITE VACATED BY THE PRIOR ADMIRAL OPERATIONS. CONSTRUCTION ON THE NEW CAMPUS COMMENCED IN NOVEMBER 2010 AND CONSISTS OF 200 INDEPENDENT LIVING APARTMENTS, 39 ASSISTED LIVING SUITES, 17 MEMORY CARE UNITS, AND 36 PRIVATE SKILLED NURSING BEDS. IN JULY 2012, CONSTRUCTION ON THE INDEPENDENT LIVING APARTMENTS WAS COMPLETE. BY DECEMBER 31, 2014, THERE WERE 176 INDEPENDENT LIVING UNITS OCCUPIED FOR 88% OCCUPANCY. IN 2014, THE ADMIRAL FULFILLED ITS MISSION AND CHARITABLE PURPOSE BY PROVIDING CARE AND SERVICES TO 244 RESIDENT CONTRACT HOLDERS BETWEEN THE AGES OF 62 AND 97. THE ADMIRAL OFFERS A COMPREHENSIVE FITNESS AND WELLNESS PROGRAM THAT INCLUDES A FITNESS CENTER, INDOOR HEATED POOL, AND 17 FITNESS CLASSES PER WEEK WITH ADDITIONAL ONE ON ONE TRAINING PROGRAMS WITH THE FITNESS COORDINATOR. THERE IS A DIETICIAN WHO PROVIDES COUNSELING ON RESIDENT MEALS AND DIETS. A MYRIAD OF SOCIAL AND RECREATION ACTIVITIES ARE AVAILABLE TO ALL RESIDENTS, INCLUDING A CREATIVE ARTS STUDIO, GARDEN TERRACES, LIBRARY, MEDIA ROOM/THEATER, AND LOUNGE AMONG OTHERS. RESIDENTS ENTERING INTO THE INDEPENDENT LIVING APARTMENTS IN THE NEW CCRC SIGN LIFE CARE RESIDENCY AGREEMENTS THAT CARRY THE PROMISE THAT THEIR CONTRACT WILL NOT BE TERMINATED FOR INSUFFICIENT FUNDS IN THE EVENT THE RESIDENT OUTLIVES THEIR ASSETS OR INCOME. IN 2014, THE ADMIRAL PROVIDED $751,383 IN ROOM AND BOARD SUBSIDIES TO 20 RESIDENTS. IN 2004, THE ADMIRAL COMMENCED PLANNING FOR THE REDEVELOPMENT OF ITS COMMUNITY. IN 2007, THE ADMIRAL TORE DOWN ITS EXISTING BUILDING IN ORDER TO CREATE A NEW, STATE OF THE ART CCRC. AT THAT TIME, THE ADMIRAL RELOCATED ITS EXISTING RESIDENTS FROM ITS CURRENT CAMPUS TO 10 COMMUNITIES IN THE AREA. AT THE TIME THE RESIDENTS WERE RELOCATED, THE ADMIRAL PLEDGED TO MAINTAIN ROOM AND BOARD AT LEVELS CONSISTENT WITH THE ROOM AND BOARD CHARGED BY THE HOST COMMUNITIES. IN 2014, THE ADMIRAL PAID $135,333 IN MEDICAL COSTS AND STIPENDS IN ADDITION TO THE ROOM AND BOARD SUBSIDIES NOTED ABOVE TO THOSE RESIDENTS. FURTHER, THE ADMIRAL PLEDGED TO PAY CERTAIN MEDICAL AND OTHER COSTS FOR THE DISPLACED RESIDENTS WHO HELD CERTAIN CONTRACTS. THE NEW BUILDING, OPERATIONS, STAFF AND RESIDENTS PROVIDE AN ARRAY OF BENEFITS TO THE SURROUNDING NEIGHBORHOOD AND COMMUNITY. DURING 2014, THE ADMIRAL HOSTED 3 MEDICAL RESIDENTS FROM THE NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE. THE INTERNS PROVIDED MORE THAN 400 HOURS OF SERVICE AND EARNED COURSE CREDITS TOWARD THEIR DEGREES. THE ADMIRAL HOSTED 4 LUNCHEONS FOR APPROXIMATELY 75 3RD GRADE CHILDREN AND TEACHERS FROM GOUDY SCHOOL WHICH IS LOCATED IN THE UPTOWN/EDGEWATER NEIGHBORHOOD. THE ADMIRAL PROVIDES SPACE FOR A LOCAL WOMEN'S BOOK GROUP THAT MEETS ON A MONTHLY BASIS. THE ADMIRAL PROVIDED SPACE AT A SUBSTANTIALLY REDUCED PRICE FOR THE JANE ADDAMS SENIOR CAUCUS WHICH HOSTED APPROXIMATELY 100 PEOPLE AS WELL AS SUPPORTING THE UPTOWN UNITED ANNUAL EVENT. THE ADMIRAL PROVIDED SPACE FOR POLLING FOR THE CHICAGO BOARD OF ELECTIONS. THE ADMIRAL ALSO PROVIDED SPACE FOR LOCAL ROTARY CLUB CHAPTER MEETING. THE ADMIRAL HAS BOARD MEMBERS ON THE BOARD OF UPTOWN UNITED. THE ADMIRAL RESIDENTS AND STAFF ALSO PROVIDED OVER 10,000 HOURS OF VOLUNTEER WORK TO THE SURROUNDING COMMUNITY, INCLUDING READING TO GOUDY SCHOOL GRADE SCHOOL CHILDREN. TWO ADMIRAL STAFF MEMBERS PARTICIPATED IN A HIGH SCHOOL MENTORING PROGRAM AT THE NORTH LAWNDALE HIGH SCHOOL. THE ADMIRAL PROVIDES SNOW REMOVAL OF THE COMMUNAL ALLEY BEHIND OUR BUILDING AS WELL AS ALL THE SIDEWALKS SURROUNDING OUR BUILDING TO THE BENEFIT OF OUR NEIGHBORS. THE ADMIRAL HAS ALSO PROVIDED FUNDING TO CERTAIN COMMUNITY PARTNERS SUCH AS LINCOLN PARK VILLAGE, EDGEWATER HISTORICAL SOCIETY AND LOCAL BLOCK CLUBS. 28623143 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 46 0 228 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X DAN CHURCHILL 7734331800 929 WEST FOSTER AVE CHICAGO IL 60640 ANDREA O HASTEN DIRECTOR 2.00 2.00 X 0 0 0 CHARLES F CLARKE III DIRECTOR 2.00 2.00 X 0 0 0 CAROL A STITZER DIRECTOR 2.00 X 0 0 0 JOHN DIFFEY DIRECTOR 2.00 X 0 0 0 RICHARD FARMER DIRECTOR 2.00 X 0 0 0 JOAN BLISS DIRECTOR 2.00 X 0 0 0 GLENN BRICHACEK CEO 40.00 2.00 X 214792 0 22574 DONALD OLSEN DIRECTOR OF FACILITIES 40.00 X 117669 0 0 VANESSA PARADA DIRECTOR OF HUMAN RESOURCE 40.00 X 110156 0 22243 AKINTUNDE LITTLEJOHN DIRECTOR OF IT 40.00 X 103849 0 11696 CHRISTINE SEGIN DIRECTOR OF MARKETING 40.00 X 103006 0 7695 DANIEL CHURCHILL CFO 40.00 2.00 X 105299 0 10010 754771 0 74218 6 0 1 0 GLYNNDEVINS 11230 COLLEGE BLVD OVERLAND KS 66210 MARKETING 674798 THE KENDAL CORPORATION WORTH CENTER 1107 E BALTIMORE PIKE KENNETT SQ PA 19348 DEVELOPMENT SERVICES 500872 RYAN COMPANIES US INC 50 SOUTH 10TH STREET STE 300 MINNEAPOLIS MN 55403 CONSTRUCTION 490220 ALLIANCE REHAB INC 28100 TORCH PARKWAY 600 WARRENVILLE IL 60555 REHABILITATION SERVICES 419533 SYSCO FOOD SERVICES - CHICAGO INC 250 WIEBOLDT DRIVE DES PLAINES IL 60016 FOOD 334497 23 716541 218104 934645 RESIDENT FEES FOR SERVICES 623000 9089753 9089753 HEALTH CENTER FEES 623000 3173714 3173714 AMORTIZATION OF DEFERRED REV 623000 2045502 2045502 HOST FACILITY RESIDENT FEES 623000 178773 178773 14487742 771871 771871 37600738 37913328 -312590 -312590 -312590 OTHER OPERATING REVENUE 900099 401979 401979 401979 16283647 14487742 0 861260 371223 371223 237366 237366 6141271 4908970 1232301 646242 468615 177627 478064 371884 106180 101642 24398 77244 55425 55425 1356642 974511 382131 1438885 1438885 290519 73755 216764 605706 360000 245706 958515 958515 9088 1290 7798 79597 17683 61914 12160740 12160740 5496060 5496060 529083 261828 267255 OTHER EXPENSES 1868741 1819745 48996 HOST FACILITY SERVICES 290904 290904 LICENSES AND FEES 72520 63022 9498 33188233 28623143 4565090 0 960715 1350787 2509 818268 353218 733217 449468 301654 149933636 10904803 143326121 139028833 100500 100500 60798244 57953755 205990775 200287014 3575446 3891029 20646268 21466212 163264037 149719369 47148993 70845723 41240924 52733261 275875668 298655594 X -71350530 -99718647 122069 0 1343568 1350067 -69884893 -98368580 205990775 200287014 X -16904586 61305 -11640406 X 0 1 X 1 0 X 1880683 884726 1168803 1088793 934645 5957650 1584238 1227977 1760701 7353973 14487742 26414631 3464921 2112703 2929504 8442766 15422387 32372281 256901 42648 299549 0 256901 42648 299549 32072732 43043 48868 729035 714548 771871 2307365 43043 48868 729035 714548 771871 2307365 6368 58294 311455 401979 778096 3514332 2161571 3716833 9468769 16596237 35457742 0.90450 0.89180 0.06510 0.07600 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 429674 429674 147469708 10408595 137061113 2034254 496208 1538046 139028833 REFUNDABLE RESERVATION DEPOSITS 141457 BENEFICIAL INTEREST IN TRUSTS 1300069 DEBT SERVICE RESERVE FUND 14469960 DEFERRED FINANCING COSTS 4293428 DEFERRED MARKETING COSTS 10094335 LIQUIDITY SUPPORT FUND 9939857 WORKING CAPITAL FUND 1 TRUSTEE HELD-ENTRANCE FEES AND OPERATING RESERVE 11784095 CURRENT PORTION ENTRANCE FEE RECEIVABLE 5523130 SELF INSURANCE DEPOSIT 253985 INTEREST RECEIVABLE 153438 57953755 DUE TO AFFILIATES 8290652 ACCRUED PENSION PLAN LIABILITY 1454779 OBLIGATION TO PROVIDE FUTURE SERVICES 42987830 52733261 X 4704546 61305 -11640406 -11579101 16283647 0 16283647 33188233 0 33188233 0 33188233 PART IV, LINE 2B: THE ORGANIZATION ACCEPTS DEPOSITS FROM PERSONS INTERESTED IN RESERVING A UNIT IN THE COMMUNITY. DEPOSITS ARE HELD IN ESCROW AND FULLY REFUNDABLE SHOULD A DEPOSITOR DECIDE NOT TO MOVE IN TO THE COMMUNITY. INTEREST EARNED ON REFUNDABLE DEPOSITS IS PAID TO DEPOSITORS WHO CANCEL THEIR RESERVATION, OR WILL BE APPLIED TO THE FIRST MONTH'S RENT WHEN THE DEPOSITOR TAKES POSSESSION OF A UNIT. PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE GUIDANCE FURTHER PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2011 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: INCREASE IN OBLIGATION IN PROVIDING FUTURE SERVICES -10,871,014. PENSION RELATED LOSSES -775,891. VALUATION CHANGE IN ASSETS HELD IN TRUST 6,499. 1 FINANCIAL ASSISTANCE TO RESIDENTS 14 363386 PART I, LINE 2: THE ADMIRAL IS IN CONTROL OF ALL GRANTS OR ASSISTANCE GIVEN WHICH CONSISTS OF ROOM AND BOARD SUBSIDIES FOR ADMIRAL RESIDENTS. X X X X 0 0 0 0 0 0 0 0 0 GLENN BRICHACEK CEO 214792 0 0 0 0 0 22574 0 0 0 237366 0 0 0 A ILLINOIS FINANCE AUTHORITY 861091967 45200F6M6 2010-11-19 43 CCRC 0 0 0 B ILLINOIS FINANCE AUTHORITY 861091967 45200F6R5 2010-11-19 7982925 CCRC 0 0 0 C ILLINOIS FINANCE AUTHORITY 861091967 45200F6N4 2010-11-19 11511945 CCRC 0 0 0 D ILLINOIS FINANCE AUTHORITY 861091967 45200F6P9 2010-11-19 41867949 CCRC 0 0 0 A 4675000 368761 200167 80637 3180396 845038 2012 0 0 0 0 B 8070000 636664 345588 139220 5490941 1457587 2012 0 0 0 0 C 11685000 921902 500418 201594 7950991 2110095 2012 0 0 0 0 D 42105000 3320421 1802362 726081 28637159 7618976 2012 0 0 0 0 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 A ILLINOIS FINANCE AUTHORITY 861091967 45200F6Q7 2010-11-19 56040457 CCRC 0 0 0 B ILLINOIS FINANCE AUTHORITY 861091967 45200F6S3 2010-11-19 6000000 CCRC 0 0 0 C ILLINOIS FINANCE AUTHORITY 861091967 45200F6T1 2010-11-19 5000000 CCRC 0 0 0 D ILLINOIS FINANCE AUTHORITY 861091967 45200F6U8 2010-11-19 12150000 CCRC 0 0 0 A 56865000 4483436 2433659 980400 38667641 10299866 2012 0 0 0 0 B 6000000 472770 256625 103381 4077431 1089793 2012 0 0 0 0 C 5000000 393975 213854 86151 3397859 908160 2012 0 0 0 0 D 12150000 958147 520093 209519 8263594 2198646 2012 0 0 0 0 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 A ILLINOIS FINANCE AUTHORITY 861091967 45200F6V6 2010-11-19 18075000 CCRC 0 0 0 A 13775000 18075000 1424614 773296 311522 12286660 3278908 2012 0 0 0 0 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 6 THE ADMIRAL SHALL HAVE A SINGLE CLASS OF VOTING MEMBERS, AND THE SOLE MEMBER OF THAT CLASS SHALL BE THE OLD PEOPLE'S HOME OF THE CITY OF CHICAGO, AN ILLINOIS NOT-FOR-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE TRUSTEES OF THE ADMIRAL SHALL BE ELECTED OR APPOINTED BY THE MEMBER AT THE ANNUAL MEETING OF THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE ADMIRAL MUST HAVE APPROVAL FROM THE MEMBER BEFORE COMPLETING THE FOLLOWING ACTIONS: - ELECTION AND REMOVAL OF TRUSTEES AND OFFICERS - AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE ADMIRAL - AMENDMENT OF THE BYLAWS OF THE ADMIRAL - MERGER, CONSOLIDATIONS OR DISSOLUTION OF THE ADMIRAL - THE CREATION OF ANY SUBSIDIARIES OR AFFILIATES OF THE ADMIRAL - ADOPTION OF THE BUSINESS PLAN PREPARED ANNUALLY BY THE BOARD OF TRUSTEES OF THE ADMIRAL - ADOPTION OF THE ANNUAL BUDGET PREPARED BY THE ADMIRAL - THE SELECTION OF BANKING AFFILIATIONS, ACCOUNTING FIRMS OR LEGAL COUNSEL, AS WELL AS APPROVAL OF THE ENGAGEMENT OF ANY CONSULTANTS NOT SPECIFICALLY PROVIDED IN AN APPROVED BUDGET. - THE SELECTION AND RETENTION OF THE EXECUTIVE DIRECTOR OF THE ADMIRAL - THE MAKING OF CAPITAL EXPENDITURES OR SALE OF ANY CAPITAL BY THE ADMIRAL IN EXCESS OF $50,000 - THE SELECTION OF THE MANNER AND LOCATION OF INVESTMENT OF ANY FUNDS - THE EXTENSION OF ANY LOANS BY OR ANY BORROWING BY THE ADMIRAL FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED FOR ACCURACY AND COMPLETENESS BY THE CEO AND THE AUDIT COMMITTEE CHAIR. A COPY OF THE FORM IS THEN PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO READ AND SIGN THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ALL EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY RELATED PARTY TRANSACTIONS PRIOR TO ENGAGING IN SAID TRANSACTIONS, AND ARE REQUIRED TO DISCLOSE ANY RELATED PARTY TRANSACTIONS ANNUALLY AS PART OF THE ANNUAL CONFLICT OF INTEREST DISCLOSURE. THE RESPONSES ARE REVIEWED BY THE CEO AND CHAIRPERSON. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND MAY BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES AND COMMITTEE MEMBERS WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE INTERESTED PERSON SHALL THEN BE EXCUSED FROM THE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OF TRUSTEES OR DESIGNATED COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ADMIRAL, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15A THE ADMIRAL AT THE LAKE COMPENSATION COMMITTEE COMPARES COMPENSATION TO INDUSTRY AND COMPETITOR STANDARDS. THE COMMITTEE THEN DECIDES IF THE CEO'S COMPENSATION IS REASONABLE AND CONSISTENT WITH INDUSTRY STANDARDS AND DOCUMENTS ITS FINDINGS. THE FINDINGS ARE THEN PRESENTED TO AND APPROVED BY THE EXECUTIVE COMMITTEE. THE CEO'S COMPENSATION WAS LAST REVIEWED IN DECEMBER 2012. OFFICERS AND KEY EMPLOYEES COMPENSATION IS DECIDED BY THE CEO, CFO, AND DIRECTOR OF HUMAN RESOURCES. A REVIEW OF QUALIFICATION IS DONE WHICH IS ALSO COMPARED TO SALARY BENCHMARKS ACROSS THE INDUSTRY. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 1023 AND 990 AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: INCREASE IN OBLIGATION TO PROVIDE FUTURE SERVICES TO CURRENT RESIDENTS -10,871,014. PENSION RELATED LOSSES -775,891. VALUATION CHANGE IN ASSETS HELD IN TRUST 6,499. THE ADMIRAL AT THE LAKE FOUNDATION 929 WEST FOSTER AVE CHICAGO IL 60640 204057278 PROVIDING FINANCIAL SUPPORT FOR RELATED TAX EXEMPT ORGANIZATIONS IL 501(C)(3) 7 THE ADMIRAL AT THE LAKE 1 OLD PEOPLE'S HOME OF THE CITY OF CHICAGO 929 WEST FOSTER AVE CHICAGO IL 60640 204057089 OVERSEEING THE PERFORMANCE AND OPERATIONS OF THE ADMIRAL AT THE LAKE IL 501(C)(3) 11 0 THE ADMIRAL AT THE LAKE RESIDENTS' TRUST 929 WEST FOSTER AVE CHICAGO IL 60640 276291550 PROVIDING FINANCIAL SUPPORT TO RESIDENTS IL 501(C)(3) 9 THE ADMIRAL AT THE LAKE 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 ADMIRAL AT THE LAKE RESIDENTS' TRUST C 350000 THE ADMIRAL AT THE LAKE FOUNDATION C 368055