2014-11-17T18:23:45-06:00 2013-12-31 990 2013-01-01 201835089 TIMOTHY PLACE NFP TIMO 7083428100 18601 NORTH CREEK DRIVE TINLEY PARK IL 60477 WILLIAM DEYOUNG CFO 7083428100 2014-11-17 2014-11-17 2013 2015-11-30 17:44:51Z PARK PLACE CHRISTIAN COMM ELMHURST RICHARD SCHUTT 18601 NORTH CREEK DRIVE TINLEY PARK IL 60477 10181537 false X PROVIDENCELIFESERVICES.COM X 2004 IL TO PROVIDE HOUSING AND THE FULL CONTINUUM OF CARE FOR SENIORS. 7 7 279 25 0 96978 1801325 9734058 550214 350501 0 2351539 10181537 0 0 2395517 5169272 0 0 18779742 22741982 21175259 27911254 -18823720 -17729717 191580112 170150597 239876316 235415068 -48296204 -65264471 TO PROVIDE HOUSING AND THE FULL CONTINUUM OF CARE FOR SENIORS. false false 27441574 TO PROVIDE HOUSING AND CARE FOR THE ELDERLY AND SICK. 27441574 true false false false false false false false false false true false false true true true false true false false false false false false false false false false false true true false false false false false false false false false false false false false false false true false false false true 5 0 true 279 true false false false false false false X 7 7 false true false false false false false true true false false false true true true true true true true false IL X PROVIDENCE LIFE SERVICES 7083428100 18601 NORTH CREEK DR TINLEY PARK IL 60477 AARDEMA NORM VICE CHAIR 1.00 2.00 X X 0 0 0 CLOUSING SHARON SECRETARY/TR 1.00 2.00 X X 0 0 0 HOFF HOWARD TRUSTEE 1.00 2.00 X 0 0 0 KOLDENHOVEN ARNIE CHAIR 1.00 2.00 X X 0 0 0 NELSON KURT TRUSTEE 1.00 2.00 X 0 0 0 PORTER RON TRUSTEE 1.00 2.00 X 0 0 0 TAMELING CAL ASST SEC/TRE 1.00 2.00 X X 0 0 0 SCHUTT RICHARD CEO 45.00 X 0 444366 144635 DEYOUNG WILLIAM CFO 45.00 X 0 295208 66009 ENGELSMAN DONALD ADMINISTRATO 45.00 X 162266 0 40857 MARY BETH FRITZ MARKETING DI 45.00 X 149772 0 15030 NOLDEN RICHARD SNF ADMINIST 45.00 X 137454 0 32351 KATHLEEN LORENZ SR LIVING CO 45.00 X 106861 0 5976 556353 739574 304858 4 false true false SYMBRIA RX SERVICES 28100 TORCH PARKWAY WARRENVILLE IL 60555 PHARMACY 476739 PROVIDENCE LIFE SERVICES 18601 NORTH CREEK DR TINLEY PARK IL 60477 MANAGEMENT 470596 GREYSTONE DEVELOPMENT COMPANY 225 E JOHN CARPENTER FWY IRVING TX 75062 CONSULTING 454514 GORDON FOOD SERVICE PO BOX 88029 CHICAGO IL 60680 DIETARY 416240 AEP ENERGY DEPT CH 19346 PALATINE IL 60055 UTILITY 382558 8 96978 96978 ROUTINE REVENUE 623000 9552770 9552770 ANCILLARY REVENUE 623000 181288 181288 9734058 350501 350501 10181537 10084559 4506339 4506339 32565 32565 303256 303256 327112 327112 469680 469680 8563 8563 26808 26808 35737 35737 455784 455784 61119 61119 746523 746523 15159 15159 12567334 12567334 4403893 4403893 353195 353195 THERAPY 877098 877098 DIETARY SERVICES 558428 558428 PHARMACY 473169 473169 MAINTENANCE & REPAIR 397991 397991 1291501 1291501 27911254 27441574 469680 0 750317 1320296 5159027 2640044 10462 15983 52090 44896 136426995 6225362 132761860 130201633 11776008 11029696 41070348 24898049 191580112 170150597 6806453 6525658 39726763 46480755 167195000 156585000 26148100 25823655 239876316 235415068 X -48296204 -65264471 -48296204 -65264471 191580112 170150597 -17729717 -190420 951870 X false true X true false X 96978 96978 2440191 10084559 12524750 2440191 10181537 12621728 12621728 2440191 10181537 12621728 1.00000 1.00000 0.00000 X 14600000 14600000 119187131 5611889 113575242 2639864 613473 2026391 130201633 ASSETS LIMITED TO USE 24898049 24898049 OBLIGATION TO PROVIDE FUTURE SERVICE 27616000 RESIDENT DEPOSITS 511556 ORIGINAL ISSUE DISCOUNT -2303901 25823655 X SCHEDULE D, PAGE 3, PART X ASC 740 FOOTNOTE THE CORPORATIONS ACCOUNT FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC SUBTOPIC 740-10, INCOME TAXES - GENERAL, 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, 2013 AND 2012, THE CORPORATIONS DO NOT HAVE A LIABILITY FOR ANY UNRECOGNIZED TAX BENEFITS. X X true true X X X X X false false false false false false false false false SCHUTT RICHARD CEO 406240 21192 16934 114318 30317 589001 DEYOUNG WILLIAM CFO 269201 14305 11702 35648 30361 361217 ENGELSMAN DONALD ADMINISTRATOR 152279 9987 5454 35403 203123 MARY BETH FRITZ MARKETING DIRECTOR 120904 28550 318 1500 13530 164802 NOLDEN RICHARD SNF ADMINISTRATOR 120870 15000 1584 2500 29851 169805 SCHEDULE J, PART III QUESTION 1A THE ORGANIZATION PROVIDES AN ALLOWANCE FOR UP TO 10 BOARD MEMBERS TO ATTEND THE ANNUAL ASSOCIATION CONVENTION TO PROVIDE MORE IN DEPTH KNOWLIEDGE 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 ORGANIZATIN 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. QUESTION 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 96,226 WILLIAM DEYOUNG 24,206 IN 2005, THE BOARD OF DIRECTORS ESTABLISHED A RETENTION INCENTIVE PLAN FOR CERTAIN OFFICERS. THIS PLAN RECOGNIZES THE HISTORIC CONTRIBUTION OF THE EXECUTIVES WITH THE ORGANIZATION UNTIL NORMAL RETIREMENT AGE. AMONG VARIOUS CRITERIA, IN ORDER TO QUALIFY FOR THE BENEFIT, THE EXECUTIVE WILL NEED TO BE CONTINOUSLY EMPLOYED THRU AND UNTIL FUTURE DATE. THE OPRGANIZATIONS 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 ACHIEVEMENT OR SATISFACTION OF SOME FUTURE EVENTS. THE PLAN CONTRIBUTIONS ARE NOT UNDER THE CONTROL OF THE EXECUTIVES, THEY REMAIN THE ASSET OF THE ORGANIZATION, AND THE ENTIRE PLAN IS SUBJUECT TO A FULL RISK FORFEITURE BY THE INDIVIDUAL. QUESTIONS 5A AND 6A THE EXECUTIVE COMPENSATION PROGRAM HAS TWO MAJOR ELEMENTS: SALARY, OR BASE PAY, AND VARIABLE PAY. THE SALARY REFLECTS THE VALUE OF AN EXECUTIVE'S CAPABALITIES AND EXPERIENCE. THE VARIABLE PAY REFLECTS THE ORGANIZATIONS COMMITMENT TO PAY FOR SPECIFIC PERFORMANCE TOWARDS THE ORGANIZATIONS 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 COMPETIVIE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSITIONS IN SIMILARLY SIZED AND TYPE ORGANIZATIONS. THE COMMITTEE RECIEVES AN EXECUTIVE COMPENSAITON OPINION NOTING THAT THE ORGANIZATIONS 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 45200F3D9 2010-05-27 4725000 CONSTRUCT RETIREMENT HOUSING false false false B ILLINOIS FINANCE AUTHORITY 861091967 45200F3E7 2010-05-27 18590000 CONSTRUCT RETIREMENT HOME false false false C ILLINOIS FINANCE AUTHORITY 861091967 45200F3F4 2010-05-27 40365000 CONSTRUCT RETIREMENT HOME false false false D ILLINOIS FINANCE AUTHORITY 861091967 45200F3C1 2010-05-27 45435000 CONSTRUCT RETIREMENT HOME false false false A 4647194 389849 645807 92944 4504576 90770 2012 false false false true B 18283879 1533820 2540859 365678 17722767 357124 2012 false false false true C 39700312 3330428 5603244 794006 38481953 775434 2012 false false false true D 44686824 3748743 6404065 893736 43315434 872832 2012 false false false true A false false false false false false false B false false false false false false false C false false false false false false false D false false false false false false false A true false false false false true B true false false false false true C true false false false false true D true false false false false true FORM 990, PAGE 6, PART VI, LINE 3 PROVIDENCE LIFE SERVICES FORM 990, PAGE 6, PART VI, LINE 11B A DRAFT OF THE 990 IS PREPARED AND REVIEWED BY THE CONTROLLER, VP OF FINANCE AND CFO BEFORE SUBMISSION. A COMPLETED COPY OF THE 990 IS PROVIDED TO THE FULL BOARD AT THE SUBSEQUENT BOARD MEETING, AFTER FILING. FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICES AND DIRECTORS/TRUSTEES ARE RQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT UPON BEGINNING THEIR POSITION. THEREAFTER, THE CONFLICT OF INTEREST STATEMENTS ARE UPDATED ON AN ANNUAL BASIS AND REVIEWED BY THE BOARD. ANY POTENTIAL CONFLICTS ARE REVIEWED AND ADDRESSED AS NECESSARY. FORM 990, PAGE 6, PART VI, LINE 15A THE EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIO TALENT IN ORDER TO ACHIEVE THE ORGANIZATIONS MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECTUIVE 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 REASONABLENSS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. FORM 990, PAGE 6, PART VI, LINE 15B THE EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIO TALENT IN ORDER TO ACHIEVE THE ORGANIZATIONS MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECTUIVE 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 REASONABLENSS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. FORM 990, PAGE 6, PART VI, LINE 19 AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 TRANSFER FROM RELATED ORGANIZATION 0 ENTRANCE FEE AMORTIZATION -329,870 CHANGE IN OBLIGATION TO PROVIDE FUTURE SERVICE -622,000 REST HAVEN ILLIANA CHRISTIAN REST HAVEN ILLIANA CHRISTIAN 18601 N CREEK DRIVE TINLEY PARK IL 60477 362382853 HEALTHCARE IL 501C3 7 N/A false CHRISTIAN HEALTHCARE FOUNDATION CHRISTIAN HEALTHCARE FOUNDATION 18601 N CREEK DRIVE TINLEY PARK IL 60477 200722359 RESEARCH IL 501C3 7 N/A false PROVIDENCE MANAGEMENT & DEVELOPMENT PROVIDENCE MANAGEMENT & DEVELOPMENT 18601 N CREEK DR TINLEY PARK IL 60477 363774205 MANAGEMENT IL N/A false false false false false false false false false false false false false false false true true false false false REST HAVEN ILLIANA CHRISTIAN P 469860 FMV PROVIDENCE MANAGEMENT P 138860 FMV