2014-11-25T11:25:25-06:00 2014-06-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2013-07-01 431155242 FRIENDSHIP VILLAGE OF SOUTH COUNTY FRIE 3148426840 12503 VILLAGE CIRCLE DRIVE ST LOUIS MO 63127 LYDIA SEIBERT PRESIDENT 3148426840 2014-11-18 1 AMANDA TINNEY P01587658 3149254300 2013 2015-11-30 17:44:51Z FRIENDSHIP VILLAGE - SUNSET HILLS LYDIA SEIBERT 12503 VILLAGE CIRCLE DRIVE ST LOUIS MO 63127 95762356 0 X N/A X 1976 MO FRIENDSHIP VILLAGE OF SOUTH COUNTY WILL BE OPERATED BY HIGH MORAL STANDARDS IN CONDUCTING ITS PERSONAL AND BUSINESS AFFAIRS, IN MAKING THE VILLAGE EACH RESIDENT'S HOME, IN CARING FOR EACH RESIDENT AND STAFF MEMBER, AND IN PROVIDING OPPORTUNITIES AND CHALLENGES FOR THE GROWTH OF EACH RESIDENT AND STAFF MEMBER ACCORDING TO BIBLICAL PRINCIPLES. 13 13 475 15 0 0 0 748 20270917 19478191 5163658 1504335 79439 359978 25514014 21343252 0 0 0 0 10336568 10772785 0 0 4884 8261206 8733477 18597774 19506262 6916240 1836990 105979962 170394661 60158196 133856414 45821766 36538247 X FRIENDSHIP VILLAGE OF SOUTH COUNTY WILL BE OPERATED BY HIGH MORAL STANDARDS IN CONDUCTING ITS PERSONAL AND BUSINESS AFFAIRS, IN MAKING THE VILLAGE EACH RESIDENT'S HOME, IN CARING FOR EACH RESIDENT AND STAFF MEMBER, AND IN PROVIDING OPPORTUNITIES AND CHALLENGES FOR THE GROWTH OF EACH RESIDENT AND STAFF MEMBER. 0 0 9557094 10376928 THE VILLAGE IS A LIFE CARE SENIOR LIVING COMMUNITY, DESIGNED TO ACCOMMODATE PERSONS 63 YEARS OF AGE OR OLDER IN A DIGNIFIED MANNER. CURRENTLY, THE VILLAGE HAS 303 RESIDENCES AND A LICENSED 118-BED SKILLED NURSING FACILITY (THE "HEALTH CENTER"). THE PRIMARY INTENT OF FVSC, IS TO ASSURE THE RESIDENTS OF LIFE CARE THROUGHOUT THEIR RETIREMENT YEARS. THE VILLAGE IS DESIGNED TO CREATE AN ENVIRONMENT THAT WILL ENRICH THE LIVES OF THE PEOPLE WHO LIVE AND WORK THERE. THE DESIGN OF THE MAIN COMMON FACILITIES PROVIDES LARGE AREAS FOR DINING AND MEETINGS WITHOUT DETRACTING FROM THE HOMELIKE ENVIRONMENT OF THE VILLAGE. IN ADDITION TO PROVIDING A RESIDENCE FOR LIFETIME USE BY THE RESIDENT, FVSC WILL PROVIDE: MAINTENANCE OF THE RESIDENCES AND COMMON AREAS; WEEKLY FLAT LAUNDRY SERVICE; FOOD SERVICE, INCLUDING ONE MEAL FOR EACH DAY IN THE MONTH AT NO ADDITIONAL CHARGE; THE SERVICES OF A CHAPLAIN AND RESIDENT SOCIAL DIRECTOR; SCHEDULED TRANSPORTATION SERVICES; 24-HOUR NURSING CARE IN THE HEALTH CENTER SEE ADDITIONAL PROGRAM DESCRIPTION; BIWEEKLY HOUSEKEEPING; A CALL SYSTEM; VARIOUS ADMINISTRATIVE SERVICES; AND ALL UTILITIES EXCEPT LONG DISTANCE TELEPHONE. 5628279 5778881 HEALTH CENTER - THE VILLAGE'S 118-BED HEALTH CENTER IS LICENSED TO PROVIDE SKILLED NURSING CARE. HEALTH CENTER SERVICES ARE AVAILABLE TO ALL RESIDENTS OF THE VILLAGE, AND RESIDENTS MAY BE ADMITTED DIRECTLY TO THE HEALTH CENTER FROM THEIR RESIDENCES, AND NEED NOT COME FROM A HOSPITAL. RESIDENTS ARE ENCOURAGED TO RETURN TO THEIR RESIDENCES AS SOON AS POSSIBLE. RESIDENTS WHO ARE UNABLE TO RETURN TO THEIR RESIDENCES, HOWEVER, HAVE THE BENEFIT OF PERMANENT CARE IN THE HEALTH CENTER. 1564516 3322382 ASSISTED LIVING - FOUNTAIN VIEW AT FRIENDSHIP VILLAGE OF SOUTH COUNTY IS THE ASSISTED LIVING ADDITION TO THE CONTINUUM OF CARE AT THE VILLAGE. FOUNTAIN VIEW HAS 61 APARTMENT SUITES, CAPABLE OF HOUSING UP TO 78 RESIDENTS. 16749889 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 75 0 475 1 0 0 0 0 0 0 0 0 X 13 13 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 X CHERYL ALLEY 3148426840 12503 VILLAGE CIRCLE DRIVE ST LOUIS MO 63127 LYDIA SEIBERT BOARD PRESIDENT 5.00 1.00 X X 1800 0 0 DAVID GIFFIN BOARD VICE PRESIDENT 3.00 1.00 X X 0 0 0 JEFFERY KLINGER BOARD SECRETARY 3.00 1.00 X X 1800 0 0 D JERRY LEIGH BOARD ASSISTANT SECRETARY 3.00 1.00 X X 1500 0 0 GEORGE POLAND BOARD TREASURER 3.00 1.00 X X 0 0 0 FRED SUTTON BOARD ASSISTANT TREASURER 3.00 1.00 X X 1800 0 0 D WADE HAMMOND MD BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN FASICK BOARD MEMBER 1.00 1.00 X 0 0 0 BARTH HOLOHAN BOARD MEMBER 1.00 1.00 X 1200 0 0 REV BILL BELMAR BOARD MEMBER 1.00 1.00 X 1200 0 0 FRANK HUELSKOETTER BOARD MEMBER 1.00 1.00 X 1200 0 0 MARY BETH MCGREEVY BOARD MEMBER 1.00 1.00 X 1200 0 0 ALICE TOURVILLE RESIDENT BOARD MEMBER 2.00 X 300 0 0 MICHAEL HESELBARTH EXECUTIVE DIRECTOR 20.00 20.00 X 0 0 0 MARY LAZARE EXECUTIVE DIRECTOR 40.00 X 0 0 0 CARMEN WALKER RESIDENCY DIRECTOR 40.00 X 151206 0 10158 163206 0 10158 1 0 1 0 BRINKMANN CONSTRUCTORS 16650 CHESTERFIELD GROVE RD STE CHESTERFIELD MO 63005 CONSTRUCTION 4327911 REHABCARE GROUP PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 470020 THW DESIGN 2100 RIVEREDGE PARKWAY STE 900 ATLANTA GA 30328 ARCHITECTURE 412744 LIFE CARE SERVICES LLC 400 LOCUST STREET STE 820 DES MOINES IA 503092334 MANAGEMENT COMPANY 400808 AJ GALLAGHER RISK MGMT SERVICES 5229 PAYSHERE CIRCLE CHICAGO IL 60674 RISK MANAGEMENT 389333 19 748 748 APARTMENT SERVICE & MEALS 623000 7895360 7895360 MEDICAL CENTER 623000 5778881 5778881 ASSISTED LIVING 623000 3322382 3322382 ENTRANCE FEES 623000 2481568 2481568 19478191 1747629 1747629 74175810 74233826 185278 -58016 -185278 -243294 -243294 MISCELLANEOUS 623000 154690 154690 MEAL INCOME 623000 99008 99008 GUEST ROOM 623000 38207 38207 68073 68073 359978 21343252 19478191 0 1864313 X 170523 170523 8290963 7601391 689572 210747 179556 31191 1466528 1367689 96335 2504 634024 581924 51610 490 347646 347646 21380 21380 38004 38004 184692 104710 79982 349583 348343 1240 1018083 860119 157564 400 66600 66600 1563319 1537079 26240 64721 49554 15167 22813 11963 10600 250 449835 449835 2310595 2194390 116205 236731 224894 11837 DIETARY 1405305 1405305 MEDICAL CENTER 511269 511269 SUBSCRIPTIONS, DUES, LI 100207 85113 15094 RESIDENT SERVICES 34933 34933 7761 7761 19506262 16749889 2751489 4884 3496671 3814348 35622099 5158491 3301622 1751421 126396 140145 144484 658560 80284169 35223767 35726321 45060402 18564652 55433712 494500 1530547 8503217 56847035 105979962 170394661 3862164 5978105 28081063 41933176 26960000 84960000 1254969 985133 60158196 133856414 X 45821766 36538247 45821766 36538247 105979962 170394661 1836990 2630783 -13751292 0 X X 0 1 X 1 0 X 276987 39222 32103 748 349060 18261555 19396966 19345433 20270917 19478191 96753062 18538542 19436188 19377536 20270917 19478939 97102122 0 609720 893621 1122496 767216 3393053 609720 893621 1122496 767216 3393053 93709069 778477 764688 262018 425949 1747629 3978761 778477 764688 262018 425949 1747629 3978761 455977 217160 135126 79429 359978 1247670 19772996 20418036 19774680 20776295 21586546 102328553 0.91580 0.91790 0.03890 0.03240 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: GARAGE FEES - 2009 AMOUNT: $ 455,977. 2010 AMOUNT: $ 217,160. 2011 AMOUNT: $ 135,126. 2012 AMOUNT: $ 29,069. 2013 AMOUNT: $ 14,706. GUEST ROOM - 2012 AMOUNT: $ 35,420. 2013 AMOUNT: $ 38,207. BEAUTY AND BARBER SHOP - 2012 AMOUNT: $ 14,940. 2013 AMOUNT: $ 17,047. MISCELLANEOUS - 2013 AMOUNT: $ 154,690. LAUNDRY - 2013 AMOUNT: $ 36,320. MEAL INCOME - 2013 AMOUNT: $ 99,008. 3289691 3289691 59900265 31257455 28642810 11242131 11242131 1892599 1035664 856935 3959483 2930648 1028835 45060402 MORTGAGE ESCROW DEPOSITS 10977056 CONSTRUCTION FUND 45869979 56847035 BOND DISCOUNT/PREMIUMS 985133 985133 X 23974035 2630783 2630783 21343252 0 21343252 19506262 0 19506262 0 19506262 PART X, LINE 2: THE VILLAGE IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE VILLAGE APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE VILLAGE'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE VILLAGE IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE FISCAL YEARS 2011 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. X X X 0 0 0 0 0 0 0 0 0 CARMEN WALKER RESIDENCY DIRECTOR 151206 0 0 0 0 0 6676 0 3482 0 161364 0 0 0 A THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE COUNTY OF ST LOUIS MISSOURI 431170145 791524BQ3 2012-08-30 26960000 REFINANCE EXISTING BONDS (SERIES 1996, 2000, 2002) & NEW CAPITAL PROJECTS 0 0 0 B THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE COUNTY OF ST LOUIS MISSOURI 431170145 791524BU4 2013-12-19 57802511 EXPANSION AND CAPITAL IMPROVEMENTS 0 0 0 A 28234355 6082361 13240450 537252 8374292 2014 1 0 1 1 B 57802511 4894695 1134800 4602905 47170111 2015 0 0 0 1 A 0 0 1 1 0 0 0 1 B 0 0 1 1 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 SCHEDULE K, PAGE 1, PART II, LINE 14 THE REFUNDED BONDS FROM SERIES 1996, 2000, AND 2002, WERE RESPECTIVELY ISSUED ON 7/31/1996, 10/31/2000, AND 11/14/2002 FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT OF THE VILLAGE IS PERFORMED BY LIFE CARE SERVICES(LCS) UNDER CONTRACT WITH FVSC. LCS'S RESPONSIBILITIES INCLUDE RECRUITING AND EMPLOYING THE EXECUTIVE DIRECTOR, HEALTH CENTER ADMINISTRATOR AND ASSITED LIVING ADMINISTRATOR; SUPERVISING THE LICENSING, EQUIPPING, AND STAFFING OF THE VILLAGE; PREPARING ANNUAL BUDGETS; ESTABLISHING AND OPERATING A SYSTEM OF FINANCIAL CONTROLS FOR THE VILLAGE, INCLUDING COMPARATIVE ANALYSES WITH OTHER FACILITIES; SUPERVISING THE DELIVERY OF HEALTH CARE SERVICES WHICH MEET THE GUIDELINES OF THE FEDERAL MEDICARE (TITLE XVIII) PROGRAM; AND OVERSEEING THE FOOD SERVICE AND QUALITY OF ACCOMMODATIONS PROVIDED BY THE VILLAGE. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVEIWED BY THE EXECUTIVE DIRECTOR AND BOARD PRESIDENT. AFTER THE INITIAL REVIEW THE FINAL RETURN IS THEN SENT TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST POLICY ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 TO DETERMINE SALARIES, EVERY TWO YEARS THE MANAGEMENT COMPANY HIRES AN INDEPENDENT COMPANY TO PREPARE A SALARY SURVEY AND COMPARE THOSE SALARIES WITH THE SALARIES THAT ARE ACTUALLY BEING PAID. THIS IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE TO DETERMINE APPROPRIATE SALARIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 5 THE OFFICER COMPENSATION LISTED ON LINE 5, IS PAID BY THE MANAGEMENT COMPANY, LIFE CARE SERVICES, AND IS REIMBURSED BY THE ORGANIZATION. W-2'S ARE ISSUED BY THE MANAGEMENT COMPANY. FORM 990, PART XII, LINE 2C PROCESSES HAVE NOT CHANGED FROM PRIOR YEARS. FRIENDSHIP VILLAGE OF WEST COUNTY 15201 OLIVE STREET ROAD CHESTERFIELD MO 63017 237333148 PROVIDE SENIOR CITIZENS WITH QUALITY HOUSING AND HOME CARE MO 501(C)(3) LINE 9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0