2014-12-23T12:05:05-06:00 2014-06-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2013-07-01 421279738 RISEN SON CHRISTIAN VILLAGE RISE 3145877903 622 EMERSON ROAD NO 310 ST LOUIS MO 63141 SUSAN MCGHEE CFO 3145877903 2014-12-19 1 AMANDA TINNEY P01587658 3149254300 2013 2015-11-30 17:44:51Z SUSAN MCGHEE 622 EMERSON ROAD NO 310 ST LOUIS MO 63141 13666633 0 X WWW.CHRISTIANHOMES.ORG X 1984 IA TO PROVIDE QUALITY CARE FOR THE AGED IN A CHRISTIAN ENVIRONMENT. 14 14 254 220 0 0 42380 80413 12833617 13516756 230380 -565 251756 65288 13358133 13661892 0 0 0 0 5162249 5610934 0 0 0 7164840 6881316 12327089 12492250 1031044 1169642 17666114 18802096 23742276 23665002 -6076162 -4862906 X THE MISSION OF RISEN SON CHRISTIAN VILLAGE IS TO CREATE AN EXCITING LIFESTYLE AND TO PROVIDE HIGH QUALITY CARE FOR SENIORS ON A CONTINUUM OF CARE CAMPUS. PROVIDING CARE IN A CHRISTIAN ENVIRONMENT PROVIDES A UNIQUE OPPORTUNITY TO MEET THE NEEDS OF SENIORS PHYSICALLY, MENTALLY, AND SPIRITUALLY. OUR COMMITMENT TO EXCELLENCE IS MOTIVATED BY OUR CHRISTIAN BELIEF THAT ALL ARE PRECIOUS IN THE SIGHT OF GOD. 0 0 10073184 13516756 RISEN SON CHRISTIAN VILLAGE PROVIDES QUALITY CARE TO SENIORS IN A CHRISTIAN ENVIRONMENT. THE OPERATIONS INCLUDE SKILLED NURSING CARE, ASSISTED LIVING, SENIOR APARTMENTS, AND INDEPENDENT LIVING APARTMENTS. RISEN SON CHRISTIAN VILLAGE PROVIDED 53,330 PATIENT DAYS OF SERVICE IN THE SKILLED NURSING AND ASSISTED LIVING AREAS OF THE CAMPUS. RISEN SON CHRISTIAN VILLAGE CAMPUS HAS 51 SENIOR APARTMENTS WHERE RESIDENTS LIVE INDEPENDENTLY AND ARE PROVIDED MEALS IN COMMON AREAS AS WELL AS USE OF THE COMMON AREAS. THE CAMPUS AVERAGED 47 UNITS OCCUPIED DURING FISCAL YEAR 2014. RISEN SON CHRISTIAN VILLAGE HAS 50 INDEPENDENT GARDEN HOMES WHERE RESIDENTS LIVE INDEPENDENTLY AND ENJOY THE BENEFITS OF LIVING ON A CAMPUS WITH OTHER SENIORS. THE CAMPUS AVERAGED 46 OF THESE UNITS OCCUPIED DURING FISCAL YEAR 2014. 10073184 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 1 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 27 0 254 1 0 0 0 0 0 0 0 0 0 1 0 X 14 14 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MIDWEST CHRISTIAN VILLAGES 3145877903 622 EMERSON ROAD SUITE 310 ST LOUIS MO 63141 MARK A BEHRENDS BOARD MEMBER 0.30 2.00 X 0 1000 0 JIMMIE BLALOCK BOARD MEMBER 0.30 2.00 X 0 0 0 MAURINE COLLETT BOARD MEMBER 0.30 2.00 X 0 1000 0 ROBERT CROSBY BOARD MEMBER - CHAIRMAN 0.30 2.00 X X 0 1000 0 BILLY D CARTER BOARD MEMBER - TREASURER 0.30 2.00 X X 0 1000 0 RANDY CLARK BOARD MEMBER 0.30 2.00 X 0 1000 0 NICHOLAS A FILING BOARD MEMBER 0.30 2.00 X 0 1000 0 JAMES FRASURE MD BOARD MEMBER 0.30 2.00 X 0 750 0 TERRY GOODNER BOARD MEMBER - SECRETARY 0.30 2.00 X X 0 1000 0 BILL W LASH BOARD MEMBER 0.30 2.00 X 0 1000 0 PATRICIA M LINCOLN BOARD MEMBER 0.30 2.00 X 0 1000 0 DON FITZGERALD BOARD MEMBER 0.30 2.00 X 0 500 0 RONALD F SEWELL BOARD MEMBER - VICE CHAIRMAN 0.30 2.00 X X 0 1000 0 VICTOR S WILLIAMS BOARD MEMBER 0.30 2.00 X 0 0 0 TIMOTHY PHILLIPPE PRESIDENT/CEO 2.00 38.00 X 0 501346 22340 SUSAN MCGHEE CFO 2.00 38.00 X 0 302234 12840 SHERRY GUTERMUTH VICE PRESIDENT OF OPERATIONS 2.00 38.00 X 0 264628 12840 JOHN RUPKEY PHARMACIST/MANAGER 0.00 40.00 X 0 201424 5500 MICHAEL CARDENAS VP OF LEGAL AFFAIRS AND GENERAL COUNSEL 2.00 38.00 X 0 292456 3000 GREG WITTE EXECUTIVE DIRECTOR 40.00 0.00 X 185681 0 12340 TROY BAUMANN VP OF BUSINESS OPERATIONS 2.00 38.00 X 0 289720 8340 LAURIE BROWN EXECUTIVE DIRECTOR 0.00 40.00 X 0 190223 12340 185681 2053281 89540 2 0 1 0 REHABCARE GROUP EAST INC BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 939661 COMMUNITY PHARMACY SERVICES PO BOX 524 GRETNA NE 68028 PHARMACY 271381 LEWIS RICE FINGERSH 600 WASHINGTON AVE SUITE 2500 ST LOUIS MO 63101 LEGAL 213924 JIMS GLASS SERVICE 2528 N 69TH ST OMAHA NE 68104 CONSTRUCTION 132073 4 80413 11505 80413 NURSING HOME OPERATIONS (NET OF C 623000 12334786 12334786 SENIOR LIVING UNITS(CONGREGATE)(N 623990 757419 757419 INDEPENDENT RETIREMENT APARTMENTS 623990 424551 424551 13516756 1599 1599 2577 0 4741 2577 -4741 -2164 -2164 CABLE TV REVENUE 900099 32645 32645 MEAL REVENUE 900099 20822 20822 MISCELLANEOUS 900099 10366 10366 1455 1455 65288 13661892 13516756 0 64723 4536547 4093194 443353 7500 6744 756 734072 646459 87613 332815 299287 33528 782694 146357 636337 111541 111541 1178739 1171736 7003 17244 17244 1483300 733763 749537 42004 42004 590244 590244 24190 15694 8496 1957 697 1260 993211 993211 819590 819590 144206 144206 RAW FOOD 404961 404961 MISCELLANEOUS 142479 780 141699 BAD DEBT EXPENSE 91007 91007 LICENSE, DUES, & SUBSCR 52815 6255 46560 1134 6 1128 12492250 10073184 2419066 0 6986 11147 6243061 7543051 970218 1074649 14563 12119 42274 42161 22238701 12428935 10133117 9809766 171237 162225 84658 146978 17666114 18802096 2575012 2856037 1806404 1989556 7660000 7832014 5640 6230 10332314 9654003 1362906 1327162 23742276 23665002 X -6092470 -4894195 16308 31289 -6076162 -4862906 17666114 18802096 X 1169642 10341 33273 X X 0 1 X 1 0 X 37645 85034 30320 42380 80413 275792 12054549 12802402 13078539 12840652 13516756 64292898 12092194 12887436 13108859 12883032 13597169 64568690 0 246781 380989 201169 398510 1227449 246781 380989 201169 398510 1227449 63341241 44863 38962 37637 232517 1599 355578 44863 38962 37637 232517 1599 355578 50894 47620 598496 244721 65288 1007019 12187951 12974018 13744992 13360270 13664056 65931287 0.96070 0.96200 0.00540 0.00660 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY AND BARBER SHOP - 2011 AMOUNT: $ 335. CABLE TV REVENUE - 2009 AMOUNT: $ 27,684. 2010 AMOUNT: $ 28,794. 2011 AMOUNT: $ 31,208. 2012 AMOUNT: $ 30,674. 2013 AMOUNT: $ 32,645. TELEPHONE SERVICE - 2009 AMOUNT: $ 6,222. MISCELLANEOUS REVENUE - 2009 AMOUNT: $ 14,789. 2010 AMOUNT: $ 17,121. 2011 AMOUNT: $ 559,398. 2012 AMOUNT: $ 214,047. 2013 AMOUNT: $ 10,366. EXEMPT MISCELLANEOUS INCOME - 2009 AMOUNT: $ 2,199. 2010 AMOUNT: $ 1,705. 2011 AMOUNT: $ 7,555. MEAL REVENUE - 2013 AMOUNT: $ 20,822. VENDING REVENUE - 2013 AMOUNT: $ 1,455. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 5640 590 6230 1 X 79855 5305 85160 72613 7242 79855 68606 4007 72613 65643 2963 68606 65759 -116 65643 1.00000 0 0 426135 426135 20021522 11287862 8733660 1791044 1141073 649971 9809766 REFUNDABLE ENTRANCE FEES 1320511 DUE TO - CORP OFFICE 6651 1327162 X PART IV, LINE 2B: RESIDENT FUNDS ARE AGENCY FUNDS HELD LOCALLY AT THE FACILITIES FOR INDIVIDUAL RESIDENTS' PERSONAL USE, RESIDENT SECURITY DEPOSITS, AND OTHER MISCELLANEOUS DEPOSITS. PART V, LINE 4: ORGANIZATION HOLDS FUNDS IN ENDOWMENT DESIGNATED BY THE BOARD OF DIRECTORS TO BE USED FOR RESIDENT CARE. PART X, LINE 2: THE ORGANIZATIONS, EXCEPT FOR THE LIMITED PARTNERSHIPS, QUALIFY AS TAX-EXEMPT CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATIONS, EXCEPT FOR THE LIMITED PARTNERSHIPS, ARE NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE ORGANIZATIONS ARE CLASSIFIED AS PUBLICLY-SUPPORTED CHARITABLE ORGANIZATIONS UNDER THE CODE AND CONTRIBUTIONS TO THE ORGANIZATIONS QUALIFY AS A CHARITABLE TAX DEDUCTION FOR THE CONTRIBUTOR. THE ORGANIZATIONS' INCOME TAX RETURNS FOR THE YEARS 2011 TO 2013 ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATIONS ARE NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THEIR TAX-EXEMPT STATUS. THE ORGANIZATIONS ARE NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES OTHER THAN WHAT IS ALREADY BEING REPORTED. X 1 1 X X X X 1 0 0 0 0 0 0 0 0 TIMOTHY PHILLIPPE PRESIDENT/CEO 0 441644 0 59702 0 0 0 0 0 22340 0 523686 0 0 SUSAN MCGHEE CFO 0 263234 0 39000 0 0 0 0 0 12840 0 315074 0 0 SHERRY GUTERMUTH VICE PRESIDENT OF OPERATIONS 0 221161 0 35445 0 8022 0 0 0 12840 0 277468 0 0 JOHN RUPKEY PHARMACIST/MANAGER 0 165145 0 29000 0 7279 0 0 0 5500 0 206924 0 0 MICHAEL CARDENAS VP OF LEGAL AFFAIRS AND GENERAL COUN 0 222539 0 30000 0 39917 0 0 0 3000 0 295456 0 0 GREG WITTE EXECUTIVE DIRECTOR 166681 0 19000 0 0 0 0 0 12340 0 198021 0 0 0 TROY BAUMANN VP OF BUSINESS OPERATIONS 0 262420 0 27300 0 0 0 0 0 8340 0 298060 0 0 LAURIE BROWN EXECUTIVE DIRECTOR 0 164769 0 18989 0 6465 0 0 0 12340 0 202563 0 0 PART I, LINE 1A TIMOTHY PHILLIPPE RECEIVED A HOUSING ALLOWANCE OF $18,200. PART I, LINE 4A MICHAEL CARDENAS RECEIVED A TAXABLE SEVERANCE PAYMENT OF $39,917. A COUNTY OF POTTAWATTAMIE IOWA 426004433 73787PAD2 2007-06-28 8364117 REFINANCE 0 0 0 B ILLINOIS FINANCE AUTHORITY 861091967 45200B6K9 2007-09-28 37578378 REFINANCE 0 0 0 A 875000 8364117 825507 93133 575314 6870163 2010 1 0 1 1 B 45808 401722 41452 7486 138127 214657 2010 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: COUNTY OF POTTAWATTAMIE, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/28/2012 ISSUER NAME: ILLINOIS FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/28/2012 2007 BOND ISSUANCE PROCEEDS THE PROCEEDS OF THE 2007 BOND ISSUANCE WAS FOR THE BENEFIT OF: CHRISTIAN HOMES, INC. 37-0841562 $2,673,156 FAIR HAVENS CHRISTIAN HOME, INC. 37-0987659 $9,630,822 LEWIS MEMORIAL CHRISTIAN VILLAGE 51-0173104 $5,270,559 MIDWEST SENIOR MINISTRIES, INC. 20-1053401 $18,396,953 SPRING RIVER CHRISTIAN VILLAGE 43-1341462 $401,722 HOOSIER CHRISTIAN VILLAGE 23-7423749 $401,722 CROWN POINT CHRISTIAN VILLAGE 31-1114614 $401,722 RISEN SON CHRISTIAN VILLAGE 42-1279738 $401,722 IN THE CURRENT YEAR, THE BOND PROCEEDS WERE REALLOCATED DUE TO MANAGEMENT AGREEMENT THAT THE MAJORITY OF THE PROCEEDS WERE USED FOR FACILITY USE, NOT CORPORATE (CHRISTIAN HOMES, INC) USE. AS SUCH THE CORPORATE ALLOCATION DECREASED. FURTHER, A DISREGARDED ENTITY THAT WAS REPORTED WITH CHRISTIAN HOMES, INC WAS SOLD DURING THE CURRENT YEAR AND NO DEBT WAS ALLOCATED TO THIS FACILITY AT YEAR END AS A RESULT. THE ENTITY WAS ALSO ALLOCATED BOND PROCEEDS FROM A 2010 BOND ISSUANCE. THIS BOND ISSUANCE HAS NOT BEEN INCLUDED ON SCHEDULE K AS THE ALLOCATED OUTSTANDING PRINCIPAL OF THIS ISSUANCE DID NOT EXCEED THE REPORTING THRESHOLD OF $100,000. 2007E BONDS: THE PROCEEDS OF THE 2007E BONDS WERE USED TO REFUND THE $9,250,000 SERIES 1992 BONDS OF RISEN SON CHRISTIAN VILLAGE. SCH K, PART II, LINE 7: RISEN SON CHRISTIAN VILLAGE HAS ELECTED TO AMORTIZE THE ISSUANCE COST OVER THE LIFE OF THE BOND. THIS HAS LED TO A DIFFERENCE BETWEEN THE ISSUED 8038 AND THE BOOK VALUE OF ISSUANCE COST. SCHEDULE K, PART III LINE 7 THE BONDS ARE NOT PRIVATE ACTIVITY BONDS AS THEY DO NOT MEET THE PRIVATE BUSINESS USE TEST. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES MANAGEMENT DUTIES INCLUDING SUPERVISING PERSONNEL, OPERATIONS, AND BUDGETING TO MIDWEST CHRISTIAN VILLAGES, A MANAGEMENT COMPANY AND RELATED EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD GETS A DRAFT OF THE 990 ELECTRONICALLY SENT TO THEM FOR REVIEW PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST STATEMENT IS INCLUDED IN THE EMPLOYEE HANDBOOK WHICH EVERY EMPLOYEE IS GIVEN A COPY OF AND SIGNS AN ACKNOWLEDGEMENT FOR ON THEIR FIRST DAY OF EMPLOYMENT. IF A VIOLATION OCCURS EMPLOYEES CAN REPORT DIRECTLY TO THEIR SUPERVISOR OR USE THE 800 NUMBERS WHICH ARE POSTED AT EACH LOCATION. VIOLATIONS ARE INVESTIGATED BY INDIVIDUALS AT THE VICE PRESIDENT LEVEL AND AT LEAST TWO INDIVIDUALS WOULD MAKE THE FINAL DETERMINATION AS TO THE APPROPRIATE ACTION TO BE TAKEN. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PARTICIPATES IN SEVERAL (MINIMUM OF 3) INDUSTRY SPECIFIC, EXECUTIVE SALARY SURVEYS EACH YEAR TO HELP DETERMINE COMPETITIVENESS OF OUR EXECUTIVE AND SENIOR MANAGEMENT POSITIONS. THE SALARIES ARE DISCUSSED AND REVIEWED BY THE PRESIDENT AND VICE PRESIDENT OF HUMAN RESOURCES. IF A NEW HIRE IS BEING CONSIDERED FOR AN EXECUTIVE LEVEL POSITION, IT MAY ALSO BE DISCUSSED WITH THE BOARD. IN 2010, THE ORGANIZATION ESTABLISHED A COMPENSATION COMMITTEE OF THE BOARD HEADED BY A PERSON WHOSE ENTIRE CAREER WAS IN HUMAN RESOURCES AND INCLUDES THE ORGANIZATION'S VICE PRESIDENT OF HUMAN RESOURCES AS WELL AS A FEW OTHER BOARD MEMBERS. OTHER OFFICERS' AND KEY EMPLOYEES' SALARIES ARE DETERMINED BASED ON A REVIEW AND PARTICIPATION IN SEVERAL INDUSTRY SPECIFIC SALARY SURVEYS WHICH PROVIDE DATA ON OTHER EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION POSTS ITS FINANCIAL STATEMENTS ON ITS WEBSITE MONTHLY. FINANCIAL STATEMENTS CAN ALSO BE OBTAINED ON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFER FROM AFFILIATE 33,273. FORM 990, PAGE 12, PART XII, LINE 2C - AUDIT COMMITTEE OVERSIGHT & REVIEW THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR. CHRISTIAN HOMES INC 200 N POSTVILLE DR LINCOLN IL 62656 370841562 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 9 N/A 0 FAIR HAVENS CHRISTIAN HOMES 1790 S FAIRVIEW AVE DECATUR IL 62521 370987659 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 9 N/A 0 LEWIS MEMORIAL CHRISTIAN VILLAGE 3400 W WASHINGTON ST SPRINGFIELD IL 62711 510173104 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 9 N/A 0 HOOSIER CHRISTIAN VILLAGE 621 S SUGAR ST BROWNSTOWN IN 47220 237423749 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(C)(3) LINE 9 N/A 0 SPRING RIVER CHRISTIAN VILLAGE 201 S NORTHPARK LANE JOPLIN MO 64801 431341462 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS MO 501(C)(3) LINE 9 N/A 0 CROWN POINT CHRISTIAN VILLAGE 6685 E 117TH ST CROWN POINT IN 46307 311114614 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(C)(3) LINE 9 N/A 0 VILLAGE CHRISTIAN PARKE 675 SOUTH FORD RD ZIONSVILLE IN 46077 311172227 RETIREMENT APARTMENTS IN 501(C)(3) LINE 9 N/A 0 MIDWEST SENIOR MINISTRIES 111 E WASHINGTON BENSENVILLE IL 60106 201053401 SKILLED NURSING FACILITY, RETIREMENT APARTMENTS & PHARMACY IL 501(C)(3) LINE 9 N/A 0 MIDWEST CHRISTIAN VILLAGES 200 N POSTVILLE DR LINCOLN IL 62656 260275009 MGMT NURSING AND RETIREMENT COMMUNITIES IL 501(C)(3) LINE 9 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0