2014-11-10T09:35:32-06:00 2014-06-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2013-07-01 311002846 WESTMINSTER VILLAGE WEST LAFAYETTE INC WEST 7654637546 2741 NORTH SALISBURY STREET WEST LAFAYETTE IN 47906 STEVE HABBEN BOARD PRESIDENT 7654637546 2014-10-28 1 JEFF PARKER P00970069 3149254300 2013 2015-11-30 17:44:51Z VICKI GREGORY 2741 NORTH SALISBURY STREET WEST LAFAYETTE IN 47906 18015784 0 X N/A X 1976 IN PROVIDES RESIDENTIAL FACILITIES DESIGNED TO MEET THE NEEDS OF THE ELDERLY. 9 9 380 62 0 0 111641 111455 14595094 15696124 118975 469364 574955 636493 15400665 16913436 88838 111355 0 0 7389772 8587794 0 0 0 8589442 9667247 16068052 18366396 -667387 -1452960 56750158 56649014 51907572 53234663 4842586 3414351 PROVIDES RESIDENTIAL FACILITIES DESIGNED TO MEET THE NEEDS OF THE ELDERLY AND PROVIDE FOR THE PHYSICAL, MENTAL AND FINANCIAL WELL BEING OF ITS RESIDENTS. FINANCIAL ASSISTANCE IS PROVIDED TO THOSE RESIDENTS UNABLE TO MEET THEIR LIVING EXPENSES. 0 0 16185754 111355 15696124 WESTMINSTER VILLAGE WEST LAFAYETTE, INC. IS A NOT-FOR-PROFIT, CONTINUING CARE RETIREMENT COMMUNITY LOCATED IN WEST LAFAYETTE, INDIANA. FACILITIES INCLUDE 130 RESIDENTIAL UNITS (INDEPENDENT LIVING CENTER), 57 INDEPENDENT LIVING COTTAGES, A 70 BED COMPREHENSIVE CARE FACILITY (THE HEALTH CENTER), AND A 76 BED ASSISTED LIVING FACILITY. WESTMINSTER'S PRIMARY PURPOSE IS THE PROVISION OF CONTINUING CARE SERVICES TO THE CITIZENS OF WEST LAFAYETTE, INDIANA AND THE SURROUNDING COMMUNITIES. 16185754 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 30 0 380 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X WESTMINSTER VILLAGE WEST LAFAYETTE 7654637546 2741 NORTH SALISBURY WEST LAFAYETTE IN 47906 PETER NIESEL VICE PRESIDENT 12.00 X X 0 0 0 ROBERT WOERNER SECRETARY 10.00 X X 0 0 0 JOLENE MILLER PRESIDENT 15.00 X X 0 0 0 MARY ANN SLOAN MEMBER 5.00 X 0 0 0 LOUIS CARR MEMBER 5.00 X 0 0 0 JAMES ALMOND TREASURER 12.00 X X 0 0 0 STEVE HABBEN MEMBER 10.00 X 0 0 0 MARTHA CHISCON MEMBER 5.00 X 0 0 0 ANDREW S GUTWEIN MEMBER 5.00 X 0 0 0 VICKI GREGORY EXECUTIVE DIRECTOR 40.00 X 0 0 0 DAWN WALKER MARKETING DIRECTOR 40.00 X 141273 0 8998 141273 0 8998 1 0 1 0 CRSA LCS MANAGEMENT LLC 400 LOCUST ST SUITE 820 DES MOINES IA 50309 MANAGEMENT SERVICES 961300 REHABCARE GROUP PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 743312 LAWN & SHRUB PO BOX 155 BUCK CREEK IN 47924 LANDSCAPING 579426 INTERDESIGN 141 E OHIO ST INDIANAPOLIS IN 46204 ARCHITECT SERVICES 380769 KETTELHUT CONSTRUCTIONS PO BOX 5000 LAFAYETTE IN 47903 CONSTRUCTION SERVICES 347321 7 111355 100 111455 SERVICE FEES 623000 15029876 15029876 LIFE OCC. FEE AMORTIZATION 623000 666248 666248 15696124 89289 89289 1482423 1083468 18880 398955 -18880 380075 380075 OTHER INCOME 623000 236315 236315 PHARMACY INCOME 623000 138769 138769 BEAUTY SALON INCOME 623000 110598 110598 150811 150811 636493 16913436 15696124 0 1105857 111355 111355 151050 151050 6714054 6047681 666373 41668 36707 4961 1100489 969455 131034 580533 511409 69124 497357 497357 1791 1791 61988 61988 1305140 1255580 49560 192959 192959 803089 698417 104672 82333 82333 1258761 1183059 75702 87176 16784 70392 913253 858330 54923 2950656 2773204 177452 264157 248271 15886 FOOD 962018 962018 EMPLOYEE RECRUITMENT 109030 109030 MISCELLANEOUS 90864 6433 84431 DUES AND SUBSCRIPTIONS 45234 45234 41441 9694 31747 18366396 16185754 2180642 0 380342 495802 5861147 4641111 23733 22605 339331 547411 61665 65745 45591 45920 73602477 28796053 45176873 44806424 4283414 4709650 418062 403729 160000 910617 56750158 56649014 1282278 1478516 24891318 25754159 24870000 24375000 863976 1626988 51907572 53234663 X 4812505 3385298 30081 29053 4842586 3414351 56750158 56649014 X -1452960 -56737 81462 X X 0 1 X 1 0 X 103346 92045 113599 111641 111455 532086 12603449 13982511 10582729 14595094 15696124 67459907 12706795 14074556 10696328 14706735 15807579 67991993 0 0 0 67991993 29715 12188 3919 118975 89289 254086 29715 12188 3919 118975 89289 254086 402801 454844 483096 574955 636493 2552189 13139311 14541588 11183343 15400665 16533361 70798268 0.96040 0.96220 0.00360 0.00350 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: LAUNDRY - 2009 AMOUNT: $ 402,801. 2010 AMOUNT: $ 454,844. 2011 AMOUNT: $ 483,096. 2012 AMOUNT: $ 18,075. 2013 AMOUNT: $ 14,293. GUEST ROOMS/MEALS - 2012 AMOUNT: $ 69,608. 2013 AMOUNT: $ 83,880. OTHER INCOME - 2012 AMOUNT: $ 241,515. 2013 AMOUNT: $ 236,315. SALON - 2012 AMOUNT: $ 102,889. 2013 AMOUNT: $ 110,598. PHARMACY - 2012 AMOUNT: $ 96,761. 2013 AMOUNT: $ 138,769. GENERAL STORE - 2012 AMOUNT: $ 46,107. 2013 AMOUNT: $ 52,638. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2939505 2939505 61910609 25391617 36518992 7777001 3404436 4372565 975362 975362 44806424 RESIDENT DEPOSITS 1003475 FAIR VALUE OF INTEREST RATE SWAPS 623513 1626988 X 16826806 -56737 81462 24725 16802081 111355 111355 16913436 18255041 0 18255041 111355 111355 18366396 PART X, LINE 2: THE VILLAGE ADOPTED 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 DOES NOT CURRENTLY INCLUDE AN INCOME TAX PROVISION IN THE FINANCIAL STATEMENTS. MANAGEMENT MONITORS THE REPORTING OF UNCERTAIN TAX POSITIONS, WHICH COULD RESULT IN RECORDING OF AN INCOME TAX PROVISION IN THE FUTURE. WESTMINSTER VILLAGE WEST LAFAYETTE, INC. 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 TAX EXCEPT FOR THOSE THAT ARE ALREADY REPORTED ANNUALLY. THE TAX RETURNS FOR THE YEARS 2011 THROUGH 2013 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED GAIN ON SWAP 81,462. PART XI, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSES NETTED WITH REVENUE ON F/S 111,355. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSES NETTED WITH REVENUE ON F/S 111,355. 1 FINANCIAL ASSISTANCE 7 111355 FMV PART I, LINE 2: THE FINANCIAL ASSISTANCE IS PROVIDED ON AN ANNUAL BASIS WITH THE REVIEW AND WRITE OFF OF THE ACCOUNTS RECEIVABLE. 0 0 0 0 0 0 0 0 0 DAWN WALKER MARKETING DIRECTOR 137278 0 3995 0 0 0 0 0 8998 0 150271 0 0 0 A CITY OF WEST LAFAYETTE IN 356001233 NONEAVAIL 2010-08-26 25500000 REPAY PREVIOUS MORTGAGE, NEW CONSTRUCTION, RENOVATION OF EXISTING FACILITY, 0 0 0 A 1125000 25500000 444999 16646478 8408523 2012 0 0 1 1 A 0 1 1 1 0 0.00160 0.00160 1 0 1 A 0 1 0 0 1 0 0 0 1 A 1 PAGE 1, PART III, LINE 2 THE INSTITUTION DOES REGULARLY "LEASE" OR MAKES PROPERTY AVAILABLE FOR USE BY THE ELDERLY AS PART OF ITS TAX EXEMPT MISSION. SCHEDULE K. PART III, LINE 7 THE BONDS ARE NOT PRIVATE ACTIVITY BONDS AS THEY DO NOT MEET THE PRIVATE BUSINESS USE TEST. SCHEDULE K, PAGE 1, PART II PREVIOUSLY, THE ORGANIZATION'S SCHEDULE K REPORTED THE SERIES 2010A BONDS AND THE 2010B BONDS AS TWO DIFFERENT ISSUES IN COLUMNS A & B, RESPECTIVELY. THIS YEAR AND ON A GOING FORWARD BASIS, THEY WILL BE REPORTED IN ONE COLUMN AS THEY WERE ACTUALLY A PART OF THE SAME ISSUE. STEVE HABBEN STEVE HABBEN IS A MEMBER OF THE BOARD OF DIRECTORS 347321 STEVE HABBEN IS A MEMBER OF THE BOARD OF DIRECTORS AND HE IS ALSO AN EXECUTIVE AT KETTELHUT CONSTRUCTION, INC., WHICH PERFORMED CONSTRUCTION SERVICES FOR THE FACILITY DURING THE YEAR. 0 FORM 990, PART VI, SECTION A, LINE 3 THREE KEY MANAGEMENT EMPLOYEES, THE EXECUTIVE DIRECTOR, CONTROLLER, AND THE HEALTH FACILITY ADMINISTRATOR ARE EMPLOYEES OF CRSA/LCS, THE MANAGEMENT COMPANY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING. THE FORM 990 IS APPROVED BY THE FINANCE AND MANAGEMENT COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD OF DIRECTORS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. IF A POSSIBLE CONFLICT OF INTEREST DOES ARISE, THE ISSUE IS VOTED ON BY ALL BOARD MEMBERS THAT DO NOT HAVE AN INTEREST IN THE OUTCOME. FORM 990, PART VI, SECTION B, LINE 15 REVIEW OF COMPENSATION FOR A SIMILAR POSITION IN THE GEOGRAPHIC AREA. FORM 990, PART VI, SECTION C, LINE 19 ALTHOUGH NOT REQUIRED, THE ORGANIZATION WILL PROVIDE PHOTOCOPIES OF ITS FINANCIAL STATEMENTS TO ALL WHO REQUEST THEM. A COPY OF THE FINANCIAL STATEMENTS IS ALSO LOCATED IN THE WESTMINSTER VILLAGE LIBRARY. FORM 990, PART XI, LINE 9: UNREALIZED GAIN ON SWAP 81,462. FORM 990, PAGE 12, PART XII, LINE 2C THE ORGANIZATION HAS A FINANCE AND MANAGEMENT COMMITTEE THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT. THIS PRACTICE IS CONSISTENT WITH THE PRIOR YEARS. FORM 990, PAGE 7, PART VII AND PAGE 10, PART IX LINE 5 THE EXECUTIVE DIRECTOR'S COMPENSATION IS PAID BY THE MANAGEMENT COMPANY AND REIMBURSED BY THE ORGANIZATION. THE MANAGEMENT COMPANY ISSUES THE W-2. AS A RESULT, COMPENSATION IS LISTED ON PAGE 10 LINE 5, BUT NOT INCLUDED ON PAGE 7. WESTMINSTER VILLAGE FOUNDATION OF WEST LAFAYETTE INDIANA INC 2741 N SALISBURY STREET WEST LAFAYETTE IN 47906 351537414 SUBSIDIZE EXEMPT ACTIVITIES IN 501(C)(3) LINE 11A, I 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0