2013-12-18T10:48:06-06:00 2013-06-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2012-07-01 201053401 MIDWEST SENIOR MINISTRIES MIDW 3145877903 622 EMERSON ROAD NO 310 ST LOUIS MO 63141 SUSAN MCGHEE 3145877903 2013-12-17 1 JEFF PARKER P00970069 3149254300 2012 2016-03-07 17:11:31Z SUSAN MCGHEE 622 EMERSON ROAD NO 310 ST LOUIS MO 63141 29263398 0 X WWW.CHRISTIANHOMES.ORG X 2005 IL TO PROVIDE QUALITY CARE FOR THE AGED IN A CHRISTIAN ENVIRONMENT. 14 14 481 105 129883 -350131 32444 22754 29442451 27862996 119885 1219990 143656 -440847 29738436 28664893 0 0 0 0 10679405 11176989 0 0 0 20061222 18046686 30740627 29223675 -1002191 -558782 44385023 42794857 47753372 46750178 -3368349 -3955321 X THE MISSION OF MIDWEST SENIOR MINISTRIES 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 25062806 27196662 MIDWEST CHRISTIAN MINISTRIES PROVIDES QUALITY CARE TO SENIORS IN A CHRISTIAN ENVIRONMENT. THE OPERATIONS INCLUDE SKILLED NURSING CARE, ASSISTED LIVING, SENIOR APARTMENTS, AND INDEPENDENT LIVING APARTMENTS. 56,107 PATIENT DAYS OF SKILLED NURSING SERVICE WERE PROVIDED IN FISCAL 2013 AND 5,709 PATIENT DAYS OF ASSISTED LIVING SERVICES WERE PROVIDED IN FISCAL 2013. SERVICE WAS PROVIDED TO 113 RESIDENTS LIVING IN THE INDEPENDENT LIVING UNITS WHERE RESIDENTS LIVE INDEPENDENTLY, ARE PROVIDED MEALS, AND HAVE ACCESS TO OTHER SERVICES IN A CHRISTIAN ENVIRONMENT WITH OTHER SENIORS. PHARMACY OPERATIONS ARE TO PROVIDE PHARMACEUTICALS, CONSULTING, AND SUPPLIES TO RESIDENTS OF ITS OWN NURSING CAMPUSES AND AFFILIATES. 25062806 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 1 1 0 0 0 1 40 0 481 1 1 1 0 0 0 0 0 0 0 X 14 14 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X MIDWEST CHRISTIAN VILLAGES 3145877903 622 EMERSON ROAD ST LOUIS MO 63141 JIMMIE BLALOCK 0.30 2.00 X 0 0 0 ROBERT CROSBY 0.30 2.00 X X 0 1000 0 RANDY CLARK 0.30 2.00 X 0 1000 0 JAMES S FRASURE MD 0.30 2.00 X 0 1000 0 MAURINE COLLETT 0.30 2.00 X 0 750 0 TERRY GOODNER 0.30 2.00 X X 0 1250 0 NICHOLAS A FILING 0.30 2.00 X 0 1000 0 MARYLYN ROWE 0.30 2.00 X 0 1000 0 RONALD F SEWELL 0.30 2.00 X X 0 1000 0 BILLIE LASH 0.30 2.00 X 0 750 0 PATRICIA LINCOLN 0.30 2.00 X 0 1000 0 MARK A BEHRENDS 0.30 2.00 X 0 1000 0 BILLY D CARTER 0.30 2.00 X X 0 1000 0 VICTOR S WILLIAMS 0.30 2.00 X 0 0 0 TIMOTHY PHILLIPPE 2.00 38.00 X 0 422709 6840 SUSAN MCGHEE 2.00 38.00 X 0 216605 12840 MARK LONGENECKER 2.00 38.00 X 0 220152 12840 SHERRY GUTERMUTH 2.00 38.00 X 0 189051 12840 JOHN RUPKEY 2.00 38.00 X 181078 0 12340 ROBERT VINCENT 0.00 40.00 X 0 147266 6840 GREG WITTE 0.00 40.00 X 0 155776 12340 JODI NYLIN 2.00 38.00 X 0 179154 4500 MICHAEL CARDENAS 2.00 38.00 X 0 159743 6840 181078 1702206 88220 5 0 1 0 KINDRED REHAB SERVICES INC PO BOX 277365 ATLANTA GA 30384 THERAPY 1487187 1 22754 22754 HEALTHCARE SERVICES NET OF CHARIT 623000 17509738 17509738 PHARMACY OPERATIONS 446110 9458382 8789761 668621 ASSISTED LIVING 623000 894876 894876 27862996 1219244 1219244 59767 598505 -538738 -538738 -538738 42 704 0 0 42 704 746 746 MISCELLANEOUS 900099 45505 45505 GARAGE RENTAL 900099 28197 28197 CABLE TV REVENUE 900099 11517 11517 12672 2287 10385 97891 28664893 27196662 129883 1315594 8764319 7768497 995822 1734600 1537511 197089 678070 601026 77044 1463513 1463513 34411 34411 1641759 1523556 118203 123533 123533 7800240 7226416 573824 39970 39970 1018227 1018227 46958 8381 38577 9015 1255 7760 1559681 1559681 1808234 1808234 242600 242600 RAW FOOD 773072 773072 PURCHASED SERVICES 697623 697623 MISCELLANEOUS 402882 6656 396226 LIFE RIGHT DISCOUNT 259624 259624 125344 30447 94897 29223675 25062806 4160869 0 3164007 3018856 712764 777470 24666 65160 43724541 10022545 33710247 33701996 873834 830141 5899505 4401234 44385023 42794857 2838963 2439665 8134143 8532227 24476799 23917076 12303467 11861210 47753372 46750178 X -3370539 -3965651 2190 10330 -3368349 -3955321 44385023 42794857 -558782 -28190 0 X X 0 1 X 1 0 X 51813 13383 38454 32444 22754 158848 28378458 29151536 30744162 28367705 27862996 144504857 28430271 29164919 30782616 28400149 27885750 144663705 0 0 0 144663705 604047 382012 202335 128020 1219244 2535658 604047 382012 202335 128020 1219244 2535658 22951 22951 27560 25053 119873 124491 97891 394868 29061878 29571984 31104824 28675611 29202885 147617182 0.98000 0.98530 0.01720 0.01190 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY SHOP - 2008 AMOUNT: $ 3,935. 2009 AMOUNT: $ 6,540. 2010 AMOUNT: $ 2,605. 2011 AMOUNT: $ 1,070. 2012 AMOUNT: $ 800. SPACE RENTAL - 2008 AMOUNT: $ 4,499. 2009 AMOUNT: $ 4,960. 2010 AMOUNT: $ 540. 2011 AMOUNT: $ 1,407. 2012 AMOUNT: $ 9,585. MISCELLANEOUS - 2008 AMOUNT: $ 19,126. 2009 AMOUNT: $ 13,553. 2010 AMOUNT: $ 116,728. 2011 AMOUNT: $ 116,706. 2012 AMOUNT: $ 45,505. DISCOUNTS - 2011 AMOUNT: $ 5,308. 2012 AMOUNT: $ 2,287. CABLE TV - 2012 AMOUNT: $ 11,517. GARAGE RENTAL - 2012 AMOUNT: $ 28,197. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8800000 8800000 32420702 8605831 23814871 2503839 1416714 1087125 33701996 RESIDENT FUNDS 45771 BOND FUNDS 4213299 CONSTRUCTION IN PROGRESS 39077 ENTRANCE FEES RECEIVABLE 102500 ENDOWMENT FUNDS 587 4401234 FIN 47 LIABILITY 77459 SECURITY DEPOSIT PAYABLE 37500 OVERDRAFT ON BANK BALANCE 11640922 INTERCOMPANY PAYABLE 329 CURRENT PORTION OF REFUNDABLE LIFE RIGHTS 105000 11861210 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION QUALIFIES AS A TAX-EXEMPT CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATION IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE ORGANIZATION IS CLASSIFIED AS A PUBLICLY-SUPPORTED CHARITABLE ORGANIZATION UNDER THE CODE AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS A CHARITABLE TAX DEDUCTION FOR THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATIONS FINANCIAL STATEMENTS. IT ALSO PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THIS STANDARD HAS NO IMPACT ON THE ORGANIZATIONS' FINANCIAL STATEMENTS. THE ORGANIZATIONS' INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THEIR TAX-EXEMPT STATUS. THE ORGANIZATION IS 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. THE TAX RETURNS FOR THE YEARS 2010 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. X 1 1 X X X X 1 0 0 0 0 0 0 0 0 TIMOTHY PHILLIPPE 0 373209 0 49500 0 0 0 0 0 6840 0 429549 0 0 SUSAN MCGHEE 0 216605 0 0 0 0 0 0 0 12840 0 229445 0 0 MARK LONGENECKER 0 177455 0 40000 0 2697 0 0 0 12840 0 232992 0 0 SHERRY GUTERMUTH 0 163304 0 21000 0 4747 0 0 0 12840 0 201891 0 0 JOHN RUPKEY 147408 0 28000 0 5670 0 0 0 12340 0 193418 0 0 0 ROBERT VINCENT 0 132845 0 10000 0 4421 0 0 0 6840 0 154106 0 0 GREG WITTE 0 132936 0 21500 0 1340 0 0 0 12340 0 168116 0 0 JODI NYLIN 0 143885 0 15000 0 20269 0 0 0 4500 0 183654 0 0 MICHAEL CARDENAS 0 159743 0 0 0 0 0 0 0 6840 0 166583 0 0 PART I, LINE 1A TIMOTHY PHILLIPPE RECEIVED A HOUSING ALLOWANCE OF $16,478 AND ROBERT VINCENT RECEIVED A HOUSING ALLOWANCE OF $25,480. PART I, LINE 4A JODI NYLIN - SEVERANCE PAYMENT OF $20,269. A ILLINOIS FINANCE AUTHORITY 861091967 45200B6K9 2007-06-28 37578378 REFINANCE 0 0 0 B ILLINOIS FINANCE AUTHORITY 861091967 45200F5E5 2010-07-29 24614950 REFINANCE SERIES 2007C AND FUND CONSTRUCTION PROJECTS 0 0 0 A 1471100 17661838 1822445 329115 6072797 9437482 2010 1 0 1 1 B 168086 10091311 1130325 201826 5207515 3551644 2012 1 0 1 1 A 0 1 0 0 0.02110 0.02110 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 SCHEDULE K PART IV, ARBITRAGE, LINE 2C DATE REBATE COMPUTATION PERFORMED ISSUER NAME: ILLINOIS FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/28/2012 SCH K, PART II; 2007 BONDS: THE PROCEEDS OF THE 2007A, 2007B AND 2007C BONDS WERE USED TO REFUND THE $4,775,000 SERIES 1989A BONDS OF BENSENVILLE HOME SOCIETY, REFUND THE $17,100,000 SERIES 1995A BONDS OF LIFELINK CORPORATION OBLIGATED GROUP, REFUND THE $18,410,000 SERIES 1998 BONDS OF LIFELINK CORPORATION OBLIGATED GROUP, REFUND THE $1,920,000 SERIES 2002 BONDS OF LEWIS MEMORIAL CHRISTIAN VILLAGE, AND REFUND THE $6,800,000 SERIES 2004 BONDS OF FAIR HAVENS CHRISTIAN HOME. PROCEEDS OF 2010 BOND ISSUANCE: THE PROCEEDS OF THE 2010 BOND ISSUANCE WAS FOR THE BENEFIT OF: CHRISTIAN HOMES, INC 37-0841562 $4,545,361 FAIR HAVENS CHRISTIAN HOME, INC 37-0987659 $4,626,048 LEWIS MEMORIAL CHRISTIAN VILLAGE 51-0173104 $5,352,230 MIDWEST SENIOR MINISTRIES, INC. 20-1053401 $10,091,311 PROCEEDS OF 2007 BOND ISSUANCE: THE PROCEEDS OF THE 2007 BOND ISSUANCE WAS FOR THE BENEFIT OF: CHRISTIAN HOMES, INC. 37-0841562 $6,388,324 FAIR HAVENS CHRISTIAN HOME, INC. 37-0987659 $8,643,027 LEWIS MEMORIAL CHRISTIAN VILLAGE 51-0173104 $4,885,189 MIDWEST SENIOR MINISTRIES, INC. 20-1053401 $17,661,838 SCH K, PART II, LINE 7: MIDWEST SENIOR MINISTRIES 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. SCH K, PART III, LINE 5: MIDWEST SENIOR MINISTRIES, INC. LEASES OFFICE SPACE TO THREE UNRELATED NONPROFIT ORGANIZATIONS. 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. AUDIT COMMITTEE OVERSIGHT & REVIEW: FORM 990, PAGE 12, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS. SENIOR CARE PHARMACY SERVICES LLC 1204 BEAR LANE MONTICELLO IL 61856 201053401 PHARMACY SERVICES IL 9466501 8048490 MIDWEST SENIOR MINISTRIES INC 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 CHICAGOLAND 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 RISEN SON CHRISTIAN VILLAGE 3000 RISEN SON BLVD COUNCIL BLUFFS IA 51503 421279738 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IA 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 CHRISTIAN VILLAGES 200 N POSTVILLE DR LINCOLN IL 62656 260275009 MGMT NURSING AND RETIREMENT 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 1 0 0