UNLIMITED DEVELOPMENT INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
UNLIMITED DEVELOPMENT INC (EIN 36-4094409)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-06-19
IRS object ID
201341709349300009
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-06-19T09:03:27-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420714325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1117 E MAIN ST STE 210AddressLine1
CityGALESBURGCity
StateILState
ZIP Code61401ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN364094409EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UNLIMITED DEVELOPMENT INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUNLINameControl
Phone3093431550Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1285 SOUTH FARNHAM STREETAddressLine1
CityGALESBURGCity
StateILState
ZIP Code61401ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT WAGNERName
TitlePRESIDENTTitle
Phone3093431550Phone
Date Signed2013-06-04DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBEN MCMAHANName
PTINP00702421PTIN
Phone3093428026Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT WAGNERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1285 SOUTH FARNHAM STREETAddressLine1
CityGALESBURGCity
StateILState
ZIP Code61401ZIPCode
FieldValueIRS element (for citing)
Gross Receipts84393583GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteSIMPLYTHEFINEST.NETWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionUDI PROVIDES & OPERATES NURSING AND ASSISTED LIVING FACILITIES FOR THE ELDERLY.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees2633TotalNbrEmployees
Total Nbr Volunteers98TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year12918ContributionsGrantsPriorYear
Contributions Grants Current Year63143ContributionsGrantsCurrentYear
Program Service Revenue Prior Year80172025ProgramServiceRevenuePriorYear
Program Service Revenue CY82567334ProgramServiceRevenueCY
Investment Income Prior Year87564InvestmentIncomePriorYear
Investment Income Current Year238042InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year80272507TotalRevenuePriorYear
Total Revenue Current Year82868519TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY15000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year36332899SalariesEtcPriorYear
Salaries Etc Current Year38861368SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year36188680OtherExpensePriorYear
Other Expenses Current Year41277983OtherExpensesCurrentYear
Total Expenses Prior Year72521579TotalExpensesPriorYear
Total Expenses Current Year80154351TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7750928RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2714168RevenuesLessExpensesCY
Total Assets BOY33426597TotalAssetsBOY
Total Assets EOY36141092TotalAssetsEOY
Total Liabilities BOY10052084TotalLiabilitiesBOY
Total Liabilities EOY9747986TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY23374513NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY26393106NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF THE ORGANIZATION IS ARTICULATED IN ITS ARTICLES OF INCORPORATION AS FOLLOWS:THE CORPORATION IS ORGANIZED EXCLUSIVELY FOR CHARTIABLE PURPOSES AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN FURTHERANCE OF THOSE CHARITABLE PURPOSES, THE CORPORATION SHALL BE EMPOWERED TO BUILD, LEASE, ACQUIRE AND OTHERWISE OWN AND OPERATE RESIDENTIAL FACILITIES, NURSING FACILITIES AND OTHER RELATED FACILITIES AND SERVICES FOR THE ELDERLY, MENTALLY RETARDED, MENTALLY ILL, DEVELOPMENTALLY DISABLED AND OTHER LIKE CONDITIONS WITHOUT REGARD TO RACE, RELIGION, COLOR, SEX, CREED OR NATIONAL ORIGIN OF SAID PERSONS. THE CORPORATION WILL NOT ENGAGE IN THE PRACTICE OF MEDICINE NOR RENDER ANY LICENSED PROFESSIONAL SERVICES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense75182870Expense
Grants15000Grants
Revenue82567334Revenue
DescriptionALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING SKILLED NURSING FACILITIES, HEALTH CARE, ASSISTED AND SEMI-INDEPENDENT LIVING FACILITIES, AND OTHER RELATED SERVICES TO THE ELDERLY. THE ORGANIZATION OPERATES 22 FACILITIES WITH A COMBINED TOTAL OF 1,690 BEDS.Description
Total Program Service Expense75182870TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109640NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2633NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RON WILSON RFMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3093431550TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1285 SOUTH FARNHAMAddressLine1
CityGALESBURGCity
StateILState
ZIP Code61401ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
ROBERT H WAGNER
PRESIDENT2.00XX450000
GORDON AULGUR
SECRETARY2.00XX600000
DAVID HANEY
DIRECTOR2.00X600000
JERRY GILMORE
DIRECTOR2.00X600000
AUDREY FINKE
DIRECTOR2.00X600000
KAREN WAKEFIELD
DIRECTOR/SECRETARY2.00X600000
RON WILSON RFMS INC
CFO40.00X000
TRACY OWENS
ADMINISTRATOR40.0014111006608X
CHRISTOPHER STUBBLEFIELD
THERAPY COORDINATOR40.0010687004740X
KATHY BERCK
ADMINISTRATOR40.0010117404740X
FieldValueIRS element (for citing)
Total Reportable Comp From Org383654TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation16088TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
RFMS INC
285 SOUTH FARNHAMGALESBURGIL61401ADMINISTRATIVE SERVICES2033400
ENDURACARE
PO BOX 53064PHOENIXAZ850723064THERAPY SERVICES1859708
LTC SUPPORT SERVICES LLC
285 SOUTH FARNHAMGALESBURGIL61401SUPPORT SERVICES1798580
AZER CLINIC
872 W DAYTON STGALESBURGIL61401THERAPY SERVICES1012187
ONR NATIONAL INC
1101 S CAPITAL OF TEXAS HWYAUSTINTX78746THERAPY SERVICES733176
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K
All Other Contributions63143AllOtherContributions
Total Contributions63143TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE & MEDICAID6230005389825253898252
PRIVATE PAY RESIDENT S6230002823968328239683
MAINTENANCE FEES623000233507233507
OTHER RESIDENT SERVICE623000195692195692
OTHER INCOME623000200200
FieldValueIRS element (for citing)
Total Program Service Revenue82567334TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column173622TotalRevenueColumn
Exclusion$173,622ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1589484Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1525064Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities64420Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column64420TotalRevenueColumn
Exclusion$64,420ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column82868519TotalRevenueColumn
Related Or Exempt Function Income82567334RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$238,042ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total15000Total
Program Services15000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total33750Total
Management And General33750ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total33207407Total
Program Services32237892ProgramServices
Management And General969515ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total221377Total
Program Services214914ProgramServices
Management And General6463ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2657786Total
Program Services2580190ProgramServices
Management And General77596ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2741048Total
Program Services2661021ProgramServices
Management And General80027ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total3557760Total
Program Services2388624ProgramServices
Management And General1169136ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total283691Total
Management And General283691ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total102310Total
Management And General102310ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total19553Total
Management And General19553ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total18998Total
Program Services18998ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5851829Total
Program Services5851435ProgramServices
Management And General394ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total791651Total
Program Services712486ProgramServices
Management And General79165ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total585725Total
Program Services458466ProgramServices
Management And General127259ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total260891Total
Program Services208713ProgramServices
Management And General52178ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total13370276Total
Program Services12978015ProgramServices
Management And General392261ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total185019Total
Program Services176163ProgramServices
Management And General8856ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total52068Total
Program Services44824ProgramServices
Management And General7244ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1391Total
Program Services1349ProgramServices
Management And General42ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total917921Total
Program Services872025ProgramServices
Management And General45896ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total680897Total
Program Services646416ProgramServices
Management And General34481ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES & SMALL EQUIP.9544906951703827868
MEDICAID ASSESSMENT TAX29609452960945
UNCOLLECTIBLE CHARGES12647281264728
EQUIPMENT RENT & MAINT.5733965692144182

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total254028Total
Program Services69142ProgramServices
Management And General184886ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total80154351Total
Program Services75182870ProgramServices
Management And General4971481ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1477812BOY
EOY994357EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5335358BOY
EOY2442306EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY10497680BOY
EOY13181178EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2275874BOY
EOY2621141EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11413127LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3586967LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7135617BOY
EOY7826160EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5862844BOY
EOY5265784EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY451694BOY
EOY3225574EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY389718BOY
EOY584592EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY33426597BOY
EOY36141092EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4813737BOY
EOY5364748EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY584635BOY
EOY718353EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4653712BOY
EOY3664885EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10052084BOY
EOY9747986EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY23374513BOY
EOY26393106EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY23374513BOY
EOY26393106EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY33426597BOY
EOY36141092EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2714168ReconcilationRevenueExpenses
Reconcilation Other Changes304425ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2424CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years259442CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1517475CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12918CurrentTaxYearMinus1Year
Current Tax Year63143CurrentTaxYear
Total1855402Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years60739181CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years65090927CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years70722915CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year80172025CurrentTaxYearMinus1Year
Current Tax Year82567334CurrentTaxYear
Total359292382Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years60741605CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years65350369CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years72240390CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year80184943CurrentTaxYearMinus1Year
Current Tax Year82630477CurrentTaxYear
Total361147784Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509361147784PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years178991CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years69241CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years108162CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year124411CurrentTaxYearMinus1Year
Current Tax Year173622CurrentTaxYear
Total654427Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years178991CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years69241CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years108162CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year124411CurrentTaxYearMinus1Year
Current Tax Year173622CurrentTaxYear
Total654427Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years60920596CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years65419610CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years72348552CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year80309354CurrentTaxYearMinus1Year
Current Tax Year82804099CurrentTaxYear
Total361802211Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99820PublicSupportPercentage509
Prior Year Support Percentage0.99800PriorYearSupportPercentage
Investment Income Percentage0.00180InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00200PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals19553FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals19553FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals75182870FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals75202423FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus31000000CurrentYearMinus3
Current Year Minus21000000CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total4000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus318109CurrentYearMinus3
Current Year Minus218725CurrentYearMinus2
Current Year Minus120698CurrentYearMinus1
Current Year19553CurrentYear
Total77085Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3250000CurrentYearMinus3
Current Year Minus2250000CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total1000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmount

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6888694OtherCostOrOtherBasis
Depreciation1837170Depreciation
Book Value5051524BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3166510OtherCostOrOtherBasis
Depreciation1207442Depreciation
Book Value1959068BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1357923OtherCostOrOtherBasis
Depreciation542355Depreciation
Book Value815568BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7826160TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
MEMBER INTEREST - LTC SUPPORT SERVICES, LLC10000C
NOTE RECEIVABLE FROM UNRELATED 501(C)(3) ORGANIZATION196761C
ADVANCE RECEIVABLE FROM COMMUNITY LIVING OPTIONS, INC. PARENT ORGANIZATION3018813C
FieldValueIRS element (for citing)
Total Of Book Value Program Related3225574TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
DUE TO RESIDENTS$118,029
ADVANCE PAYABLE TO COMMUNITY LIVING OPTIONS, INC., PARENT ORGANIZATION$5,498
SECURITY DEPOSITS$730,805
CONSTRUCTION PAYABLE$569,215
AMOUNTS REFUNDABLE TO RESIDENTS$2,241,338
FieldValueIRS element (for citing)
Total Of Amounts3664885TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OR SECTION 501(C)(2) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2008.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1MAYO CLINICBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 FIRST STREET SWAddressLine1
CityROCHESTERCity
StateMNState
ZIP Code55905ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient416011702EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant15000AmountOfCashGrant
Purpose Of GrantALZHEIMER DISEASE RESEARCHPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: GRANT FUNDS ARE ONLY GIVEN TO ORGANIZATIONS WHO CONFIRM THE USE OF SUCH MONIES IN THE UNITED STATES. MAYO CLINIC IS A 501(C)(3) ORGANIZATION DOING BUSINESS AND LOCATED IN THE UNITED STATES.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1LTC SUPPORT SERVICES (LTC)BusinessNameLine1
FieldValueIRS element (for citing)
RelationshipA SINGLE DIRECTOR COMMON TO BOTH UDI AND LTC IS AUDREY FINKE.Relationship
Amount Of Transaction1524360AmountOfTransaction
Description Of TransactionMANAGEMENT SERVICES ARE PROVIDED BY LTC SUPPORT SERVICES, LLC, AS DESCRIBED IN SCHEDULE O RELATIVE TO PART VI, SECTION A, LINE 3. AUDREY FINKE, WHO IS A DIRECTOR OF UNLIMITED DEVELOPMENT, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $2,250 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2012.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION RECEIVES MANAGEMENT SERVICES FROM LTC SUPPORT SERVICES, LLC, AN UNRELATED COMPANY. THESE SERVICES INCLUDE OVERSIGHT, TRAINING, REGULATORY COMPLIANCE, QUALITY ASSURANCE PROGRAMS, HUMAN RESOURCE SUPPORT, MARKETING AND MAINTENANCE. UNLIMITED DEVELOPMENT, INC. OWNS 12.5% OF LTC SUPPORT SERVICES, LLC., AND COMMUNITY LIVING OPTIONS, INC., (PARENT ORGANIZATION OF UNLIMITED DEVELOPMENT, INC.) OWNS 12.5% OF LTC SUPPORT SERVICES, LLC. THE REMAINING 75% OF LTC SUPPORT SERVICES, LLC, IS OWNED BY UNRELATED EXEMPT ORGANIZATIONS. THE ORGANIZATION ALSO HAS A NEGOTIATED ARMS LENGTH ADMINISTRATIVE SERVICES CONTRACT WITH RFMS, INC., AN UNRELATED COMPANY, TO OBTAIN SERVICES SUCH AS CASH MANAGEMENT, ACCOUNTING AND FINANCIAL REPORTING, PAYROLL AND EMPLOYEE BENEFITS, INFORMATION TECHNOLOGY, REGULATORY MATTERS, AND OTHER GENERAL BUSINESS AND FINANCIAL MANAGEMENT SERVICES AS REQUIRED.
FORM 990, PART VI, SECTION A, LINE 7ATHE ORGANIZATION IS A SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC. COMMUNITY LIVING OPTIONS, INC. IS THE MEMBER OF THE ORGANIZATION. COMMUNITY LIVING OPTIONS, INC., ELECTS THE GOVERNING BODY ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION B, LINE 11EACH MEMBER OF THE BOARD OF DIRECTORS RECEIVES A PAPER COPY OF FORM 990 FOR THEIR REVIEW AND COMMENT PRIOR TO ITS FILING. THE BOARD ALSO REVIEWS IN DETAIL EACH FORM 990 FILED BY THE ORGANIZATION AT ITS REGULARLY SCHEDULED BOARD MEETINGS. ON AN ANNUAL BASIS, EACH BOARD MEMBER ATTENDS A TRAINING SESSION THAT PROVIDES UPDATES ON CURRENT EXEMPT ORGANIZATION TAX COMPLIANCE MATTERS.
FORM 990, PART VI, SECTION B, LINE 12CALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO ATTEST TO THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. THE BOARD OF DIRECTORS REVIEWS ALL COMPLETED CONFLICT OF INTEREST STATEMENTS TO DETERMINE IF ANY CONFLICTS EXIST WHICH WOULD REQUIRE RESTRICTION ON PARTICIPATION IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN ANY TRANSACTIONS INVOLVING THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 18A PAPER COPY OF FORM 990 IS PROVIDED UPON REQUEST. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE VIA THE GUIDESTAR.ORG WEBSITE AND THROUGH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXCEPT THROUGH PUBLIC FILING REQUIREMENTS.
FORM 990, PART VII, SECTION A, COLUMN F:RON WILSON IS EMPLOYED BY RFMS, INC., AN UNRELATED ORGANIZATION WHICH HAS AN ADMINISTRATIVE SERVICES CONTRACT WITH UNLIMITED DEVELOPMENT, INC. THE TYPE OF SERVICES PROVIDED BY RFMS, INC., ARE DETAILED IN THE SCHEDULE O EXPLANATION ABOVE RELATIVE TO FORM 990, PART VI, SECTION A, LINE 3. RON WILSON IS THE CHIEF FINANCIAL OFFICER OF RFMS, INC. HIS COMPENSATION REPORTED ON HIS RFMS, INC. FORM W-2, BOX 5 FOR CALENDAR YEAR 2011 IS $174,956. RON WILSON'S COMPENSATION AMOUNT AND HOURS HAVE NOT BEEN PRORATED BASED ON TIME SPENT FOR EACH OF THE NINETEEN ORGANIZATIONS TO WHOM SERVICES ARE PROVIDED BY RFMS, INC.
FORM 990, PART VII, SECTION A, COLUMN B:APPROXIMATELY ONE HALF OF THE AVERAGE HOURS PER WEEK ESTIMATED FOR EACH DIRECTOR IS DEVOTED TO RELATED ORGANIZATIONS LISTED ON SCHEDULE R.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 304,425.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PART XII, LINE 2B:THE FINANCIAL STATEMENTS OF UNLIMITED DEVELOPMENT, INC., WERE AUDITED AS PART OF THE CONSOLIDATED FINANCIAL REPORT ISSUED FOR COMMUNITY LIVING OPTIONS, INC. AND SUBSIDIARIES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (12 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNA
UDI#1 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401364578335OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL97360802452759N/A
UDI#2 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401201313855OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL72007951452296N/A
UDI#3 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401201313843OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL64073632041371N/A
UDI#4 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401201313828OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL51062151981167N/A
UDI#5 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401300296841OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL89386953723N/A
UDI#6 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401300356843OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL37328801188221N/A
UDI#7 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401364560808OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL120466662539616N/A
UDI#8 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401201313699OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL97734402452957N/A
UDI#9 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401364560807OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL51949271957034N/A
UDI#10 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401371514555OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL76396473145063N/A
UDI#11 LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401371504181OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIL85936502323171N/A
KEOKUK VILLAGE DRIVE LLC
285 SOUTH FARNHAM STREETGALESBURGIL61401272192755OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIESIA63397332595688N/A

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
COMMUNITY LIVING OPTIONS INC
285 SOUTH FARNHAMGALESBURGIL61401371079626OPERATION OF LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLEDIL501(C)(3)LINE 9N/A0
KEOKUK VILLAGE CIRCLE LTD NFP
285 SOUTH FARNHAMGALESBURGIL61401262341634ACQUIRING & HOLDING TITLE TO PROPERTY; REMITTING ALL INCOME TO 501(C)(3)IL501(C)(2)N/A0
RFMS INC MEDICAL BENEFIT PLAN TRUST
285 SOUTH FARNHAMGALESBURGIL61401367042729MEDICAL, ST DISABILITY & DEATH BENEFITS FOR ELIGIBLE EMPLOYEESIL501(C)(9)N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
KEOKUK VILLAGE CIRCLE LTD NFP - (A 501(C)(2) ORGANIZATION)
J2257387CASH TRANSACTION BASED ON FMV
RFMS INC MEDICAL BENEFIT PLAN TRUST
Q1289920COST OF PREMIUMS

Form990 Schedule R Part VII Form990ScheduleRPartVII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
SCHEDULE R, PART II:UNLIMITED DEVELOPMENT, INC., IS A SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC. KEOKUK VILLAGE CIRCLE, LTD., NFP, IS A SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC.
SCHEDULE R, PART II AND PART V:THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST IS A SELF-INSURED BENEFIT PROGRAM FUNDED BY THE EMPLOYERS AND PARTICIPANTS WITHIN THE PLAN. PARTICIPANTS IN THE PLAN ARE CURRENT AND FORMER EMPLOYEES OF THE FOLLOWING SPONSORS: RFMS, INC., LTC SUPPORT SERVICES, LLC, COMMUNITY RESIDENTIAL CENTERS, INC., COMMUNITY LIVING OPTIONS, INC., FRANCES HOUSE, INC., UNLIMITED DEVELOPMENT, INC., KENSINGTON OF GALESBURG, INC., ACHIEVEMENT UNLIMITED, INC., CONCEPTS PLUS, INC., PINNACLE OPPORTUNITIES, INC., PIONEER CONCEPTS, INC., RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., RESIDENTIAL ALTERNATIVES OF IOWA, DESERT HEALTHCARE FACILITIES, INC., FLORIDA LIVING OPTIONS, INC., AND HIGHLAND ESTATES RESORT, LLC. NO TRUSTEE FEES OR MANAGEMENT FEES ARE PAID BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST. THE AMOUNT OF PREMIUMS RECEIVED BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST IS FOR THE PLAN'S FISCAL YEAR ENDING OCTOBER 31, 2012.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.