2013-11-04T08:20:44-06:00 2013-03-31 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2012-04-01 620699106 CHRISTIAN HOME FOR THE AGED INC CHRI 4236108500 309 PRINCETON ROAD JOHNSON CITY TN 37601 MYRA ZUMWALT PAESSLER 4236108500 2013-11-04 AMY BIBBY P00445891 8282542254 2012 2016-02-25 16:41:14Z APPALACHIAN CHRISTIAN VILLAGE MYRA ZUMWALT PAESSLER 309 PRINCETON ROAD JOHNSON CITY TN 37601 16150774 0 X WWW.CHRISTIANVILLIAGE.ORG X 1954 TN HELPING WITH THE CHALLENGES OF AGING BY PROVIDING QUALITY HOUSING, HEALTHCARE, AND SERVICES. 18 18 447 64 0 0 84053 58373 16182971 15774888 376944 110076 36259 64793 16680227 16008130 62299 3779 0 0 6591550 6737160 0 0 474446 9817160 10323431 16471009 17064370 209218 -1056240 30295395 30778195 21324337 23887649 8971058 6890546 X TO REFLECT CHRIST'S LOVE BY BEING THE PREMIER REGIONAL PROVIDER OF QUALITY SENIOR LIVING SERVICES. 0 0 14320276 3779 15774888 CHRISTIAN HOME FOR THE AGED, INC. D/B/A APPALACHIAN CHRISTIAN VILLAGE IS A NOT-FOR-PROFIT CORPORATION, ESTABLISHED BY CHRISTIAN CHURCHES TO PROVIDE HOUSING, HEALTHCARE, AND OTHER RELATED SERVICES TO THE RETIRED AND AGED IN JOHNSON CITY, TENNESSEE, AND NEIGHBORING COMMUNITIES. CHRISTIAN HOME FOR THE AGED, INC. CONSISTS OF 83 INDEPENDENT LIVING UNITS, 97 CONGREGATE LIVING UNITS, 103 INTERMEDIATE AND SKILLED CARE NURSING BEDS, AND 89 ASSISTED LIVING UNITS.DURING THE FISCAL YEAR ACV HAS SUPPORTED THE COMMUNITY BY:- ANNUAL FOOD DRIVE BENEFITING GOOD SAMARITAN MINISTRIES - OVER 181 POUNDS OF LAUNDRY COMPLETED FOR INTERFAITH HOSPITALITY NETWORK, A HOMELESS MINISTRY - BLOOD DRIVE IN APRIL 2012 SUPPORTING MARSH REGIONAL BLOOD CENTER- HOSTED COMMUNITY BLOCK PARTY AT PINE OAKS IN JUNE 2012 WITH FREE FOOD, MUSIC, AND ACTIVITIES FOR ALL AGES- SPONSORED GOLD TOURNAMENT TO BENEFIT EAST TENNESSEE CHRISTIAN HOME & ACADEMY- $318.50 IN DONATIONS TO LOCAL CHURCHES IN MEMORY OF RESIDENTS- HOSTED AND SPONSORED FREE HEALTH SEMINARS OPEN TO COMMUNITY- EASTER LILY FUNDRAISER IN MARCH 2013 TO BENEFIT A LOCAL 9 YEAR OLD GIRL IN NEED OF A SPORTS WHEELCHAIR AND RAISED OVER $700.00IN SEPTEMBER 2012, ACV WELCOMED AN 18 YEAR OLD TO OUR HCC FAMILY WHO WAS INJURED IN A TRAMPOLINE ACCIDENT AND IS A QUADRIPLEGIC. OUR STAFF ARRANGED FOR HOME BOUND TEACHINGS SO HE COULD RETURN TO SCHOOL AND COMPLETE HIS EDUCATION. CONTRIBUTIONS WERE GIVEN BY EMPLOYEES AND BOARD MEMBERS AND A TRUST FUND FOR HIM WAS ESTABLISHED. ADDITIONALLY, COUNTLESS VOLUNTEER HOURS HAVE HELPED TO CHANGE THIS YOUNG MAN'S EXPERIENCE, EXPECTATIONS, AND ASPIRATIONS. EVEN THOUGH HE HAS MANY PHYSICAL LIMITATIONS, HE HAS AN AVENUE FOR ASSISTANCE IN MEETING THOSE CHALLENGES AND ALLOWING HIM TO ACHIEVE AN EDUCATION AND SOCIAL EXPERIENCES LIKE HIS PEERS; ACV EMPLOYEES SUPPLIED NEEDY FAMILIES WITH THANKSGIVING MEALS THROUGH GOOD SAMARITAN MINISTRY. 14320276 1 1 0 1 0 0 0 0 0 0 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 1 1 0 0 1 77 0 1 447 1 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MYRA ZUMWALT PAESSLER 4236108556 309 PRINCETON ROAD JOHNSON CITY TN 37601 RON HICKS 1.00 0.10 X X 0 0 0 PAUL DAVID WALKER 1.00 0.10 X X 0 0 0 JOHN HENSLEY 1.00 0.10 X X 0 0 0 L PHILLIPS SAMS 1.00 0.10 X X 0 0 0 DOUGLAS THEOBALD SR 1.00 0.10 X X 0 0 0 STARLA BROOKS 1.00 X 0 0 0 LESLIE H OSBORN 1.00 X 0 0 0 LARRY REAVES 1.00 X 0 0 0 LARRY REYNOLDS 1.00 X 0 0 0 RONALD SALYER 1.00 X 0 0 0 RUTH KETRON 1.00 X 0 0 0 SHERYL SHIPLEY 1.00 X 0 0 0 ANN BROOKER 1.00 X 0 0 0 JACK CARRIER 1.00 1.00 X 0 0 0 MICHAEL FRENCH 1.00 1.00 X 0 0 0 JAMES RICHARD LEWIS 1.00 1.00 X 0 0 0 ADAM CROUCH 1.00 X 0 0 0 RICHARD MEASNER 1.00 X 0 0 0 TOM SEXTON 40.00 0.10 X 177585 0 11003 MYRA PAESSLER 40.00 0.10 X 135616 0 26161 313201 0 37164 2 0 1 0 TEKA BUILDING & DEVELOPMENT 142 OKLAHOMA ROAD TELFORD TN 37690 CONSTRUCTION, RENOVATION, & FACILITY MAN 2094599 SODEXO INC PO BOX 536922 ATLANTA GA 30319 FOOD SERVICES 1698480 FUNCTIONAL PATHWAYS PO BOX 102426 ATLANTA GA 303682426 THERAPY SERVICES 902039 PNS INSTITUTIONAL INC PO BOX 5289 JOHNSON CITY TN 37604 PHARMACY 293773 BAKER DONELSON BEARMAN CALDWELL & BER 265 BROOKVIEW CENTRE WAY STE 600 KNOXVILLE TN 37919 LEGAL SERVICES 261181 6 54486 3887 58373 RESIDENT SERVICES 623000 15774888 15774888 15774888 160337 160337 314 314 46008 0 46008 46008 46008 92069 0 142644 92069 -142644 -50575 -50575 TOWER CAFE REVENUE 900099 9511 9511 OTHER INCOME 900099 4114 4114 GIFT SHOP INCOME 900099 2940 2940 2220 2220 18785 16008130 15793673 0 156084 3779 3779 350365 331506 18859 5396103 4851232 445629 99242 478640 413247 54747 10646 512052 444936 57553 9563 261181 261181 1298118 1069159 194996 33963 254874 254874 1904382 1221090 649094 34198 137969 66524 70730 715 947374 927084 20290 61454 18689 35846 6919 1067031 1044770 22261 1683957 1639314 42519 2124 181952 131342 50610 FOOD COSTS 2028546 2025367 3179 MISCELLANEOUS EXPENSE 187421 187421 BAD DEBT 171205 160135 11070 EMPLOYEE EXPENSES 105619 83839 21616 164 32348 32348 17064370 14320276 2269648 474446 3680 3715 485121 518922 1354516 1099141 24399 21486 99339 111091 35458830 16109561 19640548 19349269 7373863 8880702 75876 72541 1238053 721328 30295395 30778195 1025673 982365 3060517 3246494 17169358 19612422 28265 40524 46368 21324337 23887649 X 8895754 6890546 75304 0 8971058 6890546 30295395 30778195 X -1056240 13610 -1037882 X 0 1 X 1 0 X 148685 157120 36994 18830 3887 365516 14184904 15065652 15789757 16248194 15774888 77063395 14333589 15222772 15826751 16267024 15778775 77428911 0 0 0 77428911 243252 293145 251308 409344 206659 1403708 243252 293145 251308 409344 206659 1403708 18785 18785 14576841 15515917 16078059 16676368 16004219 78851404 0.98200 0.97970 0.01780 0.02030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 806 806 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO AN INDUSTRY ASSOCIATIONS. THE ORGANIZATION WAS NOTIFIED THAT APPROXIMATELY 6.3% OR $806 OF ITS DUES WERE USED FOR LOBBYING. 1385609 1385609 27876973 13199346 14677627 189552 89750 99802 5920413 2803231 3117182 86283 17234 69049 19349269 PATIENT TRUSTS 16300 SECURITY DEPOSITS 35875 ANNUITY OBLIGATIONS -5807 46368 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACV IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. ACV HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF MARCH 31, 2013. FISCAL YEARS ENDING ON OR AFTER MARCH 31, 2010 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. X X 0 0 0 1 0 0 0 0 0 TOM SEXTON 160085 0 17500 0 0 0 2692 0 8311 0 188588 0 0 0 MYRA PAESSLER 119616 0 16000 0 0 0 16800 0 9361 0 161777 0 0 0 PART I, LINE 5 THE ORGANIZATION'S CEO AND CFO ARE PAID BONUSES WHICH ARE DETERMINED BY BOTH PERFORMANCE AND EARNINGS OF THE ORGANIZATION. A THE HEALTH AN EDUCATIONAL FACILITIES BOARD OF THE CITY OF JOHNSON CITY TN 521464028 4782R4AP6 2013-02-15 19853552 SEE PART VI 0 0 0 A 19853552 17451947 390399 2011206 2014 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 1 0 A 1 PART I COLUMN F PROCEEDS WERE USED TO ADVANCE REFUND 2004 SERIES AND TO FUND CONSTRUCTION. PART II LINE 6 THE AMOUNTS REPORT ON LINE 6 ARE TO USED TO REFUND BONDS ISSUED 10/15/2004 NO LATE THAN 02/15/2014. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE COMMITTEE REVIEWED THE FORM 990 AND MADE A RECOMMENDATION TO THE FULL BOARD OF DIRECTORS FOR APPROVAL. THIS APPROVAL OCCURRED AT THE LAST BOARD MEETING BEFORE THE FORM 990 WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POILCY BY ASKING EACH BOARD MEMBER TO, AT THE RENEWAL OF EACH TERM, SIGN A STATEMENT INDICATING THAT HE OR SHE HAS READ AND UNDERSTANDS THE POLICY AND ASKING EACH BOARD MEMBER TO DISCLOSE IN WRITING ANY ORGANIZATIONAL RELATIONSHIP OR OTHER ACTIVITY OR INTEREST THAT MIGHT POSSIBLY CONSITITUTE A CONFLICT OF INTEREST. IN ADDITION, THE POLICY REQUIRES THE ORGANIZATION TO IDENTIFY CONFLICTS OF INTEREST AS THEY ARISE AND CONTAINS DETAILED PROCEDURES ON HOW THE ORGANIZATION HANDLES CONFLICTS AS THEY ARISE. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE COMPENSATION FOR BOTH THE CEO AND CFO ON AN ANNUAL BASIS. AAHSA'S CCRC SALARY & BENEFIT REPORT FOR THE CURRENT FISCAL YEAR IS USED IN COMPENSAITON DETERMINATION. THIS INFORMATION IS REPORTED IN 3 MANNERS: BASED ON STATE, BASED ON REVENUE AND BASED ON THE NUMBER OF UNITS. THE EXECUTIVE COMMITTEE IS PROVIDED WITH THE REPORT FOR EACH MANNER AND AN AVERAGE OF THE THREE. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE UPON REQUEST. ADDITIONALLY, RECENT FILINGS OF THE FORM CAN BE FOUND ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: LOSS ON REFINANCING OF BOND -983,396. APPALACHIAN CHRISTIAN VILLAGE FOUNDATION GRANT -54,486. APPALACHIAN CHRISTIAN VILLAGE FOUNDATION INC 309 PRINCETON ROAD JOHNSON CITY TN 37601 311789637 TO RAISE FUNDS FOR APPALACHIAN CHRISTIAN VILLAGE TN 501(C)(3) 11, I CHRISTIAN HOME FOR THE AGED INC 1 LIBERTY HOUSING CORPORATION 309 PRINCETON ROAD JOHNSON CITY TN 37601 621611779 HOUSING TN 501(C)(3) PF CHRISTIAN HOME FOR THE AGED INC 1 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 APPALACHIAN CHRISTIAN VILLAGE FOUNDATION INC L 1261914 FMV