OAK GROVE CHRISTIAN RETIREMENT VILLAGE INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- OAK GROVE CHRISTIAN RETIREMENT VILLAGE INC (EIN 35-1986767)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-02
- IRS object ID
- 201211239349300116
- Schema version
- 2010v3.4
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-02T09:36:35-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 307 | AddressLine1 |
| City | SOUTHFIELD | City |
| State | MI | State |
| ZIP Code | 480370307 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351986767 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAK GROVE CHRISTIAN RETIREMENT VILLAGE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | OAKG | NameControl |
| Phone | 2199877005 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 221 WEST DIVISION ROAD | AddressLine1 |
| City | DEMOTTE | City |
| State | IN | State |
| ZIP Code | 46310 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DALE SHENK | Name |
| Title | TREASURER | Title |
| Phone | 2199877005 | Phone |
| Date Signed | 2012-05-02 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2483522500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | P WILLIAM TRIPLETT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 221 WEST DIVISION ROAD | AddressLine1 |
| City | DEMOTTE | City |
| State | IN | State |
| ZIP Code | 46310 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5293517 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.OAKGROVECRV.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | OAK GROVE CHRISTIAN RETIREMENT VILLAGE PROVIDES HOUSING AND CARE FOR THE AGED IN AN ATMOSPHERE OF CHRISTIAN FELLOWSHIP WITH OTHERS. CHARITY CARE FYE JUNE 30, 2011 AMOUNTED TO $1,323,079. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 165 | TotalNbrEmployees |
| Total Nbr Volunteers | 85 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 15648 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 62667 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5043509 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5146479 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3158 | InvestmentIncomePriorYear |
| Investment Income Current Year | -8705 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 61114 | OtherRevenuePriorYear |
| Other Revenue Current Year | 83828 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5123429 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5284269 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2654391 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2669199 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2440532 | OtherExpensePriorYear |
| Other Expenses Current Year | 2361394 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5094923 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5030593 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 28506 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 253676 | RevenuesLessExpensesCY |
| Total Assets BOY | 5721336 | TotalAssetsBOY |
| Total Assets EOY | 5667216 | TotalAssetsEOY |
| Total Liabilities BOY | 4596306 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4235292 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1125030 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1431924 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OAK GROVE CHRISTIAN RETIREMENT VILLAGE, INC. IS A NON-PROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF INDIANA FOR THE PURPOSE OF PROVIDING HOUSING AND CARE FOR THE AGED. THE ORGANIZATION CONSISTS OF 39 ASSISTED LIVING UNITS AND 49 NURSING CARE BEDS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 3441243 | Expense |
| Revenue | 4131335 | Revenue |
| Description | NURSING SERVICES - OAK GROVE'S SKILLED AND LONG-TERM NURSING CARE FACILITY CONSISTS OF 49 NURSING CARE BEDS, IS MEDICARE AND MEDICAID CERTIFIED, AND WAS REGISTERED WITH THE STATE OF INDIANA IN 2006 AS A CONTINUING CARE RETIREMENT COMMUNITY (CCRC). OAK GROVE IS A PLACE WHERE GENUINE LOVING CHRISTIAN CARE IS GIVEN TO ALL WHO RESIDE HERE AND TO ALL PEOPLE WHO ENTER ITS DOORS, WHETHER IT BE FAMILY OR FRIENDS, TO BE SHOWN WITH THE SAME KIND OF COURTESY. WE PLEDGE TO PROVIDE THE FINEST PERSONAL SERVICE AND FACILITIES FOR OUR RESIDENTS, WHO WILL ALWAYS ENJOY A WARM, RELAXED, AND REFINED ENVIRONMENT. OAK GROVE OFFERS SKILLED AND LONG-TERM NURSING CARE WHICH INCLUDES OUR NEW SHORT-TERM REHAB UNIT PROVIDING PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. RESIDENTS WHO DO NOT MISUSE THEIR ASSETS MAY BE ELIGIBLE FOR SUPPORT FROM OAK GROVE IF THEIR ASSETS RUN OUT. OVER 25% OF TOTAL REVENUES WERE USED TO PROVIDE COMMUNITY BENEFITS, WHICH INCLUDES THE FOLLOWING AMOUNTS: INDIGENT CARE/CHARITY CARE - $680,671, MEDICARE WRITE-OFFS - $642,408. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 973063 | Expense |
| Revenue | 1015144 | Revenue |
| Description | ASSISTED LIVING AND DIETARY SERVICES - OAK GROVE CHRISTIAN RETIREMENT VILLAGE (OG) IS A CHRISTIAN RETIREMENT COMMUNITY WITH INDEPENDENT AND ASSISTED LIVING. OUR BEAUTIFUL TWO-STORY VICTORIAN ARCHITECTURE OFFERS SPACIOUS ACCOMMODATIONS AND PERSONALIZED CARE TO PROMOTE INDEPENDENCE. THE 39 INDEPENDENT AND ASSISTED LIVING FACILITIES OFFER BOTH STUDIO AND ONE BEDROOM APARTMENTS EQUIPPED WITH FULL KITCHENS. OG PROVIDES CCRC SERVICES INCLUDING ASSISTED LIVING AND SKILLED NURSING CARE. INDEPENDENT LIVING RESIDENTS PAY A LIFE-LEASE ENTRY FEE TO OCCUPY THE RESIDENCE AND PAY A MONTHLY SERVICE FEE FOR SERVICES RENDERED. ASSISTED LIVING AND SKILLED NURSING RESIDENTS PAY A MONTHLY OR DAILY FEE FOR SERVICES RENDERED. ADDITIONALLY, THEY HAVE SOME A LA CARTE FEES FOR INCIDENTALS AND SUPPLIES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 4414306 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 29 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 165 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JAMELYN GRIFFIN | NamePerson |
| Telephone Number | 2199877005 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 221 WEST DIVISION ROAD | AddressLine1 |
| City | DEMOTTE | City |
| State | IN | State |
| ZIP Code | 46310 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| RONALD SIPKEMA | ||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| WILBERT HAMSTRA | ||||||
| CHAIR - PARTIAL YEAR | 1.00 | X | X | 0 | 0 | 0 |
| ROBERT KAPER | ||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| JIM WALSTRA | ||||||
| VICE CHAIR - PARTIAL YEAR | 1.00 | X | X | 0 | 0 | 0 |
| OLIVER DORN | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| RON FIELDHOUSE | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| MIKE PETERSON | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| TOM POSTMA | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| STANLEY SCHOLL | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| JOEL SCHURMAN | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| WESLEY VAN BRUGGEN | ||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |
| P WILLIAM TRIPLETT | ||||||
| PRESIDENT | 35.00 | X | 0 | 91634 | 21421 | |
| DALE SHENK | ||||||
| TREASURER | 1.00 | X | 0 | 106750 | 27761 | |
| JAMELYN GRIFFIN | ||||||
| SECRETARY/ADMINISTRATOR | 40.00 | X | 51645 | 0 | 12653 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 51645 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 198384 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 61835 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HEALTHCARE THERAPY SERVICES INC | |||||
| 5214 SOUTH EAST STREET | INDIANAPOLIS | IN | 46227 | THERAPY SERVICES | 332457 |
| GREENCROFT RETIREMENT COMMUNITIES | |||||
| PO BOX 819 | GOSHEN | IN | 46527 | MANAGEMENT & CORPORATE SERVICES | 307844 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| All Other Contributions | 62667 | AllOtherContributions |
| Total Contributions | 62667 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NURSING SERVICES | 623000 | 4131335 | 4131335 |
| RESIDENT SERVICES | 623000 | 1015144 | 1015144 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5146479 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 543 | TotalRevenueColumn |
| Exclusion | $543 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9248 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -9248 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -9248 | TotalRevenueColumn |
| Exclusion | -$9,248 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| BEAUTY/BARBER/MASSAGE | 623990 | 35174 | $35,174 |
| TV/LAUNDRY/TRANSPORT | 900099 | 21135 | $21,135 |
| GUEST MEALS/VENDING | 722210 | 15393 | $15,393 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12126 | TotalRevenueColumn |
| Exclusion | $12,126 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 83828 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5284269 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5146479 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $75,123 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65087 | Total |
| Management And General | 65087 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2180612 | Total |
| Program Services | 2148794 | ProgramServices |
| Management And General | 31818 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80513 | Total |
| Program Services | 79338 | ProgramServices |
| Management And General | 1175 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 182357 | Total |
| Program Services | 179696 | ProgramServices |
| Management And General | 2661 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 160630 | Total |
| Program Services | 158286 | ProgramServices |
| Management And General | 2344 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262844 | Total |
| Management And General | 262844 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2726 | Total |
| Management And General | 2726 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36025 | Total |
| Management And General | 36025 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7144 | Total |
| Management And General | 7144 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 717249 | Total |
| Program Services | 610889 | ProgramServices |
| Management And General | 106360 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14665 | Total |
| Management And General | 14665 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 496775 | Total |
| Program Services | 468473 | ProgramServices |
| Management And General | 28302 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204453 | Total |
| Program Services | 204453 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12978 | Total |
| Program Services | 5840 | ProgramServices |
| Management And General | 7138 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2025 | Total |
| Management And General | 2025 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 185581 | Total |
| Program Services | 185581 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 281514 | Total |
| Program Services | 281514 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23253 | Total |
| Program Services | 19765 | ProgramServices |
| Management And General | 3488 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 40833 | 40833 | |
| DUES, LICENSE & SUBS. | 30923 | 30923 | |
| PROF. DEVELOPMENT | 13910 | 10850 | 3060 |
| REPAIRS & MAINTENANCE | 9988 | 2597 | 7391 |
| MEDICAL DIRECTOR | 6000 | 5640 | 360 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12508 | Total |
| Program Services | 11757 | ProgramServices |
| Management And General | 751 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5030593 | Total |
| Program Services | 4414306 | ProgramServices |
| Management And General | 616287 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100 | BOY |
| EOY | 100 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 448300 | BOY |
| EOY | 458114 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2900 | BOY |
| EOY | 2900 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 289311 | BOY |
| EOY | 241224 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26299 | BOY |
| EOY | 59017 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8213565 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3408963 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4877472 | BOY |
| EOY | 4804602 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2497 | BOY |
| EOY | 2585 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74457 | BOY |
| EOY | 98674 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5721336 | BOY |
| EOY | 5667216 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 279744 | BOY |
| EOY | 232491 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15000 | BOY |
| EOY | 15000 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3910000 | BOY |
| EOY | 3650000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 391562 | BOY |
| EOY | 337801 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4596306 | BOY |
| EOY | 4235292 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1121162 | BOY |
| EOY | 1414129 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3868 | BOY |
| EOY | 17795 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1125030 | BOY |
| EOY | 1431924 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5721336 | BOY |
| EOY | 5667216 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 253676 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 53218 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 359092 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 19400 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 25979 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 15648 | CurrentTaxYearMinus1Year |
| Current Tax Year | 62667 | CurrentTaxYear |
| Total | 482786 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3946905 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4623162 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5045771 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5043509 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5146479 | CurrentTaxYear |
| Total | 23805826 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 29348 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 55735 | CurrentTaxYearMinus1Year |
| Current Tax Year | 71702 | CurrentTaxYear |
| Total | 156785 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4305997 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4642562 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5101098 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5114892 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5280848 | CurrentTaxYear |
| Total | 24445397 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 20000 | CurrentTaxYear |
| Total | 20000 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 238758 | CurrentTaxYearMinus1Year |
| Current Tax Year | 608845 | CurrentTaxYear |
| Total | 847603 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 238758 | CurrentTaxYearMinus1Year |
| Current Tax Year | 628845 | CurrentTaxYear |
| Total | 867603 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 23577794 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 30086 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2763 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1081 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3653 | CurrentTaxYearMinus1Year |
| Current Tax Year | 858 | CurrentTaxYear |
| Total | 38441 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 30086 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2763 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1081 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3653 | CurrentTaxYearMinus1Year |
| Current Tax Year | 858 | CurrentTaxYear |
| Total | 38441 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 26348 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4884 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11811 | CurrentTaxYear |
| Total | 43043 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4336083 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4645325 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5128527 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5123429 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5293517 | CurrentTaxYear |
| Total | 24526881 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.96130 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.98690 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00160 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00160 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
| General Explanation | SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 396000 | OtherCostOrOtherBasis |
| Book Value | 396000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6384029 | OtherCostOrOtherBasis |
| Depreciation | 2125576 | Depreciation |
| Book Value | 4258453 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12085 | OtherCostOrOtherBasis |
| Depreciation | 3181 | Depreciation |
| Book Value | 8904 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1407817 | OtherCostOrOtherBasis |
| Depreciation | 1280206 | Depreciation |
| Book Value | 127611 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13634 | OtherCostOrOtherBasis |
| Book Value | 13634 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4804602 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATE | $37,699 |
| DERIVATIVE LIABILITY - INTEREST RATE SWAP AGREEMENT | $289,374 |
| ACCRUED INTEREST PAYABLE | $10,728 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 337801 | TotalOfAmounts |
| Total Revenue | 5284269 | TotalRevenue |
| Total Expenses | 5030593 | TotalExpenses |
| Excess Or Deficit For Year | 253676 | ExcessOrDeficitForYear |
| Other | $53,218 | OtherAmount |
| Total Adjustments | 53218 | TotalAdjustments |
| Excess Or Deficit Per FS | 306894 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 5337487 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 53218 | OtherRevenues |
| Revenue Not Rptd F990 | 53218 | RevenueNotRptdF990 |
| Revenue Subtotal | 5284269 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 5284269 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 5030593 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 5030593 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 5030593 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | UNREALIZED GAIN ON INTEREST RATE SWAP 53,218. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | UNREALIZED GAIN ON INTEREST RATE SWAP 53,218. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF JASPER INDIANA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 356000160 | IssuerEIN |
| CUSIP Number | 47136PAK8 | CUSIPNumber |
| Date Issued | 2006-02-23 | DateIssued |
| Issue Price | 4800000 | IssuePrice |
| Description Of Purpose | REFUND AND RETIRE OUSTANDING BONDS, FUND CAPITAL PROJECTS | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 4800000 | TotalProceeds |
| Refunding Escrow | 3859342 | RefundingEscrow |
| Issuance Costs From Proceeds | 98228 | IssuanceCostsFromProceeds |
| Capital Expenditures | 842430 | CapitalExpenditures |
| Year Of Subst Completion | 2006 | YearOfSubstCompletion |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 0 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 1 | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORGAN STANLEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 15.000000000000 | TermOfHedge |
| Superintegrated Hedge | 0 | SuperintegratedHedge |
| Hedge Terminated | 0 | HedgeTerminated |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
Name Of GIC Provider NameOfGICProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 1 | ExceptionToRebate |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION MISSION STATEMENT | FORM 990, PART III, LINE 1 | EACH YEAR THE ORGANIZATION STRIVES TO BE A GOOD NEIGHBOR IN THE COMMUNITY WHERE WE SERVE. WE HAVE A HISTORY OF ADDING VALUE TO OUR RESIDENTS, TO SENIORS LIVING OUTSIDE OF OUR COMMUNITY, AND TO THE BROADER COMMUNITY WE SERVE. WE STRIVE TO IMPROVE THE QUALITY OF CARE BY CELEBRATING THE LIVES OF THE SENIORS LIVING IN OUR COMMUNITY AND WORKING WITH THEM TO ENSURE THEY HAVE OPPORTUNITIES TO LIVE LIFE OUT TO THE FULLEST AND TO WORK TOGETHER TO ADDRESS THE CHALLENGES OF AGING. THE BOARD HAS BEEN INTENTIONAL ABOUT UNDERSTANDING COMMUNITY BENEFIT. THESE ARE AMONG THE COMPONENTS OF WHAT WE INCLUDE AS COMMUNITY BENEFIT: FREE OR REDUCED COST SERVICES WHEN A RESIDENT IS NOT ABLE TO PAY FOR THE FULL COST OF SERVICES PROVIDED, INDIGENT CARE, SERVICES TO THE VERY POOR NOT REIMBURSED BY OTHER SOURCES, AND UNREIMBURSED SERVICES FROM THIRD PARTY PAYERS, SUCH AS MEDICARE. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION IS UNDER A MANAGEMENT/AFFILIATION CONTRACT WITH GREENCROFT RETIREMENT COMMUNITIES, INC. (GRC), A RELATED TAX-EXEMPT ORGANIZATION. ACCORDING TO THE AGREEMENT, GRC HAS THE SOLE AND EXCLUSIVE RIGHT TO SUPERVISE, MANAGE, AND OPERATE THE ORGANIZATION'S FACILITY ("THE FACILITY"). IN ADDITION, GRC HAS THE SOLE CONTROL AND DISCRETION WITH REGARD TO THE OPERATION AND MANAGEMENT OF THE FACILITY FOR ALL CUSTOMARY PURPOSES, AS WELL AS THE RIGHT TO DETERMINE ALL OPERATING POLICIES AFFECTING OR CONCERNING THE APPEARANCE AND MAINTENANCE STANDARDS OF OPERATION, AND ANY OTHER MATTER AFFECTING THE FACILITY OR THE OPERATION THEREOF. THE AGREEMENT TERMINATES IN JUNE 2012, AND IS RENEWABLE ANNUALLY FOR ADDITIONAL ONE YEAR PERIODS. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS ONE MEMBER, GREENCROFT RETIREMENT COMMUNITIES, INC. (GRC), WHO IS ALSO A RELATED TAX-EXEMPT ORGANIZATION. THE RESERVED POWERS OF THE SOLE MEMBER ARE AS FOLLOWS: 1. APPROVAL TO ANY CHANGES IN CORPORATE MISSION, WHICH MAY BE PROPOSED BY THE ORGANIZATION, BUT WHICH SHALL BECOME EFFECTIVE ONLY UPON APPROVAL OF GRC 2. APPROVAL OF NOMINATED CANDIDATES TO SERVE AS DIRECTOR OF THE ORGANIZATION 3. THE CREATION OR DISCONTINUATION OF PROGRAMS OR SERVICES OFFERED BY THE ORGANIZATION 4. AMENDMENTS TO THE BYLAWS AND ARTICLES OF INCORPORATION 5. APPROVAL OR THE ADOPTION OF THE ANNUAL BUDGET 6. APPROVAL OF NON-BUDGETED CONTRACTS AND/OR NON-BUDGETED PURCHASES OF OVER $50,000 7. THE INCURRENCE OF INDEBTEDNESS OF OVER $500,000 8. THE SALE OF REAL ESTATE 9. THE DONATION OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS 10. ANY MERGER OR CONSOLIDATION WITH ANY OTHER ORGANIZATION, OR THE PARTIAL OR TOTAL DISSOLUTION OF THE ORGANIZATION 11. THE CREATION OF SUBSIDIARY CORPORATIONS, LLCS, PARTNERSHIPS, OR OTHER ENTERPRISES 12. THE ACQUISITION OF CONTROLLING INTERESTS IN ANOTHER ENTITY 13. THE APPOINTMENT OF THE PRESIDENT/CEO, CFO, SECRETARY, AND TREASURER OF THE CORPORATION (BUT NOT THE OFFICERS OF THE BOARD OF DIRECTORS) 14. THE REMOVAL OF THE CHAIR OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE 15. THE REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE NOTWITHSTANDING THESE RESERVED POWERS, THE MEMBER HAS NO FINANCIAL OBLIGATIONS OR RESPONSIBILITIES FOR ANY ACTIONS OF THE ORGANIZATION BY REASON OF SERVING AS A MEMBER. | |
| FORM 990, PART VI, SECTION A, LINE 7A | SEE NARRATIVE FOR PART VI, SECTION A, LINE 6 | |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE NARRATIVE FOR PART VI, SECTION A, LINE 6 | |
| FORM 990, PART VI, SECTION B, LINE 11 | A FINAL DRAFT OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES, IS PRESENTED BY OUR TAX ADVISORS TO THE ORGANIZATION'S AUDIT COMMITTEE AT A REGULARLY SCHEDULED MEETING. A COPY OF THE FINAL DRAFT IS THEN PROVIDED TO EACH BOARD MEMBER PRIOR TO ITS FILING. THIS ALLOWS THE BOARD OF DIRECTORS AND MANAGEMENT TO REVIEW AND PROVIDE COMMENTS AND EXPLANATIONS REGARDING THE FORM. | |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND OFFICERS ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTERESTS THEY MAY HAVE WITH THE ORGANIZATION. THE TREASURER REVIEWS EACH POLICY STATEMENT SIGNED BY THESE INDIVIDUALS TO DETERMINE IF ANY CONFLICTS HAVE OCCURRED AND NEED TO BE BROUGHT TO THE ATTENTION OF THE BOARD. IF CONFLICT ARISES, THE RESPECTIVE BOARD MEMBER WILL ABSTAIN HIM/HERSELF FROM ANY RELATED DISCUSSION, VOTE OR SIMILAR ACTION ON THE MATTER. | |
| FORM 990, PART VI, SECTION B, LINE 15 | OAK GROVE'S (OG) PHILOSOPHY IS TO COMPENSATE TEAM MEMBERS IN A FAIR MANNER FOR THE WORTH OF WORK PROVIDED WITHIN THE CURRENT MARKET VALUE RANGE FOR EACH POSITION IN THE ORGANIZATION. OG CONDUCTS PERIODIC REVIEW OF THE MARKET TO DEVELOP AVERAGE WAGES FOR POSITIONS WITHIN OAK GROVE. OAK GROVE STARTS EMPLOYEES THAT MEET THE MINIMUM REQUIREMENTS FOR THE POSITION AT/OR NEAR THE STARTING WAGE. WE MAKE ADJUSTMENTS TO THE STARTING WAGE BASED ON YEARS OF EXPERIENCE IN THAT SPECIFIC POSITION. OUR COMPENSATION PHILOSOPHY FOR STAFF OF OUR ORGANIZATION IS BASED ON VARIOUS TIERS. THE FIRST TIER IS GENERAL STAFF. WE HAVE HIRED AN OUTSIDE CONSULTANT TO DEVELOP A COMPENSATION SYSTEM FOR ALL OF OAK GROVE'S POSITIONS. THE CONSULTANTS DEVELOPED A SYSTEM WITH WAGE SCALES THAT USE THE MARKETPLACE AVERAGE FOR KEY POSITIONS AS THE STARTING POINT FOR THE SCALES. THE WAGES SCALES HAVE A MINIMUM, A 25TH PERCENTILE, A 50TH PERCENTILE (AVERAGE) A 75TH PERCENTILE AND A MAXIMUM. WE STRIVE TO KEEP OUR AVERAGE FOR POSITIONS AT THE MID-POINT OF A RANGE DEVELOPED BY OUR CONSULTANTS. PERIODICALLY WE HIRE A CONSULTANT TO UPDATE THE MARKETPLACE AVERAGE FOR SEVERAL KEY POSITIONS. THE CONSULTANT WILL USE AREA MARKETPLACE DATA, AAHSA DATA, AND OTHER INDUSTRY DATA TO DEVELOP THE AVERAGE. OUR COMPENSATION PHILOSOPHY FOR MANAGEMENT AND EXECUTIVE STAFF (DIRECTORS AND VICE PRESIDENT) OF OUR ORGANIZATION IS SLIGHTLY DIFFERENT. THE SECOND TIER IS MANAGEMENT STAFF. THE WAGE SCALE SYSTEM IS THE SAME FOR OUR STAFF. HOWEVER, OUR POLICY STATES THAT DIRECTORS ARE LIKE OTHER STAFF AND CAN EARN UP TO THE 100TH PERCENTILE OF THE RANGE FOR THEIR POSITION. OUR THIRD TIER IS VICE PRESIDENT STAFF. THE WAGE SCALE SYSTEM IS THE SAME FOR OUR STAFF. HOWEVER, THERE IS ONE DIFFERENCE. THE POLICY STATES THAT VICE PRESIDENTS CAN EARN UP TO THE 85TH PERCENTILE OF THE RANGE FOR THEIR POSITION. THE RANGE USES THE MEDIAN AS THE MID-POINT NOT THE AVERAGE. GENERALLY THE MEDIAN IS BELOW THE AVERAGE. THE OVERALL COMPENSATION POLICY AND THE VP COMPENSATION POLICY ARE APPROVED BY THE GREENCROFT COMMUNITIES (GC) BOARD OF DIRECTORS. THE OAK GROVE (OG) BOARD REVIEWS THE COMPENSATION POLICIES. ANNUALLY THE GC BOARD AND THE OG BOARD REVIEW THE COMPENSATION OF THEIR RESPECTIVE EXECUTIVE TEAMS. THEY COMPARE CURRENT WAGES WITH NATIONAL DATA PROVIDED BY AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING (AAHSA). THE BOARDS REVIEW THE CURRENT WAGE, THE PERCENTILE RANKING OF THE EMPLOYEE IN HIS/HER RESPECTIVE RANGE AND THE MEDIAN OF THE MARKETPLACE COMPARED TO THE MID-POINT OF THE EMPLOYEES RANGE. THE BOARDS DOCUMENT THESE MEETINGS AND ACTIONS TAKEN IN THEIR BOARD MINUTES. THE OG BOARD HAS REVIEWED THE BASE WAGE AND THE VARIABLE PAY FOR THE PRESIDENT OF OAK GROVE. IN THE FISCAL YEAR 2011 THIS POSITION WAS AT THE 72TH PERCENTILE OF THE RANGE FOR THIS POSITION IN BASE COMPENSATION AND AT THE 0TH PERCENTILE OF THE MARKET FOR THE VARIABLE PAY COMPENSATION. THIS PROCESS WAS LAST CONDUCTED IN FISCAL YEAR 2011. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. | |
| FORM 990, PART VII, SECTION A: | P. WILLIAM TRIPLETT, PRESIDENT, DEVOTES APPROXIMATELY 5 HOURS PER WEEK TO GREENCROFT RETIREMENT COMMUNITIES, INC., A RELATED TAX-EXEMPT ORGANIZATION. DALE SHENK, TREASURER, DEVOTE APPROXIMATELY 40 HOURS PER WEEK TO GREENCROFT RETIREMENT COMMUNITIES, INC., A RELATED TAX-EXEMPT ORGANIZATION. HE ALSO DEVOTES APPROXIMATELY ONE HOUR PER WEEK TO THE FOLLOWING RELATED ORGANIZATIONS: CHICAGO TRAIL VILLAGE, INC. GREENCROFT COMMUNITIES FOUNDATION, INC. GREENCROFT GOSHEN, INC. GREENCROFT CENTRAL MANOR, INC. GREENCROFT MANOR II, INC. GREENCROFT MANOR III, INC. GREENCROFT MIDDLEBURY, INC. GREENCROFT HOME HEALTH SERVICES, INC. SOUTHFIELD VILLAGE, INC. HAVEN HUBBARD HOMES, INC. D/B/A HAMILTON GROVE HAMILTON FOUNDATION WALNUT HILLS RETIREMENT COMMUNITIES, INC. GREENCROFT MANAGEMENT, INC. VARIOUS BOARD MEMBERS ALSO CONTRIBUTE TIME TO OTHER RELATED ORGANIZATIONS REPORTED IN SCHEDULE R. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 5: | UNREALIZED GAIN ON INTEREST RATE SWAP 53,218. TOTAL TO FORM 990, PART XI, LINE 5: 53,218. |
| FORM 990, PART XII, LINE 2C | THE AUDIT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GREENCROFT CENTRAL MANOR INC | |||||||||||
| PO BOX 819 | GOSHEN | IN | 46527 | 356047318 | HOUSING | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| GREENCROFT COMMUNITIES FOUNDATION INC | |||||||||||
| PO BOX 819 | GOSHEN | IN | 46527 | 237126990 | FUNDRAISING | IN | 501(C)(3) | LINE 7 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| GREENCROFT GOSHEN INC | |||||||||||
| PO BOX 819 | GOSHEN | IN | 46527 | 351270709 | HEALTHCARE | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| GREENCROFT MANOR III INC | |||||||||||
| PO BOX 819 | GOSHEN | IN | 46527 | 351431475 | HOUSING | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| GREENCROFT MANOR II INC | |||||||||||
| PO BOX 819 | GOSHEN | IN | 46527 | 351377430 | HOUSING | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| GREENCROFT MIDDLEBURY INC | |||||||||||
| PO BOX 819 | GOSHEN | IN | 46527 | 300036865 | HOUSING | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| GREENCROFT RETIREMENT COMMUNITIES INC | |||||||||||
| PO BOX 819 | GOSHEN | IN | 46527 | 300036587 | MANAGEMENT | IN | 501(C)(3) | LINE 9 | 0 | N/A | |
| GREENCROFT HOME HEALTH SERVICES INC | |||||||||||
| PO BOX 819 | GOSHEN | IN | 46527 | 351606010 | HOME HEALTH | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| HAVEN HUBBARD HOMES INC DBA HAMILTON GROVE | |||||||||||
| 31869 CHICAGO TRAIL | NEW CARLISLE | IN | 46552 | 350870110 | HEALTHCARE | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| SOUTHFIELD VILLAGE INC | |||||||||||
| 6450 MIAMI CIRCLE | SOUTH BEND | IN | 46614 | 351866553 | HEALTHCARE | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| WALNUT HILLS RETIREMENT COMMUNITIES INC | |||||||||||
| PO BOX 129 | WALNUT CREEK | OH | 44687 | 351317338 | HEALTHCARE | IN | 501(C)(3) | LINE 9 | GREENCROFT RETIREMENT COMMUNITIES INC | 1 | |
| HAMILTON FOUNDATION INC | |||||||||||
| 31869 CHICAGO TRAIL | NEW CARLISLE | IN | 46552 | 351764275 | FUNDRAISING | IN | 501(C)(3) | LINE 11A, I | HAVEN HUBBARD HOMES INC DBA HAMILTON GROVE | 1 | |
| CHICAGO TRAIL VILLAGE INC | |||||||||||
| 31869 CHICAGO TRAIL | NEW CARLISLE | IN | 46552 | 310990629 | HOUSING | IN | 501(C)(3) | LINE 9 | HAVEN HUBBARD HOMES INC DBA HAMILTON GROVE | 1 | |
| MENNONITE HEALTH SERVICES | |||||||||||
| 234 S MAIN STREET SUITE A | GOSHEN | IN | 46526 | 231421919 | HEALTHCARE | IN | 501(C)(3) | LINE 9 | 0 | N/A | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREENCROFT MANAGEMENT INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 819 | AddressLine1 |
| City | GOSHEN | City |
| State | IN | State |
| ZIP Code | 46527 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 270259652 | EIN |
| Primary Activity | MANAGEMENT SERVICES | PrimaryActivity |
| Legal Domicile State | IN | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREENCROFT RETIREMENT COMMUNITIES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionType |
| Amount Involved | 307844 | AmountInvolved |
| Method Of Amt Determination | ACTUAL COST. | MethodOfAmtDetermination |