2012-03-05T11:11:18-06:00 2011-09-30 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2010-10-01 430730924 MENNONITE HOME ASSOCIATION INC MENN 5732216000 2500 PLEASANT STREET HANNIBAL MO 63401 PAUL EWERT 5732216000 2012-03-02 1 ALLAN LARSON 3149254300 2010 2016-02-24 21:20:13Z PAUL EWERT 2500 PLEASANT STREET HANNIBAL MO 63401 7035333 0 X WWW.BETHAVEN.ORG X 1957 MO PROVIDE NURSING AND ASSISTED LIVING SERVICES TO THE ELDERLY 9 9 243 464 0 0 3739 4245 6579056 6868022 17243 20052 79700 143014 6679738 7035333 0 0 0 0 3487602 3568171 0 0 0 3134690 3262650 6622292 6830821 57446 204512 7835251 7913895 4757339 4632705 3077912 3281190 PROVIDE QUALITY ELDERLY HEALTHCARE AND HOUSING IN A CHRISTIAN ENVIRONMENT. 0 0 6218473 6868022 BETH HAVEN NURSING HOME AND ASSISTED LIVING IS A 105 BED SKILLED NURSING FACILITY AND A 38 UNIT ASSISTED LIVING FACILITY PROVIDING NURSING AND ASSISTED LIVING CARE TO THE ELDERLY. 6218473 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 24 0 1 243 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X PAUL EWERT 5732216000 2500 PLEASANT STREET HANNIBAL MO 63401 WENDELL KREIDER 0.50 X X 0 0 0 JEROLD LEE 0.50 X X 0 0 0 DIRK SAUER 0.50 X X 0 0 0 TODD AHRENS 0.50 X 0 0 0 TIM GOODMAN 0.50 X 0 0 0 EDITH DANIELS-RICE 0.50 X 0 0 0 BETTY HATHAWAY 0.50 X 0 0 0 RICHARD GRIFFEN 0.50 X 0 0 0 ED CLINE 0.50 X 0 0 0 PAUL EWERT 40.00 X 0 80595 14336 0 80595 14336 0 0 0 0 BETH HAVEN MANAGEMENT SERVICES 2500 PLEASANT STREET HANNIBAL MO 63401 MANAGEMENT FEES AND SALARIES 535708 FIRST CHOICE PHYSICAL THERAPY 5 WEST STATE 8TH PLAZA QUINCY IL 62301 THERAPY SERVICES 121624 ONR INC 1101 S CAPITAL OF TEXAS HWY BLDG G AUSTIN TX 78746 THERAPY SERVICES 111793 3 4245 4245 RESIDENT SERVICES 623000 6868022 6868022 6868022 19899 19899 13000 13000 13000 13000 153 153 153 153 MISC INCOME 900099 89521 89521 VENDING MACHINE 452000 17759 17759 MEAL INCOME 722320 12876 12876 9858 9858 130014 7035333 6868022 0 163066 2983087 2926158 56929 333795 327425 6370 251289 246493 4796 310336 310336 13196 13196 36038 36038 24527 24527 1000869 967580 33289 254851 249452 5399 2599 2549 50 18567 18213 354 202273 197988 4285 298980 292645 6335 154358 151088 3270 RENTAL & MAINTENANCE 442955 435734 7221 NFRA MONTHLY FEE 372346 372346 BAD DEBTS 82916 82916 VENDING MACHINE 13990 13723 267 DUES & SUBSCRIPTIONS 13532 13532 20317 17079 3238 6830821 6218473 612348 0 544518 377577 942671 1030116 341420 538901 95555 203750 23197 24586 42912 42036 9645216 4130084 5657747 5515132 97004 97079 90227 84718 7835251 7913895 432834 479738 4262065 4093757 62440 59210 4757339 4632705 X 3077912 3281190 3077912 3281190 7835251 7913895 X 204512 -1234 X X 0 1 1 X 0 X 3080 2500 5453 3739 4245 19017 4898184 5920423 6317381 6579056 6868022 30583066 4901264 5922923 6322834 6582795 6872267 30602083 0 0 0 30602083 56926 53859 36313 30243 32899 210240 56926 53859 36313 30243 32899 210240 53453 82950 66700 130014 333117 5011643 6059732 6359147 6679738 7035180 31145440 0.98260 0.98520 0.00680 0.00770 X 103330 103330 8608770 3542183 5066587 885489 543034 342455 47627 44867 2760 5515132 RESIDENT TRUST FUNDS 22041 DUE TO AFFILIATES 32682 DUE TO TERRACE 58 DUE TO GROUP HOMES 4429 59210 7035333 6830821 204512 -1309 75 -1234 203278 7034099 -1309 75 -1234 7035333 0 7035333 6830821 0 6830821 0 6830821 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ASSOCIATION QUALIFIES AS A TAX-EXEMPT ORGANIZATION DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ASSOCIATION IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501 (C)(3) OF THE CODE. THE ASSOCIATION IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER THE CODE AND CONTRIBUTIONS TO THE ASSOCIATION QUALIFIES AS CHARITABLE TAX DEDUCTIONS FOR THE CONTRIBUTOR. THE ENTITY FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. THE ASSOCIATION'S INCOME TAX RETURNS FOR THE YEARS 2007 THROUGH 2010 ARE SUBJECT TO REVIEW AND EXAMINATION BY THE IRS. PART XI, LINE 8 - OTHER ADJUSTMENTS: GAIN ON INVESTMENT IN AFFILIATED COMPANY 75. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAIN FROM INVESTMENT IN AFFILIATED COMPANY 75. JEROLD LEE BOARD OF DIRECTORS PRESIDENT, COMMERCE BANK 202273 LOAN AND CHECKING ACCOUNT 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES MANAGEMENT DUTIES INCLUDING SUPERVISING PERSONNEL, OPERATIONS, AND BUDGETING TO BETH HAVEN MANAGEMENT SERVICES, A MANAGEMENT COMPANY. FORM 990, PART VI, SECTION B, LINE 11 THE MANAGEMENT AND BOARD OF DIRECTORS WILL BE PROVIDED A DRAFT OF THE 990 FOR REVIEW PRIOR TO BEING FILED. THE BOARD WILL AGAIN REVIEW IT AT THE NEXT REGULAR MEETING FOLLOWING THE FILING. MANAGEMENT WILL REVIEW IT WITH THE BOARD WHERE THEY WILL RECEIVE A SUMMARY DURING THE MEETING AND PROVIDED A COPY FOR REVIEW ON THEIR OWN. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, IN JANUARY THE BOARD OF DIRECTORS AND KEY MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND SIGN A CONFLICT OF INTEREST STATEMENT DISCLOSING ANY POTENTIAL CONFLICTS OF INTEREST. THESE POTENTIAL CONFLICTS OF INTEREST ARE DISCLOSED TO THE ENTIRE BOARD. DURING A BOARD MEETING IF A POTENTIAL CONFLICT OF INTEREST ARISES THE BOARD MEMBER IS TO DISCLOSE THE POTENTIAL CONFLICT AND REMOVE THEMSELVES FROM THE BOARD DISCUSSION AND VOTING. FORM 990, PART VI, SECTION B, LINE 15 PRIOR TO HIRING AN AREA WIDE REVIEW OF COMPARABLE POSITIONS IS CONDUCTED. ANNUALLY A SURVEY OF NORTHEAST MISSOURI NURSING HOMES IS CONDUCTED TO COMPARE SIMILAR POSITIONS. DURING THE ANNUAL REVIEW AN EVALUATION OF CURRENT MARKET CONDITIONS, COMPARABLE POSITIONS, AND FACILITY OPERATIONAL FORECASTS ARE CONSIDERED IN DETERMINING COMPENSATION. SALARY LEVELS FOR OFFICERS AND KEY EMPLOYEES ARE SET BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THE CONFLICT OF INTEREST POLICY AND THE FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,309. GAIN ON INVESTMENT IN AFFILIATED COMPANY 75. TOTAL TO FORM 990, PART XI, LINE 5: -1,234. FORM 990, PAGE 12, PART XII, LINE 2C- AUDIT COMMITTEE OVERSIGHT & REVIEW: THE ORGANIZATION HAS NOT CHANGED ITS PROCESS FROM THE PRIOR YEAR. BETH HAVEN GROUP HOMES 2518 PLEASANT ST HANNIBAL MO 63401 431580486 HOME FOR HANDICAPPED MO 501C3 509(A)(2) N/A 0 BETH HAVEN TERRACE 901 CENTRAL AVE HANNIBAL MO 63401 431162094 ELDERLY APARTMENTS MO 501C3 509(A)(2) N/A 0 BETH HAVEN MANAGEMENT SERVICES 2500 PLEASANT HANNIBAL MO 63401 431299897 HEALTH CARE MANAGEMENT MO N/A C 75 224386 0.50000 0 0 0 1 1 0 0 0 0 0 0 1 1 1 1 1 0 0 BETH HAVEN MANAGEMENT SERVICES L 245978 BETH HAVEN GROUP HOMES P 89466 BETH HAVEN MANAGEMENT SERVICES N 289730 BETH HAVEN MANAGEMENT SERVICES D 190063 BETH HAVEN GROUP HOMES E 4093757