2012-03-02T09:18:36-06:00 2011-06-30 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2010-07-01 311114614 CHICAGOLAND CHRISTIAN VILLAGE CHIC 3145877903 622 EMERSON RD NO 310 ST LOUIS MO 63141 SUSAN MCGHEE 3145877903 2012-03-02 1 3149254300 2010 2016-02-24 21:20:13Z SUSAN MCGHEE 622 EMERSON RD NO 310 ST LOUIS MO 63141 12856097 0 X WWW.CHRISTIANHOMES.ORG X 1980 IN TO PROVIDE QUALITY CARE FOR THE AGED IN A CHRISTIAN ENVIRONMENT. 16 16 379 200 0 0 38848 36852 12553653 12710830 55271 24696 55679 74557 12703451 12846935 0 0 0 0 6118802 5961735 0 0 0 6619401 7155761 12738203 13117496 -34752 -270561 15914002 14404659 27902319 26658872 -11988317 -12254213 X THE MISSION OF CHICAGOLAND CHRISTIAN VILLAGE IS TO CREATE AN EXCITING LIFESTYLE AND TO PROVIDE HIGH QUALITY CARE FOR SENIORS ON A CONTINUUM OF CARE CAMPUS. PROVIDING CARE IN A CHRISTIAN ENVIRONMENT PROVIDES A UNIQUE OPPORTUNITY TO MEET THE NEEDS OF SENIORS PHYSICALLY, MENTALLY, AND SPIRITUALLY. OUR COMMITMENT TO EXCELLENCE IS MOTIVATED BY OUR CHRISTIAN BELIEF THAT ALL ARE PRECIOUS IN THE SIGHT OF GOD. 0 0 11446022 12736188 CHICAGOLAND CHRISTIAN VILLAGE PROVIDES QUALITY CARE FOR THE AGED IN A CHRISTIAN ENVIRONMENT. THE CAMPUS INCLUDES OPERATION OF A SKILLED NURSING FACILITY WITH 47,488 PATIENT DAYS OF SERVICE, OPERATION OF AN INDEPENDENT RETIREMENT COMMUNITY WITH AN AVERAGE OF 18 INDEPENDENT LIVING UNITS OCCUPIED, AND OPERATION OF A SENIOR LIVING APARTMENT BUILDING WITH AN AVERAGE OF 45 SENIOR APARTMENT UNITS OCCUPIED DURING THE YEAR. 11446022 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 46 0 1 379 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X X MIDWEST CHRISTIAN VILLAGES 3145877903 622 EMERSON RD SUITE 310 ST LOUIS MO 63141 JIM BLALOCK 3.00 X 0 0 0 BOB CROSBY 3.00 X X 0 0 0 BILLY D CARTER 3.00 X X 0 0 0 GARY W EDWARDS 3.00 X X 0 0 0 RANDY CLARK 3.00 X 0 0 0 JAMES S FRASURE MD 3.00 X 0 0 0 MAURINE COLLETT 3.00 X 0 0 0 TERRY GOODNER 3.00 X 0 0 0 NICHOLAS A FILING 3.00 X 0 0 0 LARRY PERIMAN 3.00 X 0 0 0 AMY HANSON 3.00 X 0 0 0 MARYLYN ROWE 3.00 X 0 0 0 DICK HART 3.00 X 0 0 0 RONALD F SEWELL 3.00 X X 0 0 0 BILL LASH 3.00 X 0 0 0 PATRICIA LINCOLN 3.00 X 0 0 0 TIMOTHY PHILLIPPE 40.00 X 0 439802 5442 MARK LONGENECKER 40.00 X 0 63606 5442 SUSAN MCGHEE 40.00 X 0 232755 12442 SHERRY GUTERMUTH 40.00 X 0 204840 12442 DAVID STEELE 40.00 X 0 154995 8442 LAURIE BROWN 40.00 X 0 161692 11942 JOHN RUPKEY 40.00 X 0 166356 11942 BRIAN MILLER 40.00 X 0 165953 11442 LARRY BRANDON 40.00 X 0 141967 12442 KELLY KELLEY 40.00 X 0 137051 12442 LARRY KUESTER 40.00 X 0 132409 12442 0 2001426 116862 0 0 1 0 KINDRED REHAB SERVICES INC PO BOX 277365 ATLANTA GA 30384 THERAPY SERVICES 980101 ERB & HOYER ASSOCIATES LLC 9347 SARIC DRIVE HIGHLAND IN 46322 INTERIM DON 135205 LEADER STAT 1322B MANNING PKWY POWELL OH 43065 NURSE STAFFING 129340 3 36852 36852 NURSING HOME OPERATION 623000 11258413 11258413 SENIOR LIVING UNITS(CO 623000 1281215 1281215 INDPENDENT RETIREMENT 623000 171202 171202 12710830 32816 32816 1042 9162 1042 -9162 -8120 -8120 BARBER & BEAUTY 900099 40946 40946 MISCELLANEOUS 900099 33611 25358 8253 74557 12846935 12736188 0 73895 4789865 4394128 395737 805490 738941 66549 366380 336110 30270 793727 793727 31831 31831 1053629 1034074 19555 55483 55483 1039049 898306 140743 377199 377199 22324 10869 11455 3298 3298 1351537 1351537 804502 804502 148873 148873 PURCHASED SERVICES 545099 545099 MISCELLANEOUS 415846 412107 3739 RAW FOOD 388127 388127 BAD DEBT 103521 103521 LICENSE, DUES, & SUBSCR 17930 2852 15078 3786 3786 13117496 11446022 1671474 0 1195440 261402 1268365 1019831 28522 38816 17547 23901 23082615 11044188 12378815 12038427 1025313 1022282 15914002 14404659 1025125 1036378 653572 757416 6980000 6795000 17345037 16322972 1898585 1747106 27902319 26658872 X -11999461 -12260308 11144 6095 -11988317 -12254213 15914002 14404659 X -270561 4665 X X 0 1 1 X 0 X 31903 50822 51789 38848 36852 210214 11566496 12517105 13017072 12553653 12710830 62365156 11598399 12567927 13068861 12592501 12747682 62575370 0 0 0 62575370 35303 86798 85145 56029 32816 296091 35303 86798 85145 56029 32816 296091 58293 190853 91977 55679 74557 471359 11691995 12845578 13245983 12704209 12855055 63342820 0.98790 0.98900 0.00470 0.00460 X 205479 205479 20565846 9366414 11199432 2311290 1677774 633516 12038427 RESIDENT TRUST 20338 ENTRANCE DEPOSITS 17876 ENDOWMENT FUND 49676 BOND FUNDS 721797 DEFERRED FINANCING COST 212363 ACCRUED INTEREST RECEIVABLE 232 1022282 SECURITY DEPOSIT PAYABLE 15971 CURENT PORTION OF REFUNDABLE ENTRANCE FEES 267500 REFUNDABLE ENTRANCE FEES 1442089 OTHER LIABILITIES 13329 INTERCOMPANY PAYABLE 8217 1747106 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATIONS, EXCEPT FOR THE LIMITED PARTNERSHIPS, QUALIFY AS TAX-EXEMPT CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE ORGANIZATIONS, EXCEPT FOR THE LIMITED PARTNERSHIPS, ARE NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE ORGANIZATIONS ARE CLASSIFIED AS PUBLICLY-SUPPORTED CHARITABLE ORGANIZATIONS UNDER THE CODE AND CONTRIBUTIONS TO THE ORGANIZATIONS QUALIFY AS A CHARITABLE TAX DEDUCTION FOR THE CONTRIBUTOR. THE ORGANIZATIONS FOLLOW THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS. IT ALSO PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PRINCIPLES FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THIS STANDARD HAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATIONS' INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATIONS ARE NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THEIR TAX-EXEMPT STATUS. THE ORGANIZATIONS ARE NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES OTHER THAN WHAT IS ALREADY BEING REPORTED. THE TAX RETURNS FOR THE YEARS 2008 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 TIMOTHY PHILLIPPE 0 331857 0 77945 0 30000 0 0 0 5442 0 445244 0 0 SUSAN MCGHEE 0 182705 0 30050 0 20000 0 0 0 12442 0 245197 0 0 SHERRY GUTERMUTH 0 174712 0 30128 0 0 0 0 0 12442 0 217282 0 0 DAVID STEELE 0 146620 0 8375 0 0 0 0 0 8442 0 163437 0 0 LAURIE BROWN 0 140638 0 21054 0 0 0 0 0 11942 0 173634 0 0 JOHN RUPKEY 0 145356 0 21000 0 0 0 0 0 11942 0 178298 0 0 BRIAN MILLER 0 155005 0 10948 0 0 0 0 0 11442 0 177395 0 0 LARRY BRANDON 0 141967 0 0 0 0 0 0 0 12442 0 154409 0 0 PART I, LINE 1A TIMOTHY PHILLIPPE RECEIVED A HOUSING ALLOWANCE OF $14,000 AND LARRY BRANDON HAD A HOUSING ALLOWANCE OF $24,000. PART I, LINE 7 TIM PHILLIPPEE AND SUSAN MCGHEE RECEIVED $30,000 AND $20,000, RESPECTIVELY, FOR RELOCATING EXPENSE AND IS INCLUDED IN OTHER REPORTABLE COMPENSATION FROM A RELATED ORGANIZATION. CITY OF CROWN POINT INDIANA 356000997 228484BZ3 2007-07-17 7155000 REFINANCE 0 0 0 175000 7155000 720318 252369 1082178 5100135 2010 1 0 1 1 0 0 0 0 1 0 0 0 0 0 0 2007D BOND ISSUANCE: ON JULY 16, 2007, THE CHI OBLIGATED GROUP ISSUED THE SERIES 2007D BONDS AT A TOTAL VALUE OF $7,155,000 UNDER THE NEWLY FORMED MASTER TRUST INDENTURE. THE PROCEEDS FROM THESE BONDS WERE USED TO REFINANCE THE SERIES 1993 BONDS ISSUED BY THE CITY OF CROWN POINT, INDIANA, TO FUND THE DEBT SERVICE RESERVE AND THE PROJECT FUND, AND TO PAY THE UNDERWRITER'S DISCOUNT. SCH K, PART II, LINE 7: CHICAGOLAND CHRISTIAN VILLAGE HAS ELECTED TO AMORTIZE THE ISSUANCE COST OVER THE LIFE OF THE BOND. THIS HAS LED TO A DIFFERENCE BETWEEN THE AMOUNT LISTED PER THE 8038 AND THE CURRENT BOOK VALUE OF ISSUANCE COST. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES MANAGEMENT DUTIES INCLUDING SUPERVISING PERSONNEL, OPERATIONS, AND BUDGETING TO MIDWEST CHRISTIAN VILLAGES, A MANAGEMENT COMPANY AND RELATED EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD GETS A DRAFT OF THE 990 SENT TO THEM ELECTRONICALLY FOR REVIEW PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST STATEMENT IS INCLUDED IN THE EMPLOYEE HANDBOOK WHICH EVERY EMPLOYEE IS GIVEN A COPY OF AND SIGNS AN ACKNOWLEDGEMENT FOR ON THEIR FIRST DAY OF EMPLOYMENT. IF A VIOLATION OCCURS EMPLOYEES CAN REPORT DIRECTLY TO THEIR SUPERVISOR OR USE THE 800 NUMBERS WHICH ARE POSTED AT EACH LOCATION. VIOLATIONS ARE INVESTIGATED BY INDIVIDUALS AT THE VICE PRESIDENT LEVEL AND AT LEAST TWO INDIVIDUALS WOULD MAKE THE FINAL DETERMINATION AS TO THE APPROPRIATE ACTION TO BE TAKEN. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION PARTICIPATES IN SEVERAL (MINIMUM OF 3) INDUSTRY SPECIFIC, EXECUTIVE SALARY SURVEYS EACH YEAR TO HELP DETERMINE COMPETITIVENESS OF OUR EXECUTIVE AND SENIOR MANAGEMENT POSITIONS. THE SALARIES ARE DISCUSSED AND REVIEWED BY THE PRESIDENT AND VICE PRESIDENT OF HUMAN RESOURCES. IF A NEW HIRE IS BEING CONSIDERED FOR AN EXECUTIVE LEVEL POSITION, IT MAY ALSO BE DISCUSSED WITH THE BOARD. IN 2010, THE ORGANIZATION ESTABLISHED A COMPENSATION COMMITTEE OF THE BOARD HEADED BY A PERSON WHOSE ENTIRE CAREER WAS IN HUMAN RESOURCES AND INCLUDES THE ORGANIZATION'S VICE PRESIDENT OF HUMAN RESOURCES AS WELL AS A FEW OTHER BOARD MEMBERS. OTHER OFFICERS' AND KEY EMPLOYEES' SALARIES ARE DETERMINED BASED ON A REVIEW AND PARTICIPATION IN SEVERAL INDUSTRY SPECIFIC SALARY SURVEYS, WHICH PROVIDE DATA ON OTHER EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION POSTS ITS FINANCIAL STATEMENTS ON ITS WEBSITE QUARTERLY. FINANCIAL STATEMENTS CAN ALSO BE OBTAINED ON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 4,665. FORM 990, PAGE 12, PART XII, LINE 2C- AUDIT COMMITTEE OVERSIGHT & REVIEW THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CHRISTIAN HOMES INC 200 N POSTVILLE DR LINCOLN IL 62656 370841562 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501( C ) ( 3 ) 509 (A) (2) N/A 0 FAIR HAVENS CHRISTIAN HOMES 1790 S FAIRVIEW AVE DECATUR IL 62521 370987659 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501( C ) ( 3 ) 509 (A) (2) N/A 0 LEWIS MEMORIAL CHRISTIAN VILLAGE 3400 W WASHINGTON ST SPRINGFIELD IL 62711 510173104 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501( C ) ( 3 ) 509 (A) (2) N/A 0 HOOSIER CHRISTIAN VILLAGE 621 S SUGAR ST BROWNSTOWN IN 47220 237423749 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501( C ) ( 3 ) 509 (A) (2) N/A 0 SPRING RIVER CHRISTIAN VILLAGE 201 S NORTHPARK LANE JOPLIN MO 64801 431341462 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS MO 501( C ) ( 3 ) 509 (A) (2) N/A 0 RISEN SON CHRISTIAN VILLAGE 3000 RISEN SON BLVD COUNCIL BLUFFS IA 51503 421279738 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IA 501( C ) ( 3 ) 509 (A) (2) N/A 0 VILLAGE CHRISTIAN PARKE 675 SOUTH FORD RD ZIONSVILLE IN 46077 311172227 RETIREMENT APARTMENTS IN 501( C ) ( 3 ) 509 (A) (2) N/A 0 MIDWEST SENIOR MINISTRIES 111 E WASHINGTON BENSENVILLE IL 60106 201053401 SKILLED NURSING FACILITY, RETIREMENT APARTMENTS & PHARMACY IL 501( C ) ( 3 ) 509 (A) (2) N/A 0 MIDWEST CHRISTIAN VILLAGES 200 N POSTVILLE DR LINCOLN IL 62656 260275009 MGMT NURSING AND RETIREMENT COMMUNITIES IL 501( C ) ( 3 ) 509 (A) (2) N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 MIDWEST CHRISTIAN VILLAGES L 793727 CHRISTIAN HOMES INC O 956487 MIDWEST SENIOR MINISTRIES O 475829 CHRISTIAN HOMES INC O 420888