2012-12-21T08:20:27-06:00 2012-06-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2011-07-01 260275009 MIDWEST CHRISTIAN VILLAGES MIDW 3145877903 622 EMERSON ROAD NO 310 ST LOUIS MO 63141 SUSAN MCGHEE 3145877903 2012-12-20 1 ALLAN LARSON P00028482 3149254300 2011 2016-02-24 21:20:13Z SUSAN MCGHEE 622 EMERSON ROAD NO 310 ST LOUIS MO 63141 10203357 0 X WWW.CHRISTIANHOMES.ORG X 2008 IL MIDWEST CHRISTIAN VILLAGES, INC., THE CORPORATE OFFICE OF CHRISTIAN HOMES, INC. AND AFFILIATES, MANAGES THIRTEEN SKILLED NURSING CAMPUSES, TWELVE OF WHICH INCLUDE INDEPENDENT LIVING, AND THREE OF WHICH ALSO INCLUDE ASSISTED LIVING. IN ADDITION, MIDWEST CHRISTIAN VILLAGES, INC. MANAGES A CAMPUS THAT INCLUDES ASSISTED LIVING AND INDEPENDENT LIVING, TWO SUPPORTIVE LIVING FACILITIES, AND A PHARMACY. MANAGING INCLUDES PAYROLL, ACCOUNTS PAYABLE, BILLING, CLINICAL RESOURCES AND MANAGEMENT, OPERATIONS RESOURCES AND MANAGEMENT, AND HUMAN RESOURCES FOR EMPLOYEES AND RESIDENTS. 15 15 0 15 0 0 0 0 8950450 10126482 23172 6217 10681 20459 8984303 10153158 0 0 0 0 6052381 6083763 0 0 0 2110503 2694039 8162884 8777802 821419 1375356 5470554 7862189 1350073 1629220 4120481 6232969 X THE MISSION OF MIDWEST CHRISTIAN VILLAGES, INC. 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 230264 10146350 MIDWEST CHRISTIAN VILLAGES, INC., THE CORPORATE OFFICE OF CHRISTIAN HOMES, INC. AND AFFILIATES, MANAGES THIRTEEN SKILLED NURSING CAMPUSES, TWELVE OF WHICH INCLUDE INDEPENDENT LIVING, AND THREE OF WHICH ALSO INCLUDE ASSISTED LIVING. IN ADDITION, MIDWEST CHRISTIAN VILLAGES, INC. MANAGES A CAMPUS THAT INCLUDES ASSISTED LIVING AND INDEPENDENT LIVING, TWO SUPPORTIVE LIVING FACILITIES, AND A PHARMACY. MANAGING INCLUDES PAYROLL, ACCOUNTS PAYABLE, BILLING, CLINICAL RESOURCES AND MANAGEMENT, OPERATIONS RESOURCES AND MANAGEMENT, AND HUMAN RESOURCES FOR EMPLOYEES AND RESIDENTS. 230264 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 37 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X MIDWEST CHRISTIAN VILLAGES 3145877903 622 EMERSON ROAD 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 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 X 0 0 0 NICHOLAS A FILING 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 MARK A BEHRENDS 3.00 X 0 0 0 VICTOR S WILLIAMS 3.00 X 0 0 0 TIMOTHY PHILLIPPE 40.00 X 0 435271 6156 SUSAN MCGHEE 40.00 X 0 235979 13656 MARK LONGENECKER 40.00 X 0 201119 9156 SHERRY GUTERMUTH 40.00 X 0 200683 13656 LAURIE BROWN 40.00 X 0 154949 13031 JOHN RUPKEY 40.00 X 0 173381 13031 KELLY KELLEY 40.00 X 0 181306 13656 MARK CANTY 40.00 X 0 169999 1500 ROBERT VINCENT 40.00 X 0 153063 6156 GREG WITTE 40.00 X 0 152772 13031 0 2058522 103029 0 0 1 0 CLIFTONLARSONALLEN LLP 600 WASHINGTON SUITE 1800 ST LOUIS MO 63101 ACCOUNTING & CONSULTING 267285 I&G DIRECT REAL ESTATE 18 LP 15006 COLLECTION CENTER DRIVE CHICAGO IL 60693 REAL ESTATE BROKER 150820 2 MANAGEMENT FEES 623000 10126482 10126482 10126482 56416 56416 50199 -50199 -50199 -50199 MISCELLANEOUS 900099 17066 17066 DISCOUNTS 900099 2802 2802 VENDING REVENUE 900099 591 591 20459 10153158 10146350 0 6808 5161750 5161750 595121 595121 326892 326892 395914 395914 267285 267285 315948 315948 113380 113380 981292 174787 806505 31749 31749 279873 279873 55167 55167 23728 23728 MISCELLANEOUS 115876 115876 LICENSE, DUES AND SUBSC 82005 82005 PURCHASED SERVICES 31822 31822 8777802 230264 8547538 0 1881009 2014197 292892 3720011 89399 155681 6768 6768 199641 144529 2975076 1820511 25769 492 5470554 7862189 1350073 915011 0 714209 1350073 1629220 X 4120481 6232969 4120481 6232969 5470554 7862189 X 1375356 737132 X X 0 1 1 X 0 X 8045072 8192547 8950450 10126482 35314551 8045072 8192547 8950450 10126482 35314551 0 0 0 35314551 4826 28481 56416 89723 4826 28481 56416 89723 5025 1008 10681 20459 37173 8050097 8198381 8989612 10203357 35441447 X 0 INTERCOMPANY PAYABLES 714209 714209 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 ORGANIZATIONS 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 ORGANIZATIONS' 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 2009 TO 2011 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 366959 0 60800 0 7512 0 0 0 6156 0 441427 0 0 SUSAN MCGHEE 0 209979 0 26000 0 0 0 0 0 13656 0 249635 0 0 MARK LONGENECKER 0 160030 0 35700 0 5389 0 0 0 9156 0 210275 0 0 SHERRY GUTERMUTH 0 160619 0 35700 0 4364 0 0 0 13656 0 214339 0 0 LAURIE BROWN 0 123470 0 28961 0 2518 0 0 0 13031 0 167980 0 0 JOHN RUPKEY 0 142822 0 25000 0 5559 0 0 0 13031 0 186412 0 0 KELLY KELLEY 0 158580 0 22726 0 0 0 0 0 13656 0 194962 0 0 MARK CANTY 0 169999 0 0 0 0 0 0 0 1500 0 171499 0 0 ROBERT VINCENT 0 130774 0 17932 0 4357 0 0 0 6156 0 159219 0 0 GREG WITTE 0 126137 0 24453 0 2182 0 0 0 13031 0 165803 0 0 PART I, LINE 1A TIMOTHY PHILLIPPE RECEIVED A HOUSING ALLOWANCE OF $14,500 AND ROBERT VINCENT RECEIVED A HOUSING ALLOWANCE OF $28,600. PART I, LINE 7 TIM PHILLIPPEE, MARK LONGENECKER, SHERRY GUTERMUTH, LAURIE BROWN, JOHN RUPKEY, ROBERT VINCENT AND GREG WITTE RECEIVED $7,512, $5,389, $4,364, $2,518, $5,559, $4,357 AND $2,182, RESPECTIVELY, FOR SELLBACK OF PTO AND IS INCLUDED IN OTHER REPORTABLE COMPENSATION FROM A RELATED ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD GETS A DRAFT OF THE 990 ELECTRONICALLY SENT TO THEM 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 DETERMED 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 MONTHLY. FINANCIAL STATEMENTS CAN ALSO BE OBTAINED UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 16,380. EQUITY TRANSFER FROM OG 720,752. TOTAL TO FORM 990, PART XI, LINE 5: 737,132. AUDIT COMMITTEE OVERSIGHT & REVIEW FORM 990, PAGE 12, PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT OR SELECTION PROCESS DURING THE FILING YEAR. OFFICERS AND KEY EMPLOYEES COMPENSATION FORM 990, PAGE 10, PART IX, LINE 5 AND FORM 990, PAGES 7-8, PART VII ALTHOUGH OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION WERE PAID VIA W-2S ISSUED UNDER THE TAX IDENTIFICIATION NUMBER OF CHRISTIAN HOMES, INC., A RELATED TAX-EXEMPT ORGANIZATION, THE ACTUAL EXPENSE OF THESE SALARIES IS REPORTED ON THIS ENTITY. SAFE HAVEN HOSPICE 622 EMERSON ROAD ST LOUIS MO 63141 275346886 HOSPICE SERVICES MO -457294 32983 MIDWEST CHRISTIAN VILLAGES CHRISTIAN HOMES INC 200 N POSTVILLE DR LINCOLN IL 62656 370841562 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 9 N/A 0 FAIR HAVENS CHRISTIAN HOMES 1790 S FAIRVIEW AVE DECATUR IL 62521 370987659 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 9 N/A 0 LEWIS MEMORIAL CHRISTIAN VILLAGE 3400 W WASHINGTON ST SPRINGFIELD IL 62711 510173104 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 9 N/A 0 HOOSIER CHRISTIAN VILLAGE 621 S SUGAR ST BROWNSTOWN IN 47220 237423749 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(C)(3) LINE 9 N/A 0 SPRING RIVER CHRISTIAN VILLAGE 201 S NORTHPARK LANE JOPLIN MO 64801 431341462 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS MO 501(C)(3) LINE 9 N/A 0 CHICAGOLAND CHRISTIAN VILLAGE 6685 E 117TH ST CROWN POINT IN 46307 311114614 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(C)(3) LINE 9 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) LINE 9 N/A 0 VILLAGE CHRISTIAN PARKE 675 SOUTH FORD RD ZIONSVILLE IN 46077 311172227 RETIREMENT APARTMENTS IN 501(C)(3) LINE 9 N/A 0 MIDWEST SENIOR MINISTRIES 111 E WASHINGTON BENSENVILLE IL 60106 201053401 SKILLED NURSING FACILITY, RETIREMENT APARTMENTS & PHARMACY IL 501(C)(3) LINE 9 N/A 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 FAIR HAVENS CHRISTIAN HOME K 1120192 FMV LEWIS MEMORIAL CHRISTIAN VILLAGE K 889301 FMV HOOSIER CHRISTIAN VILLAGE K 406512 FMV SPRING RIVER CHRISTIAN VILLAGE K 750528 FMV CHICAGOLAND CHRISTIAN VILLAGE K 809916 FMV RISEN SON CHRISTIAN VILLAGE K 784296 FMV MIDWEST SENIOR MINISTRIES K 1611521 FMV CHRISTIAN HOMES INC K 3092312 FMV CHRISTIAN HOMES INC O 299274 FMV