2011-08-11T10:49:19-05:00 2010-09-30 RSM MCGLADREY INC 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2009-10-01 364094409 UNLIMITED DEVELOPMENT INC UNLI 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 ROBERT WAGNER 3093431550 2011-08-10 1 BEN MCMAHAN 3093428026 2009 2016-02-24 21:20:13Z ROBERT WAGNER 285 SOUTH FARNHAM STREET GALESBURG IL 61401 72349012 0 X SIMPLYTHEFINEST.NET X 1996 IL UDI PROVIDES & OPERATES NURSING AND ASSISTED LIVING FACILITIES FOR THE ELDERLY. 6 6 2319 98 0 0 259442 1517475 65090927 70722915 69241 108622 0 65419610 72349012 100 0 30409882 33509155 0 0 33335340 35689947 63745222 69199202 1674388 3149810 22549859 26270370 10000496 10514512 12549363 15755858 THE MISSION OF THE ORGANIZATION IS ARTICULATED IN ITS ARTICLES OF INCORPORATION AS FOLLOWS:THE CORPORATION IS ORGANIZED EXCLUSIVELY FOR CHARTIABLE PURPOSES AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN FURTHERANCE OF THOSE CHARITABLE PURPOSES, THE CORPORATION SHALL BE EMPOWERED TO BUILD, LEASE, ACQUIRE AND OTHERWISE OWN AND OPERATE RESIDENTIAL FACILITIES, NURSING FACILITIES AND OTHER RELATED FACILITIES AND SERVICES FOR THE ELDERLY, MENTALLY RETARDED, MENTALLY ILL, DEVELOPMENTALLY DISABLED AND OTHER LIKE CONDITIONS WITHOUT REGARD TO RACE, RELIGION, COLOR, SEX, CREED OR NATIONAL ORIGIN OF SAID PERSONS. THE CORPORATION WILL NOT ENGAGE IN THE PRACTICE OF MEDICINE NOR RENDER ANY LICENSED PROFESSIONAL SERVICES. 0 0 65053372 100 70722915 ALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING SKILLED NURSING FACILITIES, HEALTH CARE, ASSISTED AND SEMI-INDEPENDENT LIVING FACILITIES, AND OTHER RELATED SERVICES TO THE ELDERLY. 65053372 1 1 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 1 40 0 1 2319 1 0 0 0 0 0 0 0 0 0 6 6 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 IL X X RON WILSON RFMS INC 3093431550 285 SOUTH FARNHAM GALESBURG IL 61401 ROBERT H WAGNER 2.00 X X 4000 0 0 GORDON AULGUR 2.00 X X 4000 0 0 DAVID HANEY 2.00 X 4000 0 0 JERRY GILMORE 2.00 X 4000 0 0 AUDREY FINKE 2.00 X 4000 0 0 KAREN WAKEFIELD 2.00 X 4000 0 0 RON WILSON RFMS INC 10.00 X 0 0 121196 TRACY OWENS 40.00 X 126550 0 5146 TENIA CALHOON 40.00 X 120466 0 12244 BRIAN WIGGS 40.00 X 106134 0 7468 377150 0 146054 3 0 0 0 RFMS INC 285 SOUTH FARNHAM GALESBURG IL 61401 Administrative Services 1901400 ENDURACARE PO BOX 53064 PHOENIX AZ 850723064 THerapy services 1596687 LTC SUPPORT SERVICES LLC 285 SOUTH FARNHAM GALESBURG IL 61401 SUPPORT SERVICES 1339800 DEPEW & OWEN BUILDERS INC PO BOX 1252 CENTRALIA IL 62801 CONSTRUCTION SERVICES 786219 AZER CLINIC 872 W DAYTON ST GALESBURG IL 61401 therapy services 747300 13 1517475 1517475 MEDICARE & MEDICAID 623000 42907234 42907234 PRIVATE PAY RESIDENT S 623000 27313084 27313084 OTHER INCOME 623000 367252 367252 MAINTENANCE FEES 623000 135345 135345 70722915 108162 108162 460 460 460 460 72349012 70722915 0 108622 100 100 29500 29500 28580360 27704586 875774 143232 138843 4389 2282065 2212151 69914 2473998 2398174 75824 3322560 2212144 1110416 150617 150617 105910 105910 18725 18725 4910657 4910657 1011897 910707 101190 496696 386907 109789 206663 165330 41333 12546568 12175219 371349 115471 113496 1975 49430 44487 4943 1812 1758 54 774475 735751 38724 659356 560453 98903 SUPPLIES & SMALL EQUIp. 9107314 9099390 7924 UNCOLLECTIBLE CHARGES 788531 788531 MEDICAID ASSESSMENT TAX 634714 634714 equipment rent & maint. 594667 585895 8772 subscriptions & FEES 100568 32528 68040 93316 30082 63234 69199202 65053372 4145830 0 772558 703779 5074756 3598921 9697111 9012739 10517 2078686 8970469 1954200 6026745 7016269 3083976 716761 546761 251411 229239 22549859 26270370 5121090 6045113 1089967 425976 3789439 4043423 10000496 10514512 X 12549363 15755858 12549363 15755858 22549859 26270370 X 0 1 1 X 0 X 740 565 2424 259442 1517475 1780646 35242037 55570340 60739181 65090927 70722915 287365400 35242777 55570905 60741605 65350369 72240390 289146046 0 0 0 289146046 140104 184984 178991 69241 108162 681482 140104 184984 178991 69241 108162 681482 35382881 55755889 60920596 65419610 72348552 289827528 0.99760 0.99700 0.00240 0.00300 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18725 18725 65053372 65072097 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 12934 20638 18109 18725 70406 250000 250000 250000 250000 1000000 1500000 5286212 805814 4480398 2414022 647808 1766214 1270235 500578 769657 7016269 DUE TO RESIDENTS 130013 NOTE PAYABLE TO COMMUNITY LIVING OPTIONS, INC., PARENT ORGANIZATION 881654 SECURITY DEPOSITS 862567 CONSTRUCTION PAYABLE 307509 REFUNDABLE TO RESIDENTS 1861680 4043423 Part X: Description of Uncertain Tax Positions Under FIN 48: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE FINANCIAL ACCOUNTING STANDARDS BOARD ISSUED NEW GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE ORGANIZATION ADOPTED THIS NEW GUIDANCE FOR THE YEAR ENDED SEPTEMBER 30, 2010. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2005. LTC SUPPORT SERVICES (LTC) A SINGLE DIRECTOR COMMON TO BOTH UDI AND LTC IS AUDREY FINKE. 1377160 MANAGEMENT SERVICES ARE PROVIDED BY LTC SUPPORT SERVICES, LLC, AS DESCRIBED ABOVE IN SCHEDULE O RELATIVE TO PART VI, SECTION A, LINE 3. AUDREY FINKE, WHO IS A DIRECTOR OF UNLIMITED DEVELOPMENT, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVEd DIRECTOR'S FEES OF $1,000 FROM LTC SUPPORT SERVICES, LLC, for the fiscal year ending september 30, 2010. 0 Form 990, Part VI, Section A, line 3 THE ORGANIZATION RECEIVES MANAGEMENT SERVICES FROM LTC SUPPORT SERVICES, LLC, AN UNRELATED COMPANY. THESE SERVICES INCLUDE OVERSIGHT, TRAINING, REGULATORY COMPLIANCE, QUALITY ASSURANCE PROGRAMS, HUMAN RESOURCE SUPPORT, MARKETING AND MAINTENANCE. UNLIMITED DEVELOPMENT, INC. OWNS 12.5% OF LTC SUPPORT SERVICES, LLC., AND COMMUNITY LIVING OPTIONS, INC., (PARENT ORGANIZATION OF UNLIMITED DEVELOPMENT, INC.) OWNS 12.5% OF LTC SUPPORT SERVICES, LLC. THE REMAINING 75% OF LTC SUPPORT SERVICES, LLC, IS OWNED BY UNRELATED EXEMPT ORGANIZATIONS. THE ORGANIZATION ALSO HAS A NEGOTIATED ARMS LENGTH ADMINISTRATIVE SERVICES CONTRACT WITH RFMS, INC., AN UNRELATED COMPANY, TO OBTAIN SERVICES SUCH AS CASH MANAGEMENT, ACCOUNTING AND FINANCIAL REPORTING, PAYROLL AND EMPLOYEE BENEFITS, INFORMATION TECHNOLOGY, REGULATORY MATTERS, AND OTHER GENERAL BUSINESS AND FINANCIAL MANAGEMENT SERVICES AS REQUIRED. Form 990, Part VI, Section A, line 7a THE ORGANIZATION IS A SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC. COMMUNITY LIVING OPTIONS, INC. IS THE MEMBER OF THE ORGANIZATION. COMMUNITY LIVING OPTIONS, INC., ELECTS THE GOVERNING BODY ON AN ANNUAL BASIS. Form 990, Part VI, Section B, line 11 EACH MEMBER OF THE BOARD OF DIRECTORS RECEIVES A PAPER COPY OF FORM 990 FOR THEIR REVIEW AND COMMENT PRIOR TO ITS FILING. THE BOARD ALSO REVIEWS IN DETAIL EACH FORM 990 FILED BY THE ORGANIZATION AT ITS REGULARLY SCHEDULED BOARD MEETINGS. ON AN ANNUAL BASIS, EACH BOARD MEMBER ATTENDS A TRAINING SESSION THAT PROVIDES UPDATES ON CURRENT EXEMPT ORGANIZATION TAX COMPLIANCE MATTERS. Form 990, Part VI, Section B, line 12c ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO ATTEST TO THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. THE BOARD OF DIRECTORS REVIEWS ALL COMPLETED CONFLICT OF INTEREST STATEMENTS TO DETERMINE IF ANY CONFLICTS EXIST WHICH WOULD REQUIRE RESTRICTION ON PARTICIPATION IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN ANY TRANSACTIONS INVOLVING THE ORGANIZATION. Form 990, Part VI, Section C, line 18 A PAPER COPY OF FORM 990 IS PROVIDED UPON REQUEST. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE VIA THE GUIDESTAR.ORG WEBSITE AND THROUGH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. Form 990, Part VI, Section C, line 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXCEPT THROUGH PUBLIC FILING REQUIREMENTS. FORM 990, PART VII, SECTION A, COLUMN F: RON WILSON IS EMPLOYED BY RFMS, INC., AN UNRELATED ORGANIZATION WHICH HAS AN ADMINISTRATIVE SERVICES CONTRACT WITH UNLIMITED DEVELOPMENT, INC. THE TYPE OF SERVICES PROVIDED BY RFMS, INC., ARE DETAILED IN THE SCHEDULE O EXPLANATION ABOVE RELATIVE TO FORM 990, PART VI, SECTION A, LINE 3. RON WILSON IS THE CHIEF FINANCIAL OFFICER OF RFMS, INC., AND THE COMPENSATION REPORTED IN COLUMN F REPRESENTS 100% OF THE WAGES AS REPORTED ON HIS RFMS, INC. FORM W-2, BOX 5 FOR CALENDAR YEAR 2009. THE COMPENSATION AMOUNT HAS NOT BEEN PRORATED BASED ON TIME SPENT PER ORGANIZATION. fORM 990, PART VII, SECTION A, COLUMN B: APPROXIMATELY ONE HALF OF THE AVERAGE HOURS PER WEEK ESTIMATED FOR EACH DIRECTOR AND OFFICER IS DEVOTED TO RELATED ORGANIZATIONS LISTED ON SCHEDULE R. FORM 990, PART XI, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. SCHEDULE R, PART V, LINE 2, COLUMN C: THE AMOUNTS REPORTED ARE DETERMINED BY THE CASH TRANSACTIONS BETWEEN THE PARTIES AND ARE BASED ON THE FAIR MARKET VALUE OF EACH RESPECTIVE ITEM. SCHEDULE R, PART II: UNLIMITED DEVELOPMENT, INC., IS A SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC. KEOKUK VILLAGE CIRCLE, LTD., NFP, IS A SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC. FORM 990, PART XI, LINE 2B: THE FINANCIAL STATEMENTS OF UNLIMITED DEVELOPMENT, INC., WERE AUDITED AS PART OF THE CONSOLIDATED FINANCIAL REPORT ISSUED FOR COMMUNITY LIVING OPTIONS, INC. AND SUBSIDIARIES. 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