2024-05-09T13:10:38-05:00 2023-06-30 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2022-07-01 370987659 HICKORY POINT CHRISTIAN VILLAGE INC HICK 3145877903 565 W MARION AVE FORSYTH IL 62535 CHUCK SCHMITZ CFO 3145877903 2024-05-07 1 CHUCK SCHMITZ 999009999 1 DAVID LOWENTHAL P00378651 3122071040 2024-05-07 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z CHUCK SCHMITZ 565 W MARION AVE FORSYTH IL 62535 13273638 0 X HTTPS://CHRISTIANHORIZONSLIVING.ORG/ X 1975 IL CHRISTIAN HORIZONS EMPOWERS OLDER ADULTS IN MIND, BODY, AND SPIRIT THROUGH FAITH-LED SERVICE. 16 12 0 0 0 0 1088207 324920 11777768 12842724 8737 966 105550 102443 12980262 13271053 0 0 0 0 6307564 6728227 0 0 0 6582911 7279864 12890475 14008091 89787 -737038 22110767 21698083 19210343 19552932 2900424 2145151 X CHRISTIAN HORIZONS EMPOWERS OLDER ADULTS IN MIND, BODY, AND SPIRIT THROUGH FAITH-LED SERVICE. OUR SERVICES ARE DRIVEN BY OUR F.A.I.T.H.-LED VALUES WHICH INCLUDE: FUN - WE FOSTER PERSONALIZED EXPERIENCES FILLED WITH JOY FOR THOSE WE SERVE, APPRECIATION - WE CELEBRATE GOD'S DISTINCTIVE GIFTS OF TALENT, WISDOM AND BEAUTY IN EVERY INDIVIDUAL, INSPIRATION - WE LOVINGLY SHARE CHRIST'S TRUTH WITH OTHERS, TRANSPARENCY - WE WORK WITH OPENNESS AND ACCOUNTABILITY, HEART - WE SERVE WITH PASSION. 0 0 12295319 0 12842724 HICKORY POINT CHRISTIAN VILLAGE, INC. PROVIDES QUALITY CARE TO SENIORS IN A CHRISTIAN ENVIRONMENT. THE OPERATIONS INCLUDE 64 LICENSED SKILLED NURSING BEDS, 38 ASSISTED LIVING UNITS, AND 33 INDEPENDENT LIVING GARDEN HOMES. 20,218 PATIENT DAYS OF SERVICES WERE PROVIDED IN FISCAL YEAR 2023 TO SKILLED NURSING RESIDENTS. THE ORGANIZATION ALSO SERVED 38 RESIDENTS IN ASSISTED LIVING AND 33 RESIDENTS IN INDEPENDENT LIVING GARDEN HOMES DURING FISCAL YEAR 2023.THE ORGANIZATION PROVIDES CARE TO RESIDENTS WHO MEET THE CRITERIA TO BE COVERED UNDER THE MEDICAID PROGRAM IN THE VARIOUS STATES IN WHICH THEY OPERATE. TYPICALLY, THE REIMBURSEMENT RATES UNDER THIS PROGRAM ARE SIGNIFICANTLY LESS THAN THE COST OF PROVIDING THE CARE, RESULTING IN A SIGNIFICANT REDUCTION IN REVENUE. MANAGEMENT HAS ESTIMATED THE COST OF COMMUNITY BENEFITS PROVIDED UNDER THIS PROGRAM FOR FISCAL YEAR 2023 TO BE $45,507. 12295319 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 0 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 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 12 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X CHUCK SCHMITZ 3145877903 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 63141 SCOTT WILLIAMS BOARD MEMBER - SECRETARY 0.30 2.00 X X 0 1000 0 BILLY CARTER BOARD MEMBER - TREASURER 0.30 2.00 X X 0 1000 0 NICK FILING BOARD MEMBER - CHAIRMAN 0.30 2.00 X X 0 750 0 DON FITZGERALD BOARD MEMBER - VICE CHAIRMAN 0.30 2.00 X X 0 1000 0 DOUG WILEY BOARD MEMBER 0.30 2.00 X 0 1000 0 TIMOTHY BURRELL BOARD MEMBER 0.30 2.00 X 0 1000 0 SUSAN KLEIN BOARD MEMBER 0.30 2.00 X 0 1000 0 TERRY GOODNER BOARD MEMBER 0.30 2.00 X 0 1000 0 THOMAS KERINS BOARD MEMBER 0.30 2.00 X 0 1000 0 STEVE GNUSE BOARD MEMBER 0.30 2.00 X 0 1000 0 BRENDA EDEN BOARD MEMBER 0.30 2.00 X 0 1000 0 DAVID SANDEFUR BOARD MEMBER 0.30 2.00 X 0 1000 0 MARCUS THOMAS BOARD MEMBER 0.30 2.00 X 0 1000 0 JEAN DUNAWAY BOARD MEMBER 0.30 2.00 X 0 1000 0 MICHAEL MORBECK BOARD MEMBER 0.30 2.00 X 0 500 0 JOHN ALLEN BURNETT BOARD MEMBER 0.30 2.00 X 0 500 0 DONALD BELL CEO 2.00 38.00 X 0 516689 28816 CHUCK SCHMITZ CFO 2.00 38.00 X 0 316557 39469 JENELLE BERTOLINO CHIEF STRATEGY OFFICER - PART YEAR 2.00 38.00 X 0 333189 28977 KATHLEEN BERTRAM COO 0.30 2.00 X 0 212303 25683 RAYMOND DICKISON COO - FORMER 2.00 38.00 X 0 104261 995 0 1497749 123940 0 1 1 0 0 324920 324920 NURSING HOME OPERATIONS 623000 9740995 9740995 ASSISTED LIVING UNITS 623990 2332014 2332014 INDEPENDENT RETIREMENT APARTMENTS 623990 769715 769715 12842724 566 566 2985 2585 400 400 400 SECURITY DEPOSITS 623990 24300 24300 MEAL REVENUE 623990 19928 19928 DISCOUNT 623990 17307 17307 40908 40908 102443 13271053 12842724 0 103409 X 5718179 5229825 488354 6000 6000 588998 540143 48855 415050 379426 35624 781852 781852 3086 1750 1336 4206 4206 1874332 1799097 75235 36571 36571 238256 181943 56313 135105 135105 833989 794584 39405 11622 7558 4064 7367 3410 3957 763634 760015 3619 1007310 995987 11323 429139 429139 MEDICAL EXPENSES 513576 512908 668 RAW FOOD (DIETARY) 341087 341087 MEDICAID PARTICIPATION 110130 110130 COVID19 EXPENSES 84566 11085 73481 104036 25556 78480 14008091 12295319 1712772 0 5724 114743 1645758 1753490 9793 7027 41636 26176 29946674 15044248 15382554 14902426 14797 1549 5010505 4892672 22110767 21698083 726894 864589 510325 630626 16326873 16058451 1646251 1999266 19210343 19552932 X 2866917 2107547 33507 37604 2900424 2145151 22110767 21698083 X -737038 65 -18300 X X 0 1 X 1 1 1 X 23418 331304 693160 1088207 324920 2461009 23216051 14935517 11463404 11777768 12842724 74235464 23239469 15266821 12156564 12865975 13167644 76696473 452 250 225 450 1377 0 452 250 225 450 1377 76695096 90690 12553 1626 1697 566 107132 90690 12553 1626 1697 566 107132 13182 109404 62933 105550 102443 393512 23343341 15388778 12221123 12973222 13270653 77197117 0.99350 0.99270 0.00140 0.00230 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2018 AMOUNT: $ 9,760. 2019 AMOUNT: $ 1,598. 2020 AMOUNT: $ -1,381. BEAUTY AND BARBER SHOP - 2018 AMOUNT: $ 65,021. 2019 AMOUNT: $ 40,339. 2020 AMOUNT: $ 20,287. 2021 AMOUNT: $ 14,466. 2022 AMOUNT: $ 9,170. CABLE TV - 2018 AMOUNT: $ 15,014. 2019 AMOUNT: $ 16,583. 2020 AMOUNT: $ 14,161. 2021 AMOUNT: $ 12,963. 2022 AMOUNT: $ 13,057. TELEPHONE - 2018 AMOUNT: $ 8,592. 2019 AMOUNT: $ 8,171. 2020 AMOUNT: $ 7,173. 2021 AMOUNT: $ 12,470. 2022 AMOUNT: $ 16,047. MEAL REVENUE - 2018 AMOUNT: $ 21,484. 2019 AMOUNT: $ 20,960. 2020 AMOUNT: $ 4,898. 2021 AMOUNT: $ 32,060. 2022 AMOUNT: $ 19,928. INSURANCE GAIN - DEBT EXTINGUISHMENT - 2018 AMOUNT: $ -131,453. SPACE RENTAL - 2018 AMOUNT: $ 4,607. 2019 AMOUNT: $ 3,633. 2020 AMOUNT: $ 2,244. 2021 AMOUNT: $ 1,564. 2022 AMOUNT: $ 1,434. LAUNDRY AND HOUSEKEEPING SERVICES - 2018 AMOUNT: $ 552. 2019 AMOUNT: $ 1,380. ACTIVITIES REVENUE - 2018 AMOUNT: $ -1,550. 2019 AMOUNT: $ -359. DISCOUNTS - 2018 AMOUNT: $ 21,155. 2019 AMOUNT: $ 17,099. 2020 AMOUNT: $ 15,551. 2021 AMOUNT: $ 13,927. 2022 AMOUNT: $ 17,307. SECURITY DEPOSITS - 2021 AMOUNT: $ 18,000. 2022 AMOUNT: $ 24,300. GARAGE RENTAL - 2021 AMOUNT: $ 100. 2022 AMOUNT: $ 1,200. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1540 136 1676 1413 127 1540 1262 151 1413 1201528 361 1200627 1262 1158354 43174 1201528 1.00000 0.00000 0.00000 0 0 856908 856908 24539867 11212613 13327254 1364689 1162287 202402 3011766 2669348 342418 173444 173444 14902426 ACCRUED INTEREST RECEIVABLE 3 INTERCOMPANY RECEIVABLE 4396937 BOND FUND 480525 BENEFICIAL INTEREST IN CHF 15207 4892672 DUE TO APARTMENT RESIDENTS 1738209 SECURITY DEPOSITS PAYABLE 261057 1999266 PART IV, LINE 2B: RESIDENT FUNDS ARE AGENCY FUNDS HELD LOCALLY AT THE COMMUNITIES FOR THE INDIVIDUAL RESIDENTS' PERSONAL USE, RESIDENT SECURITY DEPOSITS, AND OTHER MISCELLANEOUS DEPOSITS. PART V, LINE 4: ORGANIZATION HOLDS FUNDS IN ENDOWMENT DESIGNATED BY THE BOARD OF DIRECTORS TO BE USED FOR RESIDENT CARE. 1 0 0 0 0 0 0 0 0 DONALD BELL CEO 0 480603 0 0 0 36086 0 15500 0 13316 0 545505 0 0 JENELLE BERTOLINO CHIEF STRATEGY OFFICER - PART YEAR 0 243612 0 0 0 89577 0 15500 0 13477 0 362166 0 0 CHUCK SCHMITZ CFO 0 302246 0 0 0 14311 0 15500 0 23969 0 356026 0 0 KATHLEEN BERTRAM COO 0 212303 0 0 0 0 0 0 0 25683 0 237986 0 0 RAYMOND DICKISON COO - FORMER 0 0 0 0 0 104261 0 0 0 995 0 105256 0 0 PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S CEO IS ESTABLISHED BY A RELATED ORGANIZATION, MIDWEST CHRISTIAN VILLAGES. MIDWEST CHRISTIAN VILLAGES USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4A RAYMOND DICKISON - $104,261 JENELLE BERTOLINO - $84,405 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 11B THE CFO AND THE CEO HAVE REVIEWED THE 990 PRIOR TO FILING. A DRAFT COPY OF THE 990 IS MADE AVAILABLE TO ALL DIRECTORS FOR THEIR REVIEW BEFORE FILING 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. THE BOARD OF DIRECTORS HAS ADOPTED A CONFLICT OF INTEREST POLICY. ANNUALLY EVERY BOARD MEMBER COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM AND IDENTIFIES ANY POTENTIAL CONFLICTS. THEY ALSO CERTIFY THAT THEY HAVE REVIEWED AND AGREE TO ABIDE BY THE CURRENT POLICY IN PLACE. IF A POTENTIAL CONFLICT ARISES IT IS REVIEWED BY THE BOARD OF DIRECTORS AND DISCUSSED AND VOTED ON. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, OFFICERS AND KEY EMPLOYEES IS DETERMINED BY A RELATED ORGANIZATION, MIDWEST CHRISTIAN VILLAGES. THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE CONSISTING OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS AND SUPPORTED BY THE ORGANIZATION'S VPHR. THE EXECUTIVE COMPENSATION COMMITTEE OPERATES UNDER A BOARD APPROVED CHARTER, COMPENSATION PHILOSOPHY AND RETAINS AN INDEPENDENT CONSULTANT TO COMPLETE A COMPREHENSIVE EXECUTIVE COMPENSATION EVALUATION UTILIZING CONSULTANT'S LIBRARY OF PUBLIC AND PRIVATE DATA SOURCES, SUPPLEMENTED BY THEIR EXPERIENCES IN THE INDUSTRY CULMINATING IN A WRITTEN REPORT SUBMITTED TO THE EXECUTIVE COMPENSATION COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE FINDINGS OF THE INDEPENDENT CONSULTANT, HAS THE OPPORTUNITY TO DISCUSS THE FINDINGS AMONG THE COMMITTEE MEMBERS AND WITH THE CONSULTANT. AS SPECIFIED BY THE BY-LAWS THE EXECUTIVE COMPENSATION COMMITTEE PROVIDES A RECOMMENDATION FOR THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF OTHER EXECUTIVE POSITIONS. THE EXECUTIVE COMPENSATION COMMITTEE PROVIDES THE COMMITTEE-APPROVED COMPENSATION PHILOSOPHY AND APPROVED COMPENSATION FOR THE CEO, COO AND CFO TO A THIRD PARTY TO OBTAIN A WRITTEN ASSESSMENT OF REASONABLENESS WITH THE CONTEXT OF THE STANDARDS SET FORTH UNDER THE INTERNAL REVENUE CODE SECTION 4958 AND RELATED DEPARTMENT OF TREASURY REGULATIONS. FORM 990, PART VI, SECTION C, LINE 19 ALTHOUGH NOT A REQUIREMENT, THE ORGANIZATION PROVIDES COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND OTHER DOCUMENTS TO ALL WHO REQUEST THESE ITEMS. THIS IS IN ADDITION TO INFORMATION POSTED ON ITS WEBSITE. FORM 990, PART IX, LINE 11G CONTRACTED SALARIES: PROGRAM SERVICE EXPENSES 1,267,623. MANAGEMENT AND GENERAL EXPENSES 33,166. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,300,789. CONTRACTED THERAPY: PROGRAM SERVICE EXPENSES 8,137. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,137. PROFESSIONAL & CONSULTING FEES: PROGRAM SERVICE EXPENSES 523,337. MANAGEMENT AND GENERAL EXPENSES 42,069. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 565,406. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE -33,507. CHANGE IN BENEFICIAL INTEREST IN RELATED PARTY 15,207. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS DURING THE TAX YEAR. CHRISTIAN HOMES INC 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 63141 370841562 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 10 N/A 0 LEWIS MEMORIAL CHRISTIAN VILLAGE 3400 WASHINGTON STREET SPRINGFIELD IL 62711 510173104 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IL 501(C)(3) LINE 10 N/A 0 HOOSIER CHRISTIAN VILLAGE INC 621 S SUGAR STREET BROWNSTOWN IN 47220 237423749 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(C)(3) LINE 10 N/A 0 SPRING RIVER CHRISTIAN VILLAGE INC 201 S NORTHPARK LANE JOPLIN MO 64801 431341462 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS MO 501(C)(3) LINE 10 N/A 0 CROWN POINT CHRISTIAN VILLAGE INC 6685 E 117TH ST CROWN POINT IN 46307 311114614 SKILLED NURSING FACILITY & RETIREMENT APARTMENTS IN 501(C)(3) LINE 10 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 10 N/A 0 MIDWEST SENIOR MINISTRIES INC 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 63141 201053401 PHARMACY SERVICES IL 501(C)(3) LINE 10 N/A 0 MIDWEST CHRISTIAN VILLAGES INC 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 63141 260275009 MGMT NURSING AND RETIREMENT COMMUNITIES IL 501(C)(3) LINE 10 N/A 0 CHRISTIAN HORIZONS CHARITABLE FOUNDATION 2 CITY PLACE DRIVE SUITE 200 ST LOUIS MO 63141 850509383 FUNDRAISING IL 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1