2024-11-11T06:58:50-06:00 2023-12-31 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2023-01-01 351447417 GRACE VILLAGE HEALTHCARE FACILITY INC GRAC 5743726290 337 GRACE VILLAGE DRIVE WINONA LAKE IN 46590 MARK SCHWOB DIRECTOR OF FINANCE 5743726498 2024-11-09 1 1 EMILIE M KNIERIEM CPA P01330194 3176334705 2024-11-09 2023 2024-10-15 13:58:12Z JUSTIN KIMBRELL 337 GRACE VILLAGE DRIVE WINONA LAKE IN 46590 12264229 0 X GRACEVILLAGE.ORG X 1978 IN GRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY. 11 11 178 35 0 0 34330 2223321 3233341 9724953 69107 167922 41011 109486 3377789 12225682 0 0 0 0 2685936 4916823 0 0 28248 512545 6158679 3198481 11075502 179308 1150180 4763917 5597331 4431145 4177634 332772 1419697 GRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY. 0 0 9100308 9724953 GRACE VILLAGE HEALTHCARE PROVIDES MEDICAL AND NURSING CARE, WHICH INCLUDES BUT IS NOT LIMITED TO HOUSING, NURSING, DIETARY, SOCIAL SERVICES, AND ACTIVITIES FOR THE ELDERLY IN WINONA LAKE, INDIANA. GRACE VILLAGE LEASES ITS NURSING HOME OPERATIONS TO WOODLAWN HOSPITAL. 9100308 1 1 0 0 0 0 0 0 0 1 1 1 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 0 1 1 0 0 0 1 30 0 1 178 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 0 0 IN X MARK SCHWOB - DIRECTOR OF FINANCE 5743726290 337 GRACE VILLAGE DRIVE WINONA LAKE IN 46590 CHAD HUMMEL CHAIR 0.50 0.50 X X 0 0 0 ADAM LENON SECRETARY & TREASURER 0.50 0.50 X X 0 0 0 GLENN HALL BOARD MEMBER 0.50 0.50 X 0 0 0 CHUCK JOSEY BOARD MEMBER 0.50 0.50 X 0 0 0 DAVID KOONTZ BOARD MEMBER 0.50 0.50 X 0 0 0 DAN LEININGER BOARD MEMBER 0.50 0.50 X 0 0 0 MARK MCCOLLOM BOARD MEMBER 0.50 0.50 X 0 0 0 JENNIFER PIERCE BOARD MEMBER 0.50 0.50 X 0 0 0 DALE ROBBINS BOARD MEMBER 0.50 0.50 X 0 0 0 ROGER WEIDEMAN BOARD MEMBER 0.50 0.50 X 0 0 0 MIKE MCKENNIS BOARD MEMBER 0.50 0.50 X 0 0 0 JUSTIN KIMBRELL CEO 28.00 12.00 X 206935 0 22500 SONDREA HAMILTON CFO/HFA - PARTIAL TERM 28.00 12.00 X 82049 0 5052 NICOLE KUBLEY RN/DON 40.00 0.00 X 100412 0 9952 COURTNEY WALLEN LPN 40.00 0.00 X 141764 0 7088 JENNA MODGLIN RN/MDS 40.00 0.00 X 101963 0 0 633123 0 44592 4 0 1 0 MORRISON MANAGEMENT SPECIALISTS INC 2400 YORKMONT ROAD CHARLOTTE NY 28217 DIETARY SERVICES 1726307 SERVICE MASTER BY CROSSWORDS 2851 N WEBSTER AVE INDIANAPOLIS IN 46219 RESTORATION SERVICES 430693 TITAN NURSE STAFFING LLC 2110 S 169TH PLAZA OMAHA NE 68130 CONTRACT NURSING 208114 WINONA IT LLC 1037 MARINERS DRIVE WARSAW IN 46580 INFORMATION TECHNOLOGY 121384 UNITED STAFFING SOLUTIONS PO BOX 219472 KANSAS CITY MO 64121 CONTRACT NURSING 102108 5 2151119 72202 2223321 MANAGEMENT REVENUE 623000 9116373 9116373 LEASE REVENUE 623000 608580 608580 9724953 206469 206469 12000 12000 37818 729 -37818 -729 -38547 -38547 MISCELLANEOUS INCOME 900099 97486 97486 97486 12225682 9724953 0 277408 X 229435 229435 3873679 3164555 697315 11809 30558 24964 5501 93 473206 374163 97647 1396 309945 253206 55794 945 173244 173244 2967916 2704555 261662 1699 62770 47989 13709 1072 574701 509848 59860 4993 942663 848395 94268 188118 169306 18812 388270 349443 38827 112085 112085 WOODLAWN GRACE EXPENSES 726538 653884 72654 0 OTHER EXPENSES 18707 0 4493 14214 DUES & SUBSCRIPTIONS 12253 0 11640 613 EXPENSE ALLOCATION -8586 0 0 -8586 11075502 9100308 1946946 28248 116737 900410 1832 178867 71981 71982 73161 80510 9385710 6214211 3266602 3171499 968177 1040758 265427 153305 4763917 5597331 547669 449039 3722142 3582241 161334 146354 4431145 4177634 X -464150 587061 796922 832636 332772 1419697 4763917 5597331 X 1150180 -1123 -62132 X X 0 1 X 1 0 X 131577 1278103 1297259 34330 72202 2813471 9326207 7544056 7391886 3233341 9724953 37220443 9457784 8822159 8689145 3267671 9797155 40033914 0 0 0 40033914 137085 129626 98069 69538 224469 658787 137085 129626 98069 69538 224469 658787 1078 1078 27481 35011 2248605 2313253 9595947 8952863 8814695 3372220 12270229 43005954 0.93090 0.98530 0.01530 0.01310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 878764 -2392 82228 114794 843806 802060 73387 7262 3945 878764 759012 156546 11920 125418 802060 747776 118392 11059 118215 759012 713721 113474 17503 96922 747776 0.00000 0.71695 0.28305 0 0 5145047 3246422 1898625 1551692 1099849 451843 2648866 1867940 780926 40105 40105 3171499 SCHWAB - CARING FRIENDS ENDOWMENT 800673 C CAPITAL INVESTMENT - SAMARITAN ALLI 133892 C THUMS INVESTMENT 106193 C 1040758 DEFERRED COMPENSATION PLAN OBLIGATIONS 147209 LOAN INSURANCE COST -855 146354 X 15632879 -1122 3470451 3469329 12163550 62132 62132 12225682 14273983 3198481 3198481 11075502 0 11075502 PART V, LINE 4: THE CARING FRIENDS ENDOWMENT FUND IS TO FINANCIALLY ASSIST LONG TIME RESIDENTS AT GRACE VILLAGE THAT HAVE DEPLETED THEIR FINANCES. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THEIR ORGANIZATIONS AND RECOGNIZE A TAX LIABILITY IF THEY HAVE TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY GRACE AND NATIONAL FELLOWSHIP AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE, GAINS, AND OTHER SUPPORT REPORTED ON 2022 SHORT-YEAR FORM 990 FOR THE PERIOD JULY 1, 2022 TO DECEMBER 31, 2022 INCLUDED IN AUDITED FINANCIAL STATEMENTS 3,470,451. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON INTEREST RATE SWAP 62,132. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES AND LOSSES REPORTED ON 2022 SHORT-YEAR FORM 990 FOR THE PERIOD JULY 1, 2022 TO DECEMBER 31, 2022 INCLUDED IN AUDITED FINANCIAL STATEMENTS 3,198,481. X 0 0 0 0 0 0 0 0 0 JUSTIN KIMBRELL CEO 206935 0 0 0 0 0 22500 0 0 0 229435 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE CFO ASSISTS BLUE & CO., LLC IN PREPARATION OF THE 990 BEFORE IT IS FILED. THE CFO REVIEWS THE FORM 990 BEFORE IT IS FILED. BLUE & CO. FILES THE FORM 990 ONCE FINAL APPROVAL IS RECEIVED FROM THE CFO. THE CEO AND FULL BOARD ARE GIVEN A COPY OF THE FORM 990 UPON COMPLETION OF THE PREPARATION AND FILING. FORM 990, PART VI, SECTION B, LINE 12C GRACE VILLAGE TRIES TO AVOID SITUATIONS THAT COULD POTENTIALLY BE SEEN AS CONFLICTS OF INTEREST. IF A CONFLICT IS FOUND, IT IS DEALT WITH ON A CASE BY CASE BASIS, AND THE BOARD OF DIRECTORS MAKES A DECISION AS TO MATERIALITY OF THE CONFLICT, AND WHETHER TO TERMINATE TRANSACTIONS WITH PARTIES THAT HAVE A CONFLICT OF INTEREST. CONFLICTS OF INTEREST ARE MONITORED AND DEALT WITH AT EVERY LEVEL OF THE ORGANIZATION, FROM HOURLY EMPLOYEES, TO SALARIED EMPLOYEES, TO BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S SALARY IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,704,555. MANAGEMENT AND GENERAL EXPENSES 261,662. FUNDRAISING EXPENSES 1,699. TOTAL EXPENSES 2,967,916. FORM 990, PART XI, LINE 9: GAIN (LOSS) ON INTEREST RATE SWAP -62,132. FORM 990, PART XII, LINE 2C THE PROCESS FOR THE SELECTION OF INDEPENDENT ACCOUNTANT AND OVERSIGHT OF SUCH PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INC 337 GRACE VILLAGE DRIVE WINONA LAKE IN 46590 351282401 RETIREMENT HOME IN 501C3 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0