2023-04-25T10:39:36-05:00 2022-06-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2021-07-01 820986068 FV SERVICES INC FVSE 3124636320 12563 VILLAGE CIRCLE DRIVE ST LOUIS MO 63127 JAMES T WALSH PRESIDENT 3124636320 2023-04-21 1 JAMES WALSH XXX-XX-XXXX AMBER ROGNAN-HAMILTON P01251012 3149254300 2023-04-21 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z JAMES T WALSH 12563 VILLAGE CIRCLE DRIVE ST LOUIS MO 63127 4945677 0 X WWW.FRIENDSHIPVILLAGESTL.COM X 2017 MO TO PERFORM THE FUNCTIONS OF, AND/OR TO CARRY OUT THE PURPOSES OF FRIENDSHIP VILLAGE OF SOUTH COUNTY, FRIENDSHIP VILLAGE OF WEST COUNTY AND ANY OTHER CONTROLLED AFFILIATE OF THE CORPORATION. 11 2 87 2 0 0 0 0 6992094 4937159 13 80 3713 8438 6995820 4945677 0 6741 0 0 5252346 3636734 0 0 0 1982571 1704678 7234917 5348153 -239097 -402476 7345629 4517298 8874528 6448673 -1528899 -1931375 GUIDED BY BIBLICAL VALUES, FV SERVICES, INC. AIMS TO CONTINUALLY SERVE THE SENIOR COMMUNITY WITH QUALITY OFFERINGS THAT PROMOTE LIFELONG WELL-BEING. 0 0 1827482 2399 2765910 FRIENDSHIP VILLAGE AT HOME - FOR THOSE NOT LIVING ON ONE OF OUR CAMPUSES, BRINGING EXTENSIVE EXPERIENCE AND QUALITY CARE TO MEDICARE HOME HEALTH AND PRIVATE DUTY. WHETHER YOU NEED PRIVATE DUTY HOME CARE OR MEDICARE HOME HEALTH, YOU CAN TRUST FRIENDSHIP VILLAGE AND ITS PARTNERS TO DELIVER THE BEST CARE TO YOU OR YOUR LOVES ONES. 503223 0 565630 FV AT HOME - SUPPORTIVE SERVICES, LLC - OUR EXPERIENCED TEAM PROVIDES A RANGE OF SUPPORTIVE SERVICES TO HELP YOU LIVE THE LIFE YOU LOVE IN YOUR CHESTERFIELD OR SUNSET HILLS INDEPENDENT LIVING APARTMENT. THESE SERVICES ARE CUSTOMIZED AND DESIGNED AROUND YOU AT AN AFFORDABLE RATE TO HELP YOU REMAIN INDEPENDENT AS LONG AS POSSIBLE. SERVICES INCLUDE MEAL PREPARATION, LIGHT HOUSEKEEPING, COMPANIONSHIP, ASSISTANCE WITH BATHING, DRESSING AND GROOMING, LAUNDRY AND LINEN SERVICE, MEDICATION REMINDERS, SHOPPING AND ERRANDS, TRANSPORTATION AND MORE. 160396 4342 1605619 FV MANAGEMENT PROVIDES STRATEGIC DEVELOPMENT AND MANAGEMENT FOCUS TO IMPROVE EFFECTIVENESS AND QUALITY OF THE SERVICES PROVIDED BY ITS SUPPORTED ORGANIZATIONS WITHIN THE FRIENDSHIP VILLAGE SYSTEM. 2491101 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 128 0 87 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 2 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X TIM VOSSE 3148426840 12563 VILLAGE CIRCLE DRIVE ST LOUIS MO 63127 KEITH UTLEY BOARD MEMBER 1.00 2.00 X 10000 0 0 CINDY BOLSTAD BOARD MEMBER 4.00 1.00 X 10000 0 0 FRED G SUTTON BOARD MEMBER 4.00 2.00 X 10000 0 0 JOHN FASICK BOARD MEMBER 2.00 1.00 X 10000 0 0 DAVID GIFFIN BOARD MEMBER 1.00 0.00 X 10000 0 0 JEFFERY L KLINGER SECRETARY 2.00 2.00 X X 0 0 0 JAMES S DIEL III VICE-PRESIDENT 2.00 0.00 X X 12000 0 0 JOSH WRIGHT TREASURER 2.00 1.00 X X 12000 0 0 JAMES T WALSH PRES/CEO/FVSH ED 14.00 28.00 X X 350877 0 27470 DANIEL WACKER BOARD MEMBER 1.00 2.00 X 0 0 0 LYDIA SEIBERT CHAIR 5.00 1.00 X X 15000 0 0 GAYLE RANDA CHIEF HUMAN RESOURCES OFFICER 14.00 28.00 X 220910 0 17271 CARMEN FRONCZAK CHIEF STRATEGY OFFICER 14.00 28.00 X 308736 0 23078 TIM VOSSE CFO 14.00 28.00 X 278020 0 9065 EMINA KRAJINA EXECUTIVE DIRECTOR, FV AT HOME 40.00 0.00 X 128402 0 10300 JEFF LEWIS SENIOR DIRECTOR ACCOUNTING 14.00 28.00 X 119417 0 16020 JILL FREIN SENIOR DIRECTOR CAPITAL PLANNING 14.00 28.00 X 138929 0 21174 RICHARD WARE SENIOR IT DIRECTOR 14.00 28.00 X 116556 0 19978 TIMOTHY KNOLL SR. DIRECTOR, VILLAGE SERVICES 14.00 28.00 X 133366 0 20688 1884213 0 165044 12 0 1 0 SELECT REHABILITATION PO BOX 71985 CHICAGO IL 60694 OUTSOURCED PHYSICAL THERAPY FOR RESIDENT 2960427 UNITED SCRIPTS LTC LLC 1861 CRAIG PARK CT MARYLAND HEIGHTS MO 63146 PHARMACEUTICALS 543357 ATTANE INC 8880 WARD PKWY STE 400 KANSAS CITY MO 64114 MARKETING CONSULTANTS 450759 SINGLE DIGITS INC PO BOX 93363 LAS VEGAS NV 89193 INTERNET SERVICES 283488 WESTERN SPECIALTY CONTRACTORS 7401 ALABAMA AVE ST LOUIS MO 63111 MAINTENANCE AND RESTORATION 197665 10 HOME HEALTH INCOME 621610 2765910 2765910 MANAGEMENT FEES 541610 1605619 1605619 SUPPORTIVE SERVICES IN 621610 565630 565630 4937159 80 80 FOOD 621610 6415 6415 EMPLOYEE MEALS 621610 2023 2023 8438 4945677 4937159 0 8518 X 6741 6741 463191 463191 2674575 1371330 1303245 6271 2699 3572 300323 158114 142209 192374 100499 91875 46655 46655 13009 13009 71105 71105 867325 724988 142337 28875 28875 112624 22323 90301 261450 3045 258405 24000 24000 124026 72540 51486 9887 9887 64651 64651 3372 3372 15483 15483 RECRUITING 27819 27819 BAD DEBT 25450 25450 PROFESSIONAL DUES 5076 5076 LICENSES AND FEES 2248 2248 1623 1623 5348153 2491101 2857052 0 5666086 1369226 500664 2002794 676903 683909 80138 42903 26554 8088 21838 18466 400000 400000 7345629 4517298 1384749 1388266 7489779 5060407 8874528 6448673 X -1528899 -1931375 -1528899 -1931375 7345629 4517298 -402476 0 X X 0 1 X 1 0 X X X 2 FRIENDSHIP VILLAGE OF WEST COUNTY 237333148 10 1 0 2674077 FRIENDSHIP VILLAGE OF SOUTH COUNTY 431155242 10 1 0 2674076 2 0 5348153 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 26554 8088 18466 18466 DUE TO RELATED PARTY 5060407 5060407 X PART X, LINE 2: THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. 1 EDUCATIONAL ASSISTANCE 5 6741 PART I, LINE 2: PRIOR TO TAKING TO TAKING THE COURSE, EMPLOYEES PROVIDE SUPERVISOR WITH INFORMATION ABOUT THE COURSE FOR WHICH HE/SHE WOULD LIKE TO TAKE AND RECEIVE A REIMBURSEMENT. THE "PRE-APPROVAL" SECTION OF THE "TUITION REIMBURSEMENT FORM" IS COMPLETED AND ALL THE APPROPRIATE SIGNATURES OBTAINED PRIOR TO ENROLLMENT. UPON COMPLETION OF THE COURSE AND TO RECEIVE REIMBURSEMENT, THE EMPLOYEE MUST SUBMIT TO THE HUMAN RESOURCES DEPARTMENT DOCUMENTATION TO VERIFY COURSES, COSTS, AND PAYMENTS APPLIED, INCLUDING ANY AND ALL SCHOLARSHIPS, GRANTS, AND LOANS RECEIVED. X X X 0 0 0 0 0 0 0 0 0 JAMES T WALSH PRES/CEO/FVSH ED 350877 0 0 0 0 0 12250 0 15220 0 378347 0 0 0 CARMEN FRONCZAK CHIEF STRATEGY OFFICER 275403 0 33333 0 0 0 7858 0 15220 0 331814 0 0 0 TIM VOSSE CFO 244687 0 33333 0 0 0 9065 0 0 0 287085 0 0 0 GAYLE RANDA CHIEF HUMAN RESOURCES OFFICER 167577 0 53333 0 0 0 2051 0 15220 0 238181 0 0 0 JILL FREIN SENIOR DIRECTOR CAPITAL PLANNING 115149 0 23780 0 0 0 5954 0 15220 0 160103 0 0 0 TIMOTHY KNOLL SR. DIRECTOR, VILLAGE SERVICES 121366 0 12000 0 0 0 5468 0 15220 0 154054 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE BOARD PRESIDENT. AFTER THE INITIAL REVIEW THE FINAL RETURN IS THEN SENT TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST POLICY ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 TO DETERMINE SALARIES, EVERY YEAR THE MANAGEMENT COMPANY PARTICIPATES IN AN INDEPENDENT COMPANY'S EXECUTIVE STUDY FOR ALL POSITIONS AND COMPARE THOSE SALARIES WITH THE SALARIES THAT ARE ACTUALLY BEING PAID. THIS SURVEY COMPRISES DATA OF COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THIS IS THEN REVIEWED AND APPROVED BY THE BOARD COMPENSATION COMMITTEE TO DETERMINE APPROPRIATE SALARIES. THIS COMMITTEE IS COMPRISED OF ONLY INDEPENDENT BOARD MEMBERS. CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT ARE KEPT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G THERAPY: PROGRAM SERVICE EXPENSES 724,988. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 724,988. CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 142,337. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 142,337. FORM 990, PART XII, LINE 2C PROCESSES HAVE NOT CHANGED FROM PRIOR YEARS. PART V, LINE 1A 1099'S ARE ISSUED BY A DISREGARDED ENTITY, FV OPERATIONS. FRIENDSHIP VILLAGE AT HOME LLC 12563 VILLAGE CIRCLE DR SUNSET HILLS MO 63127 364871531 AT HOME CARE SERVICES MO FV SERVICES INC FV MANAGEMENT LLC 12563 VILLAGE CIRCLE DR SUNSET HILLS MO 63127 364871317 MANAGEMENT SERVICES MO 1636813 1160724 FV SERVICES INC FV OPERATIONS LLC 12563 VILLAGE CIRCLE DR SUNSET HILLS MO 63127 301006223 HOLDING COMPANY MO 2946613 FV SERVICES INC FV VENTURES LLC 12563 VILLAGE CIRCLE DR SUNSET HILLS MO 63127 301006196 DEVELOPMENT COMPANY MO FV SERVICES INC FV AT HOME - SUPPORTIVE SERVICES LLC 12563 VILLAGE CIRCLE DR SUNSET HILLS MO 63127 320558669 PRIVATE DUTY AT HOME CARE SERVICES MO 566683 193496 FV SERVICES INC FV AT HOME - HOME HEALTH LLC 12563 VILLAGE CIRCLE DR SUNSET HILLS MO 63127 352621672 MEDICARE HOME HEALTH SERVICES MO 2766861 1371671 FV SERVICES INC BRANCHWOOD LLC 12563 VILLAGE CIRCLE DR SUNSET HILLS MO 63127 844096360 HOLDING COMPANY MO FV SERVICES INC FRIENDSHIP VILLAGE OF WEST COUNTY 15201 OLIVE BOULEVARD ST LOUIS MO 63017 237333148 PROVIDE SENIOR CITIZENS WITH QUALITY HOUSING AND HOME CARE MO 501(C)(3) LINE 10 FV SERVICES INC 1 FRIENDSHIP VILLAGE OF SOUTH COUNTY 12563 VILLAGE CIRCLE DRIVE ST LOUIS MO 63127 431155242 PROVIDE SENIOR CITIZENS WITH QUALITY HOUSING AND HOME CARE MO 501(C)(3) LINE 10 FV SERVICES INC 1 0 0 0 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 FV AT HOME - HOME HEALTH LLC D 1608923 GL FV - CHESTERFIELD E 2293634 GL FV - SUNSET HILLS E 2767928 GL FV MANAGEMENT E 1117266 GL FV OPERATIONS E 718337 GL FV AT HOME - SUPPORTIVE SERVICES D 226677 GL FV - CHESTERFIELD L 667592 ALLOCATION FV - SUNSET HILLS L 891373 ALLOCATION FV - SUNSET HILLS O 2756172 GL FV - CHESTERFIELD O 2054601 GL FV AT HOME - HOME HEALTH LLC L 150337 ALLOCATION FV AT HOME - SUPPORTIVE SERVICES L 50112 ALLOCATION