2023-10-19T12:34:31-05:00 2022-12-31 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 46240 990 2022-01-01 352187477 INDIANA MASONIC HOME INC INDI 3177366141 690 STATE STREET FRANKLIN IN 46131 MIKE SPENCER CEO 3177366141 2023-08-29 1 MIKE SPENCER 999009999 0 SCOTT A SCHUSTER P00019243 3175802000 2023-08-28 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z COMPASS PARK MIKE SPENCER 690 STATE STREET FRANKLIN IN 46131 17096988 0 X WWW.COMPASSPARK.ORG X 2003 IN TO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA. 18 16 400 0 514602 0 13547011 4391733 7421687 8592105 692537 478797 819147 952729 22480382 14415364 0 0 0 0 5519866 5538887 0 0 0 4934710 5169845 10454576 10708732 12025806 3706632 118593961 101048272 39063070 37960120 79530891 63088152 TO SERVE THE CHARITABLE PURPOSE OF OPERATING THE CONTINUING CARE RETIREMENT COMMUNITY KNOWN AS THE INDIANA MASONIC HOME IN FRANKLIN, INDIANA. 0 0 6990785 8592105 PROVIDE CARE FOR THE AGED. THE HOME PROVIDES HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITY CONTAINING INDEPENDENT LIVING HOMES AND APARTMENTS, ASSISTED LIVING APARTMENTS, AND A HEALTH CARE FACILITY LOCATED IN FRANKLIN, INDIANA. 6990785 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 42 0 1 400 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 IN X MIKE SPENCER 3173461404 690 STATE STREET FRANKLIN IN 46131 RICHARD J ELMAN GRAND SECRETARY 1.00 42.00 X X 0 108771 0 ERIC J VERMEULEN BOARD MEMBER 1.00 40.00 X 0 0 0 GARY W BRINLEY PRESIDENT 1.00 6.00 X X 0 0 0 CONSTANCE BRANIGAN BOARD MEMBER 1.00 X 0 0 0 RONALD L BUSKIRK VICE PRESIDENT 1.00 1.00 X X 0 0 0 RICHARD L LENTZ BOARD MEMBER 1.00 5.30 X 0 0 0 ANDY HUGHES BOARD MEMBER 1.00 X 0 0 0 BRIAN BATES BOARD MEMBER 1.00 X 0 0 0 CARL E CULMANN BOARD MEMBER 1.00 0.30 X 0 0 0 MICHAEL H DAVIS BOARD MEMBER 1.00 X 0 0 0 DON R REYNOLDS II TREASURER 1.00 X X 0 0 0 JERRY B MAPLE BOARD MEMBER 1.00 X 0 0 0 STEVEN A BATES BOARD MEMBER 1.00 X 0 0 0 ZACHARY R EHLARS BOARD MEMBER 1.00 X 0 0 0 STEVEN DOUGLAS BOARD MEMBER 1.00 X 0 0 0 ERIC TRACEY BOARD MEMBER 1.00 X 0 0 0 JAMES MURPHY BOARD MEMBER 1.00 X 0 0 0 DAVID MORGAN BOARD MEMBER 1.00 5.00 X 0 0 0 MIKE SPENCER CEO 40.00 X 233548 0 8891 WILLIAM PIERCE ADMINISTRATOR 40.00 X 168486 0 17314 SARAH BROCK REGISTERED NURSE 40.00 X 164212 0 7019 BETHANY GALLION HUMAN RESOURCE DIRECTOR 40.00 X 119717 0 2045 STEVE TREADWAY FOOD SERVICE DIRECTOR 40.00 X 118455 0 2045 MARDENA MCGLACKEN CONTROLLER 40.00 X 115738 0 8986 JENNIFER STEPHENS REGISTERED NURSE 40.00 X 109674 0 7019 MARISSA MEAHL DIRECTOR OF NURSHING 40.00 X 121945 0 0 1151775 108771 53319 8 0 1 0 GORDON FOOD SERVICE 3620 BETHANY ROAD INDIANAPOLIS IN 46268 FOOD SERVICES 424586 MCGOWAN INSURANCE GROUP INC 355 INDIANA AVE INDIANAPOLIS IN 46204 INSURANCE BROKERAGE 354032 HTS IN X INC 1500 AMERICAN WAY SUITE 110 GREENWOOD IN 46143 THERAPY 281379 RAYS DEMOLITION PO BOX 1 CLAYTON IN 46118 DEMOLITION SERVICES 169531 SENTRICS 265 CLYDE MORRIS BLVD SUITE 100 ORMOND BEAVH FL 32174 INFORMATION TECHNOLOGY 159552 8 457227 28975 3596176 309355 4391733 RESIDENCE SERVICES 623000 4580974 4580974 HEALTH CARE FACILITY 623000 1669500 1669500 MANAGEMENT FEES 623000 1213794 1213794 HOME HEALTH CARE 623000 1127837 1127837 8592105 215725 215725 2926195 2663123 263072 263072 263072 12165 28975 18501 -6336 -6336 DAYCARE INCOME 624410 495325 495325 OTHER INCOME 623990 463740 19277 444463 959065 14415364 8592105 514602 916924 X 242439 242439 2894158 1706152 1188006 76297 8017 68280 1533168 1384147 149021 792825 720636 72189 39232 39232 72640 72640 49955 49955 90361 19166 71195 121630 121630 317562 163938 153624 119348 50423 68925 766892 242985 523907 73284 73284 1017712 555158 462554 94406 51498 42908 298352 298352 REPAIRS & MAINTENANCE 752847 606941 145906 FOOD SERVICES 414895 414895 MEDICAL FEES, DRUGS, & 361814 361814 NON OPERATING EXPENSES 155263 87669 67594 423652 422432 1220 10708732 6990785 3717947 0 3543761 3893752 314422 686803 59044 70386 121713 119798 6334699 5882813 471380 451886 10159727 8808811 240001 240001 103683913 86776835 118593961 101048272 637665 778923 6297492 8479877 31938744 28562833 189169 138487 39063070 37960120 X -22476060 -20252517 102006951 83340669 79530891 63088152 118593961 101048272 X 3706632 -1757059 -18392312 X X 0 1 X 1 0 X 4970913 3828426 6421956 13547011 4391733 33160039 7612889 7221619 9208189 7421687 8592105 40056489 12583802 11050045 15630145 20968698 12983838 73216528 3648604 2758651 3603617 10600384 3598176 24209432 1837593 1110799 3311484 1513919 1072208 8846003 5486197 3869450 6915101 12114303 4670384 33055435 40161093 221775 166549 163580 158652 215725 926281 384072 340310 463797 514602 1702781 221775 550621 503890 622449 730327 2629062 8984 8984 261617 974872 370475 357645 444463 2409072 13067194 12584522 16504510 21948792 14158628 78263646 0.51320 0.44360 0.03360 0.04230 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: AUDIT ADJUSTMENT AND RECLASSIFICATIONS - 2019 AMOUNT: $ 672,273. OTHER INCOME - 2018 AMOUNT: $ 261,617. 2019 AMOUNT: $ 302,599. 2020 AMOUNT: $ 370,475. 2021 AMOUNT: $ 357,645. 2022 AMOUNT: $ 444,463. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4890540 4541673 348867 1444159 1341140 103019 451886 INTEREST IN NET ASSETS OF FOUNDATION 81110580 BENEFICIAL INTEREST IN TRUST 2196525 RECEIVABLE FROM DAVIESS COUNTY HOSPITAL 2328036 INTEREST RATE SWAP - FAIR VALUE 1120549 ADVANCE TO SUPPLIERS 21145 86776835 RESIDENT DEPOSITS 138487 138487 X 13696498 -1757059 1088148 -668911 14365409 49955 49955 14415364 10677278 18501 18501 10658777 49955 49955 10708732 PART X, LINE 2: THE HOME IS EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE THOUGH IT IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE INTERNAL REVENUE CODE. IN ADDITION, THE HOME HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME TAX FOR THE PERIOD ENDED DECEMBER 31, 2022 AND THE YEAR ENDED DECEMBER 31, 2021 THE HOME FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION RETURNS. IT IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR FISCAL YEARS BEFORE 2019. MANAGEMENT BELIEVES THAT THE HOME'S INCOME TAX FILING POSITION WILL BE SUSTAINED ON AUDIT AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WILL RESULT IN A MATERIAL CHANGE. PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SPECIAL EVENT 18,501. CHANGE IN VALUE OF INTEREST RATE SWAP 1,069,647. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM SPECIAL EVENT 18,501. GOLF OUTING 41140 28975 12165 18501 41140 28975 12165 18501 18501 -6336 X 0 0 0 0 0 0 0 0 0 MIKE SPENCER CEO 233548 0 0 0 0 0 0 0 8891 0 242439 0 0 0 WILLIAM PIERCE ADMINISTRATOR 168486 0 0 0 0 0 2976 0 14338 0 185800 0 0 0 SARAH BROCK REGISTERED NURSE 164212 0 0 0 0 0 0 0 7019 0 171231 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT WILL REVIEW THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C CEO SOLICITS INFORMATION ANNUALLY ON POTENTIAL CONFLICTS OF INTEREST. INFORMATION IS REVIEWED BY CEO AND PRESIDENT OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED USING COMPARABILITY DATA, APPROVED BY THE BOARD AND DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. ANNUAL STATE DISCLOSURE STATEMENT IS AVAILABLE TO ALL POTENTIAL NEW RESIDENTS. FORM 990, PART IX, LINE 24E BAD DEBT EXPENSE: PROGRAM SERVICE EXPENSES 130,798. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 130,798. RESIDENT SUPPLIES & ALLOWANCES: PROGRAM SERVICE EXPENSES 118,437. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 118,437. PASTORAL CARE: PROGRAM SERVICE EXPENSES 98,821. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 98,821. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 43,050. MANAGEMENT AND GENERAL EXPENSES 928. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,978. EQUIPMENT RENTAL & LEASING: PROGRAM SERVICE EXPENSES 31,245. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,245. HOME SUPPLIES & LAUNDRY: PROGRAM SERVICE EXPENSES 81. MANAGEMENT AND GENERAL EXPENSES 292. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 373. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS -3,596,176. CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION -14,510,623. CHANGE IN BENEFICIAL INTEREST IN TRUST -559,483. TRANSFER OF ASSETS TO INDIANA MASONIC HOME, INC. -795,677. CHANGE IN INTEREST RATE SWAP 1,069,647. FORM 990, PART XII, LINE 2C THE PROCESS HAD NOT CHANGED. FORM 990, PART VI, SECTION B, LINE 14 RECORD RETENTION AND DESTRUCTION POLICY MEDICAL RECORDS OF THE ORGANIZATION ARE GOVERNED BY A RETENTION AND STORAGE POLICY, AS WELL AS A CLOSED CHART POLICY. INDIANA MASONIC HOME FOUNDATION INC 525 N ILLINOIS ST INDIANAPOLIS IN 46204 351091997 PROVIDE SUPPORT TO THE INDIANA MASONIC HOME IN 501(C)(3) LINE 12D, III-O N/A 0 IMH REALTY INC 690 STATE STREET FRANKLIN IN 46131 364513246 PROVIDE PROPERTY TO ENSURE THE RESIDENTIAL AND MEDICAL CARE FOR THE ELDERLY IN 501(C)(2) N/A 0 GRAND LODGE FREE AND ACCEPTED MASONS OF THE STATE OF INDIANA 525 N ILLINOIS ST INDIANAPOLIS IN 46204 350300010 FRATERNAL ORGANIZATION IN 501(C)(8) & (C)(10) N/A 0 ALPHA STAFFING GROUP INC 690 S STATE ST FRANKLIN IN 46131 881241043 STAFFING AGENCY IN INDIANA MASONIC HOME INC C -87 23966 1.00000 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 IMH REALTY I 795677 FAIR MARKET VALUE