2023-11-15T12:51:29-06:00 2022-12-31 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2022-01-01 481199065 VILLAGE SHALOM INC VILL 9133172600 5500 WEST 123RD STREET OVERLAND PARK KS 66209 SHARON LATIMER CFO 9133172600 2023-11-15 1 SHARON LATIMER XXX-XX-XXXX 0 KERRI N BOGDA CPA P00760402 7177404863 2023-11-09 X 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MATTHEW E LEWIS 5500 WEST 123RD STREET OVERLAND PARK KS 66209 28471659 0 X WWW.VILLAGESHALOM.ORG X 1996 KS HIGH QUALITY RESIDENT CARE TO SENIORS TO SUPPORT THEIR HIGHEST LEVEL OF INDEPENDENCE. 21 21 250 33 0 0 2621316 3898452 16827963 19093890 49641 193566 144456 232833 19643376 23418741 138771 48557 0 0 9080417 9647254 0 0 290682 18317216 19449539 27536404 29145350 -7893028 -5726609 95247964 94838189 95054103 101283157 193861 -6444968 X OUR MISSION IS TO NURTURE THE PHYSICAL, EMOTIONAL, SOCIAL AND SPIRITUAL WELL-BEING OF EVERY INDIVIDUAL WHOM WE ARE PRIVILEGED TO SERVE, INSPIRED BY OUR HERITAGE AS A JEWISH-SPONSORED CONTINUING-CARE RETIREMENT COMMUNITY. 0 0 23876618 48557 19093890 ACROSS THE SPECTRUM OF OUR PROGRAMS AND SERVICES, VILLAGE SHALOM IS COMMITTED TO A PHILOSOPHY OF PROVIDING CARE THAT SUPPORTS THE HIGHEST LEVEL OF INDEPENDENCE FOR AN INDIVIDUAL. MOREOVER, WE ARE COMMITTED TO PROVIDING SENIORS WITH THE HIGHEST QUALITY CARE REGARDLESS OF THEIR LEVEL OF NEED, FROM BASIC RETIREMENT LIVING TO FULL NURSING CARE, AND REGARDLESS OF THEIR ABILITY TO PAY. FOR OVER 100 YEARS, VILLAGE SHALOM HAS PROVIDED EXCEPTIONAL LONG-TERM CARE FOR SENIORS IN THE GREATER KANSAS CITY AREA. WE ARE PLEASED TO BE ABLE TO OFFER TAILORED PROGRAMS AND SERVICES TO SENIORS IN AN AWARD-WINNING INNOVATIVE ENVIRONMENT THAT PROVIDES MAXIMUM INDEPENDENCE TO OUR RESIDENTS. VILLAGE SHALOM IS, AND REMAINS, A LEADER WITHIN THE SENIOR LIVING CARE INDUSTRY. VILLAGE SHALOM COMMITS TIME AND RESOURCES AND RETAINS OUTSTANDING PROFESSIONALS DEVOTED TO DEVELOPING NEW AND INNOVATIVE SERVICES THAT ENRICH THE LIVES OF SENIORS REGARDLESS OF ECONOMIC RESOURCES. NEARLY ONE FOURTH OF THE RESIDENTS AT VILLAGE SHALOM ARE RECIPIENTS OF MORE THAN $1.7 MILLION IN FINANCIAL ASSISTANCE. OUR FINANCIAL ASSISTANCE PROGRAM ACCOMPLISHES OUR MISSION BY ENSURING ALL RESIDENTS, EVEN THOSE WHO HAVE EXHAUSTED THEIR FINANCIAL RESOURCES, OR HAVE COME TO US WITH NO RESOURCES, ARE PROVIDED 24/7 NURSING CARE, THERAPIES, PRESCRIPTION MANAGEMENT, ENGAGING PROGRAMMING, INDIVIDUALIZED AND GROUP WELLNESS OPPORTUNITIES, CUSTOMIZED MEALS PER DIETARY RESTRICTIONS, AND A SAFE AND SECURE PLACE TO CALL HOME. THEIR DIGNITY, PRIVACY, AND LONG-TERM CARE ARE OUR PRIMARY CONCERN. NO RESIDENT HAS EVER BEEN ASKED TO LEAVE DUE TO THE INABILITY TO PAY FOR THE COST OF THEIR CARE. THIS IS UNIQUE IN SENIOR LIVING AND A POINT OF PRIDE FOR VILLAGE SHALOM.THE ORGANIZATION PROVIDES SERVICES TO RESIDENTS WHO MEET CERTAIN CRITERIA UNDER ITS BENEVOLENT CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS BENEVOLENT CARE, THE AMOUNTS ARE NOT REPORTED AS REVENUE. 23876618 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 32 0 250 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 21 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KS X SIMON ABRAHAMS CFO 9132668403 5500 WEST 123RD STREET OVERLAND PARK KS 66209 BOB GERSHON CHAIR 1.00 0.00 X X 0 0 0 NEAL SCHWARTZ VICE CHAIR 1.00 0.00 X X 0 0 0 SIMON ABRAHMS TREASURER 1.00 0.00 X X 0 0 0 RACHEL KRANTZ SECRETARY 1.00 0.00 X X 0 0 0 ASHASHLEY ALPERT DIRECTOR 1.00 0.00 X 0 0 0 ROBERT BARAN DIRECTOR 1.00 0.00 X 0 0 0 ALLISON BEREY DIRECTOR 1.00 0.00 X 0 0 0 IRENE BETTINGER DIRECTOR 1.00 0.00 X 0 0 0 SHIRLEY HELZBERG DIRECTOR 1.00 0.00 X 0 0 0 JAMES KLEIN DIRECTOR 1.00 0.00 X 0 0 0 JEREMY KRASHIN DIRECTOR 1.00 0.00 X 0 0 0 FRANK LIPSMAN DIRECTOR 1.00 0.00 X 0 0 0 AMANDA PALAN DIRECTOR 1.00 0.00 X 0 0 0 ROSANNE ROSEN DIRECTOR 1.00 0.00 X 0 0 0 STEVE RUBEN DIRECTOR 1.00 0.00 X 0 0 0 TRACY SHAFTON DIRECTOR 1.00 0.00 X 0 0 0 KEN SIGMAN DIRECTOR 1.00 0.00 X 0 0 0 DAVID SPIZMAN DIRECTOR 1.00 0.00 X 0 0 0 STEWART STEIN DIRECTOR 1.00 0.00 X 0 0 0 TODD STETTNER DIRECTOR 1.00 0.00 X 0 0 0 BEN WARNER DIRECTOR 1.00 0.00 X 0 0 0 LESLIE MARKS DIRECTOR (UNTIL 6/30/22) 1.00 0.00 X 0 0 0 BARRY FINK DIRECTOR (UNTIL 6/30/22) 1.00 0.00 X 0 0 0 ALANA MULLER DIRECTOR (UNTIL 6/30/22) 1.00 0.00 X 0 0 0 MATTHEW LEWIS PRESIDENT/CEO 40.00 0.00 X 323877 0 33814 SHARON LATIMER CFO 40.00 0.00 X 147455 0 30847 JILL ALLIN DIRECTOR OF SALES & MARKETING 40.00 0.00 X 146656 0 16161 NIKOL TERRILL DIRECTOR OF PHILANTHROPY 40.00 0.00 X 102907 0 6889 TAMI MIDDLETON DIRECTOR OF HUMAN RESOURCES 40.00 0.00 X 111081 0 11412 JAMIE PAREDES CHIEF OPERATING OFFICER 40.00 0.00 X 128750 0 5186 960726 0 104309 6 0 1 0 UNIDINE PO BOX 102289 ATLANTA GA 30368 DINING CONTRACTOR 2880648 AL HUBER INC 10770 EL MONTE OVERLAND PARK KS 66211 CONSTRUCTION SERVICES 735713 SUMMIT CARE INC 6731 W 121ST STREET SUITE 10 OVERLAND PARK KS 66209 CLINICAL STAFFING 539107 HERMES COMPANY INC 13030 W 87TH STREET PARKWAY LENEXA KS 66215 LANDSCAPING SERVICES 462159 ZACK GROUP A LYNN CARE LLC COMPANY 6600 COLLEGE BLVD STE 300 OVERLAND PARK KS 66211 CLINICAL STAFFING 344469 27 84435 3814017 3898452 RESIDENT CARE REVENUE 623000 19093890 19093890 19093890 101411 101411 5145073 5046362 6556 98711 -6556 92155 92155 INSURANCE REIMBURSEMENT 623000 166302 166302 WELLNESS CENTER 623000 20159 20159 REIMBURSEMENTS 623000 16507 16507 29865 29865 232833 23418741 19093890 0 426399 X 48557 48557 535993 395782 127206 13005 7580503 5597516 1799060 183927 33753 25568 7603 582 917130 676574 218067 22489 579875 435942 129426 14507 42503 42503 227993 227993 132005 132005 3564 3564 33192 33192 6607096 5940069 663253 3774 46001 83 45918 577152 298606 229455 49091 271962 2724 269238 1231334 1084164 147170 55603 47270 8291 42 1599 1599 2562448 2562448 4500592 4500592 599783 599783 DIETARY 973815 973815 REPAIRS & MAINTENANCE 816136 815825 311 MEDICAL SUPPLIES 163655 163655 PROGRAMMING 153293 153293 449813 111632 334916 3265 29145350 23876618 4978050 290682 9415 5096 1599872 1791255 2184852 770505 766557 1167962 106781 104345 442780 540200 123096480 48131886 77174750 74964594 11853877 14481547 1109080 1012685 95247964 94838189 1896366 3044538 44340229 49581866 48086919 47332334 8611 4292 41716 267969 305380 412293 1014747 95054103 101283157 X -3600610 -10025675 3794471 3580707 193861 -6444968 95247964 94838189 X -5726609 -815849 -96371 X 0 1 X 1 1 1 X 9011334 2633199 2969793 2621316 3898452 21134094 14670492 14272143 14122276 16827963 19093890 78986764 23681826 16905342 17092069 19449279 22992342 100120858 4666890 206544 35000 10000 4918434 2564367 2052581 8234242 3913540 2548712 19313442 7231257 2052581 8440786 3948540 2558712 24231876 75888982 116411 219042 60953 32220 101411 530037 116411 219042 60953 32220 101411 530037 107418 112204 1640935 144456 232833 2237846 23905655 17236588 18793957 19625955 23326586 102888741 0.73760 0.74140 0.00520 0.00520 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 4,982. 2019 AMOUNT: $ 2,177. 2020 AMOUNT: $ 775. 2021 AMOUNT: $ 9,596. 2022 AMOUNT: $ 4,476. WELLNESS CENTER - 2018 AMOUNT: $ 53,630. 2019 AMOUNT: $ 49,040. 2020 AMOUNT: $ 10,177. 2021 AMOUNT: $ 18,147. 2022 AMOUNT: $ 20,159. SALON REVENUE - 2018 AMOUNT: $ 6,676. 2019 AMOUNT: $ 6,695. 2020 AMOUNT: $ 2,800. 2021 AMOUNT: $ 7,434. 2022 AMOUNT: $ 6,495. MEALS - 2018 AMOUNT: $ 42,130. 2019 AMOUNT: $ 48,292. 2020 AMOUNT: $ 14,859. 2021 AMOUNT: $ 4,483. 2022 AMOUNT: $ 11,456. DEPOSITS - 2019 AMOUNT: $ 6,000. SETTLEMENT CLAIMS - 2020 AMOUNT: $ 984. FINANCE CHARGE REVENUE - 2020 AMOUNT: $ 805. 2021 AMOUNT: $ -392. 2022 AMOUNT: $ 998. MEDICAL RECORDS - 2020 AMOUNT: $ 375. 2021 AMOUNT: $ 67. 2022 AMOUNT: $ 338. RESIDENT INTEREST - 2020 AMOUNT: $ 360. 2021 AMOUNT: $ 338. 2022 AMOUNT: $ 5,379. PPP LOAN FORGIVENESS - 2020 AMOUNT: $ 1,609,800. VENDING MACHINE - 2021 AMOUNT: $ 949. 2022 AMOUNT: $ 723. REGISTER FEE - 2021 AMOUNT: $ 3,784. PROVIDER RELIEF FUNDING - 2021 AMOUNT: $ 100,050. INSURANCE REIMBURSEMENT - 2022 AMOUNT: $ 166,302. REIMBURSEMENTS - 2022 AMOUNT: $ 16,507. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3564 3564 0 PART II-B, LINE 1: FOR 2022, $3,564 OF DUES PAID TO LEADINGAGE KANSAS AND LEADINGAGE NATIONAL WERE USED FOR LOBBYING/ADVOCACY EXPENDITURES. 0 1 X 2104042 -226580 62781 1814681 1974521 212361 82840 2104042 1836330 200756 62565 1974521 1652322 215354 31346 1836330 1771492 50000 -110231 58939 1652322 0.00000 0.90000 0.10000 0 0 2252860 2252860 93592263 28924470 64667793 21652173 16540358 5111815 5599184 2667058 2932126 74964594 OTHER LONG-TERM LIABILITIES 19790 DEFERRED CONTRACT INVESTMENTS 994957 1014747 22457964 -815849 -144928 -960777 23418741 0 23418741 29096793 0 29096793 48557 48557 29145350 PART IV, LINE 2B: SKILLED NURSING RESIDENTS MAY ELECT TO HAVE PERSONAL FUNDS MANAGED BY VILLAGE SHALOM. RESIDENTS WHOSE PERSONAL FUNDS ARE HELD BY VILLAGE SHALOM MAY GO TO THE BUSINESS OFFICE AND WITHDRAW CASH FOR THEIR NEEDS. PART V, LINE 4: EARNINGS FROM THE ENDOWMENT FUNDS ARE TO BE USED FOR RESIDENT ACTIVITIES, FINANCIAL ASSISTANCE, EMPLOYEE RECOGNITION, STAFF DEVELOPMENT AND TRAINING. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS -126,059. CHANGE IN VALUE OF PLEDGES RECEIVABLE 29,688. GRANTS/OTHER ASSISTANCE TO INDIVIDUALS -48,557. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS/OTHER ASSISTANCE TO INDIVIDUALS 48,557. 1 FINANCIAL ASSISTANCE 32 48557 PART I, LINE 2: VILLAGE SHALOM, INC. PROVIDES FINANCIAL ASSISTANCE TO INDIVIDUALS WHO DO NOT HAVE THE RESOURCES TO PAY FOR THEIR CARE. INDIVIDUALS AND FAMILIES MUST COMPLETE AN APPLICATION INDICATING THEIR NEED FOR FINANCIAL ASSISTANCE. THE ORGANIZATION'S STAFF REVIEWS THE INDIVIDUAL AND FAMILY APPLICATIONS THROUGH THE ESTABLISHED CRITERIA OF THE ASSISTANCE PLAN. INDIVIDUALS AND FAMILIES ARE REQUIRED TO PROVIDE INCOME AND ASSET VERIFICATION AS WELL AS ANNUALLY DISCLOSING THEIR FINANCIAL INFORMATION THROUGH THEIR CONTINUATION WITHIN THE ASSISTANCE PROGRAM. X X X X 0 0 0 0 0 0 0 1 0 MATTHEW LEWIS PRESIDENT/CEO 323877 0 0 0 0 0 18033 0 15781 0 357691 0 0 0 SHARON LATIMER CFO 147455 0 0 0 0 0 3847 0 27000 0 178302 0 0 0 JILL ALLIN DIRECTOR OF SALES & MARKETING 121016 0 25640 0 0 0 5798 0 10363 0 162817 0 0 0 PART I, LINE 7 BONUSES ARE BASED ON A NUMBER OF FACTORS INCLUDING EXCEPTIONAL PERFORMANCE, OPERATIONAL AND ORGANIZATION-BASED GOALS, AND KEY INITIATIVES. BONUSES ARE TIED TO KEY ANNUAL STRATEGIC GOALS THAT SUPPORT THE MISSION, THE ACHIEVEMENT OF THE ORGANIZATION'S MISSION, AND THE ANNUAL REVIEW PROCESS. SALARIES OF COMPARABLE POSITIONS AT ORGANIZATIONS OF SIMILAR SIZES AND MISSION ARE EVALUATED AS PART OF THE PROCESS AS WELL. THE BOARD HAS SOLE DISCRETION TO REDUCE OR REVOKE THE BONUS AMOUNT. A KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 2013-05-29 12155000 NOTE IN PART VI 0 0 0 B KANSAS DEVELOPMENT FINANCE AUTHORITY 481066589 48542RCB8 2018-07-16 59841375 NOTE IN PART VI 0 0 0 A 6933642 12155000 12155000 2002 1 0 1 1 B 16700000 61341352 3778052 6979268 1183985 49400048 2022 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 1 0 0 0 0 0 1 1 A 1 B 1 PART I, LINE A, COLUMN (F): REFUND 1998AA BONDS (ORIGINALLY ISSUED 12/2/1998). PART I, LINE B, COLUMN (F): CONSTRUCTION AND IMPROVEMENT TO THE INSTITUTION'S CONTINUING CARE RETIREMENT COMMUNITY. PART II, COLUMN A, LINE 11: THIS AMOUNT WAS USED TO CURRENT REFUND THE 1998AA BONDS ON THE ISSUE DATE. PART II, COLUMN B, LINE 3: TOTAL PROCEEDS DO NOT EQUAL ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS EARNED DURING THE PROJECT PERIOD. PART II, COLUMN B, LINE 16: THE INSTITUTION IS CURRENTLY IN THE PROCESS OF COMPLETING THE FINAL WRITTEN ALLOCATION FOR THE BONDS. PART IV, COLUMN B, LINE 6: THE INVESTMENT YIELD ON ANY PROCEEDS INVESTED BEYOND THE 3-YEAR TEMPORARY PERIOD DID NOT EXCEED THE YIELD ON THE BONDS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS COMPILED/COMPLETED BY AN INDEPENDENT CPA FIRM, BAKER TILLY US, LLP (BAKER TILLY). BAKER TILLY ALSO CONDUCTS THE ANNUAL INDEPENDENT AUDIT OF VILLAGE SHALOM, INC. THE 990 IS COMPLETED IN COOPERATION WITH THE CFO AND PRESIDENT OF VILLAGE SHALOM. PRIOR TO THE MAILING TO THE VILLAGE SHALOM BOARD, THE CFO AND PRESIDENT REVIEW THE 990 AND RELATED SCHEDULES WITH BAKER TILLY. THE 990 DRAFT IS E-MAILED TO ALL VOTING MEMBERS OF THE ORGANIZATION'S GOVERNING BOARD PRIOR TO THE FILING WITH THE IRS. THE 990 IS A TOPIC AT THE FINANCE COMMITTEE MEETING AND THE REGULARLY SCHEDULED BOARD MEETING PRIOR TO THE FILING. FORM 990, PART VI, SECTION B, LINE 12C VILLAGE SHALOM HAS A WRITTEN COMPLIANCE PLAN. THE COMPLIANCE PLAN IS REVIEWED WITH EVERY EMPLOYEE AT ORIENTATION, AND EVERY BOARD MEMBER WHEN THEY ARE INSTALLED. A CODE OF CONDUCT IS SIGNED BY EVERY EMPLOYEE AND BOARD MEMBER AT ORIENTATION (UPON HIRE OR INSTALLATION). ANNUALLY, EVERY EMPLOYEE MEMBER COMPLETES AN IN-SERVICE/UPDATE ON THE CODE OF CONDUCT/COMPLIANCE PLAN. ANNUALLY, EVERY BOARD MEMBER REVIEWS THE CODE OF CONDUCT AND SIGNS AN UPDATED CONFLICT OF INTEREST POLICY. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE POLICY. THE CODE OF CONDUCT AND COMPLIANCE PLAN LAY THE FOUNDATION FOR A COMPLIANT CULTURE AND AN ATMOSPHERE FOR SELF-DISCLOSURE. VILLAGE SHALOM IS DEDICATED TO THE HIGHEST ETHICAL PRACTICES AND MAKES EVERY EFFORT TO CONDUCT RELATIONSHIPS WITH THIS BUSINESS CULTURE. FORM 990, PART VI, SECTION B, LINE 15 VILLAGE SHALOM HAS A DESIGNATED COMPENSATION COMMITTEE APPOINTED BY THE BOARD OF DIRECTORS. THE COMMITTEE REVIEWS SALARY DATA FOR THE INDUSTRY. THE SALARY DATA INCLUDES BOTH LOCAL AND REGIONAL COMPARATIVE DATA. THE COMMITTEE REVIEWS THE COMPENSATION PACKAGE AS A WHOLE, INCLUDING BOTH SALARY AND BENEFIT STRUCTURE. THE COMMITTEE MAINTAINS DOCUMENTATION RELATING TO DATES MET, TOPICS DISCUSSED, AND PROCESSES UNDERTAKEN AND CONCLUSIONS FOR COMPENSATION PACKAGES. THE BOARD ONLY REVIEWS THE CEO/PRESIDENT SALARY - ALL MANAGEMENT POSITIONS ARE REVIEWED BY THE CEO. THE CEO REVIEWS AVAILABLE COMPARABLE SALARY DATA FROM LOCAL AND REGIONAL SOURCES, INCLUDING LEADINGAGE, TO ENSURE ALL COMPENSATION IS WITHIN FAIR MARKET VALUE FOR THE INDUSTRY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 4,950. MANAGEMENT AND GENERAL EXPENSES 202,051. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 207,001. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,458,846. MANAGEMENT AND GENERAL EXPENSES 365,570. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,824,416. CONTRACTED THERAPY SERVICES: PROGRAM SERVICE EXPENSES 554,817. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 554,817. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,739,742. MANAGEMENT AND GENERAL EXPENSES 95,632. FUNDRAISING EXPENSES 3,774. TOTAL EXPENSES 2,839,148. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 181,714. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 181,714. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS -126,059. CHANGE IN VALUE OF PLEDGES RECEIVABLE 29,688.