STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

GRACE VILLAGE HEALTH CARE FACILITY INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
GRACE VILLAGE HEALTH CARE FACILITY INC (EIN 35-1447417)
Tax period
2022-07-01 to 2022-12-31
Filed
2023-11-15
IRS object ID
202313199349316326
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-15T14:02:36-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN351178661PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 N MERIDIAN ST SUITE 200AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351447417EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GRACE VILLAGE HEALTHCARE FACILITY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGRACBusinessNameControlTxt
Phone5743726290PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK SCHWOBPersonNm
Person TitleDIRECTOR OF FINANCEPersonTitleTxt
Phone5743726498PhoneNum
Signature2023-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARKPersonFirstNm
Person LastSCHWOBPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEMILIE M KNIERIEM CPAPreparerPersonNm
PTINP01330194PTIN
Phone3176334705PhoneNum
Preparation2023-11-15PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJUSTIN KIMBRELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,377,789GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressGRACEVILLAGE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionGRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee195TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,297,259PYContributionsGrantsAmt
CY Contributions Grants$34,330CYContributionsGrantsAmt
PY Program Service Revenue$7,391,886PYProgramServiceRevenueAmt
CY Program Service Revenue$3,233,341CYProgramServiceRevenueAmt
PY Investment Income$110,121PYInvestmentIncomeAmt
CY Investment Income$69,107CYInvestmentIncomeAmt
PY Other Revenue$39,481PYOtherRevenueAmt
CY Other Revenue$41,011CYOtherRevenueAmt
PY Total Revenue$8,838,747PYTotalRevenueAmt
CY Total Revenue$3,377,789CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,425,099PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,685,936CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$17,453CYTotalFundraisingExpenseAmt
PY Other Expenses$3,252,767PYOtherExpensesAmt
CY Other Expenses$512,545CYOtherExpensesAmt
PY Total Expenses$8,677,866PYTotalExpensesAmt
CY Total Expenses$3,198,481CYTotalExpensesAmt
PY Revenues Less Expenses$160,881PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$179,308CYRevenuesLessExpensesAmt
Total Assets BOY$4,795,562TotalAssetsBOYAmt
Total Assets EOY$4,763,917TotalAssetsEOYAmt
Total Liabilities BOY$4,734,761TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,431,145TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$60,801NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$332,772NetAssetsOrFundBalancesEOYAmt
MissionGRACE VILLAGE'S MISSION IS TO ENABLE OLDER ADULTS TO LIVE TO THEIR FULLEST POTENTIAL IN THE SECURITY OF A CHRISTIAN COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,583,081ExpenseAmt
Revenue$3,233,341RevenueAmt
DescGRACE 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.Desc
Total Program Service Expenses$2,583,081TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document33IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee195EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARK SCHWOB - DIRECTOR OF FINANCEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5743726290PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
CHAD HUMMEL
CHAIR0.500.50Yes (X)Yes (X)$0$0$0
ADAM LENON
SECRETARY & TREASURER0.500.50Yes (X)Yes (X)$0$0$0
DENNIS DUNCAN
BOARD MEMBER0.500.50Yes (X)$0$0$0
GLENN HALL
BOARD MEMBER0.500.50Yes (X)$0$0$0
CHUCK JOSEY
BOARD MEMBER0.500.50Yes (X)$0$0$0
DAVID KOONTZ
BOARD MEMBER0.500.50Yes (X)$0$0$0
DAN LEININGER
BOARD MEMBER0.500.50Yes (X)$0$0$0
MARK MCCOLLOM
BOARD MEMBER0.500.50Yes (X)$0$0$0
JENNIFER PIERCE
BOARD MEMBER0.500.50Yes (X)$0$0$0
DALE ROBBINS
BOARD MEMBER0.500.50Yes (X)$0$0$0
JUSTIN KIMBRELL
CEO28.0012.00Yes (X)$203,693$0$19,570
SONDREA HAMILTON
CFO/HFA28.0012.00Yes (X)$140,434$0$25,044
COURTNEY WALLEN
LPN40.000.00$130,138$0$4,509Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$474,265TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$49,123TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MORRISON MANAGEMENT SPECIALISTS INC
2400 YORKMONT ROADCHARLOTTENY28217DIETARY SERVICES$238,416
WINONA IT LLC
1037 MARINERS DRIVEWARSAWIN46580INFORMATION TECHNOLOGY$161,820
PRIME TIME HEALTHCARE LLC
15380 WEIR STOMAHANE68137CONTRACT NURSING$143,350
UNITED STAFFING SOLUTIONS
PO BOX 219472KANSAS CITYMO64121CONTRACT NURSING$108,390
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
All Other Contributions$34,330AllOtherContributionsAmt
Total Contributions$34,330TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MANAGEMENT REVENUE623000$2,929,051$2,929,051
LEASE REVENUE623000$304,290$304,290
FieldValueIRS element (for citing)
Total Program Service Revenue$3,233,341TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$63,538TotalRevenueColumnAmt
Exclusion$63,538ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,000TotalRevenueColumnAmt
Exclusion$6,000ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,569SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,569SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,569TotalRevenueColumnAmt
Exclusion$5,569ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$35,011TotalRevenueColumnAmt
Exclusion$35,011ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$35,011OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,377,789TotalRevenueColumnAmt
Related Or Exempt Func Income$3,233,341RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$110,118ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$146,129TotalAmt
Management And General$146,129ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,976,214TotalAmt
Program Services$1,768,034ProgramServicesAmt
Management And General$188,266ManagementAndGeneralAmt
Fundraising$19,914FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$36,202TotalAmt
Program Services$29,782ProgramServicesAmt
Management And General$6,085ManagementAndGeneralAmt
Fundraising$335FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$391,067TotalAmt
Program Services$321,710ProgramServicesAmt
Management And General$65,734ManagementAndGeneralAmt
Fundraising$3,623FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$136,324TotalAmt
Program Services$112,146ProgramServicesAmt
Management And General$22,915ManagementAndGeneralAmt
Fundraising$1,263FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,849TotalAmt
Management And General$1,849ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,245TotalAmt
Program Services$1,033ProgramServicesAmt
Management And General$203ManagementAndGeneralAmt
Fundraising$9FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,262TotalAmt
Program Services$1,070ProgramServicesAmt
Management And General$119ManagementAndGeneralAmt
Fundraising$73FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,609TotalAmt
Program Services$2,400ProgramServicesAmt
Management And General$205ManagementAndGeneralAmt
Fundraising$4FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$166,337TotalAmt
Program Services$85,924ProgramServicesAmt
Management And General$80,413ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$13TotalAmt
Fundraising$13FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$96,970TotalAmt
Program Services$87,273ProgramServicesAmt
Management And General$9,697ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$193,010TotalAmt
Program Services$173,709ProgramServicesAmt
Management And General$19,301ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$49,614TotalAmt
Management And General$49,614ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
OTHER$8,638$0$2,039$6,599
DUES & SUBSCRIPTIONS$5,640$0$5,378$262
EXPENSE ALLOCATION-$14,642$0$0-$14,642

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,198,481TotalAmt
Program Services$2,583,081ProgramServicesAmt
Management And General$597,947ManagementAndGeneralAmt
Fundraising$17,453FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$258,486BOYAmt
EOY$116,737EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,956BOYAmt
EOY$1,832EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$71,981BOYAmt
EOY$71,981EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$10,149BOYAmt
EOY$73,161EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,111,793LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,845,191LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,425,000BOYAmt
EOY$3,266,602EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$951,268BOYAmt
EOY$968,177EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$71,722BOYAmt
EOY$265,427EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,795,562BOYAmt
EOY$4,763,917EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$780,545BOYAmt
EOY$547,669EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,792,092BOYAmt
EOY$3,722,142EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$162,124BOYAmt
EOY$161,334EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,734,761BOYAmt
EOY$4,431,145EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$736,121BOYAmt
EOY-$464,150EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$796,922BOYAmt
EOY$796,922EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$60,801BOYAmt
EOY$332,772EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,795,562BOYAmt
EOY$4,763,917EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$179,308ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$20,938NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$71,725OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$128,737CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$131,577CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,278,103CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,297,259CurrentTaxYearMinus1YearAmt
Current Tax Year$34,330CurrentTaxYearAmt
Total$2,870,006TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,538,776CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,326,207CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,544,056CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,391,886CurrentTaxYearMinus1YearAmt
Current Tax Year$3,233,341CurrentTaxYearAmt
Total$37,034,266TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,667,513CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,457,784CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,822,159CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,689,145CurrentTaxYearMinus1YearAmt
Current Tax Year$3,267,671CurrentTaxYearAmt
Total$39,904,272TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$39,904,272PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$96,654CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$137,085CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$129,626CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$98,069CurrentTaxYearMinus1YearAmt
Current Tax Year$69,538CurrentTaxYearAmt
Total$530,972TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$96,654CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$137,085CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$129,626CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$98,069CurrentTaxYearMinus1YearAmt
Current Tax Year$69,538CurrentTaxYearAmt
Total$530,972TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$1,078CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,078CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27,481CurrentTaxYearMinus1YearAmt
Current Tax Year$35,011CurrentTaxYearAmt
Total$64,648TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,764,167CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,595,947CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,952,863CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,814,695CurrentTaxYearMinus1YearAmt
Current Tax Year$3,372,220CurrentTaxYearAmt
Total$40,499,892TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98530PublicSupportCY509Pct
Public Support PY5090.98790PublicSupportPY509Pct
Investment Income CY0.01310InvestmentIncomeCYPct
Investment Income PY0.01150InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$802,060BeginningYearBalanceAmt
Contributions$73,387ContributionsAmt
Investment Earnings Or Losses$7,262InvestmentEarningsOrLossesAmt
Other Expenditures$3,945OtherExpendituresAmt
End Year Balance$878,764EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$759,012BeginningYearBalanceAmt
Contributions$156,546ContributionsAmt
Investment Earnings Or Losses$11,920InvestmentEarningsOrLossesAmt
Other Expenditures$125,418OtherExpendituresAmt
End Year Balance$802,060EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$747,776BeginningYearBalanceAmt
Contributions$118,392ContributionsAmt
Investment Earnings Or Losses$11,059InvestmentEarningsOrLossesAmt
Other Expenditures$118,215OtherExpendituresAmt
End Year Balance$759,012EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$713,721BeginningYearBalanceAmt
Contributions$113,474ContributionsAmt
Investment Earnings Or Losses$17,503InvestmentEarningsOrLossesAmt
Other Expenditures$96,922OtherExpendituresAmt
End Year Balance$747,776EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$636,398BeginningYearBalanceAmt
Contributions$112,711ContributionsAmt
Investment Earnings Or Losses$15,570InvestmentEarningsOrLossesAmt
Other Expenditures$50,958OtherExpendituresAmt
End Year Balance$713,721EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.66346PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.33654TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,145,842OtherCostOrOtherBasisAmt
Depreciation$3,075,119DepreciationAmt
Book Value$2,070,723BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,530,271OtherCostOrOtherBasisAmt
Depreciation$1,021,126DepreciationAmt
Book Value$509,145BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,424,971OtherCostOrOtherBasisAmt
Depreciation$1,748,946DepreciationAmt
Book Value$676,025BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,709OtherCostOrOtherBasisAmt
Book Value$10,709BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,266,602TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
SCHWAB - CARING FRIENDS ENDOWMENT$728,092C
CAPITAL INVESTMENT - SAMARITAN ALLI$133,892C
THUMS INVESTMENT$106,193C
FieldValueIRS element (for citing)
Total Book Value Securities$968,177TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
REFUNDABLE DEPOSITS$160,567
DERIVATIVE ASSET$104,860
FieldValueIRS element (for citing)
Total Book Value Other Assets$265,427TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DEFERRED COMPENSATION PLAN OBLIGATIONS$165,610
LOAN INSURANCE COST-$4,276
FieldValueIRS element (for citing)
Total Liability$161,334TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$3,470,451TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$20,937NetUnrealizedGainsInvstAmt
Other Revenue$71,725OtherRevenueAmt
Revenue Not Reported$92,662RevenueNotReportedAmt
Revenue Subtotal$3,377,789RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$3,377,789TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,198,481TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$3,198,481ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$3,198,481TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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, 2022 AND JUNE 30, 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:GAIN/LOSS ON INTEREST RATE SWAP 71,725.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JUSTIN KIMBRELL
CEO$203,693$0$0$0$0$0$19,570$0$0$0$223,263$0$0$0
SONDREA HAMILTON
CFO/HFA$140,434$0$0$0$0$0$8,840$0$16,204$0$165,478$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE 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 12CGRACE 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 15ATHE CEO'S SALARY IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST
FORM 990, PART XI, LINE 9:(GAIN) LOSS ONF INTEREST RATE SWAP 71,725.
FORM 990, PART XII, LINE 2CTHE PROCESS FOR THE SELECTION OF INDEPENDENT ACCOUNTANT AND OVERSIGHT OF SUCH PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1337 GRACE VILLAGE DRIVEAddressLine1Txt
CityWINONA LAKECityNm
State AbbreviationINStateAbbreviationCd
ZIP46590ZIPCd
FieldValueIRS element (for citing)
EIN351282401EIN
Primary ActivitiesRETIREMENT HOMEPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd