2022-05-16T13:07:53-07:00 2021-12-31 990 2021-01-01 814839696 Atrio Home Health Lakeshore ATRI 6167963800 9 E 8th Street Holland MI 49423 Troy Vugteveen Chairperson 6162355005 2022-05-16 1 11 1 AAL2 X 2021 2022-09-23 18:48:47Z Troy Vugteveen 2100 Raybrook St SE Suite 300 Grand Rapids MI 49546 2909373 0 X www.atriohomecare.org X 2016 MI To provide home health care, skilled nursing, and other therapy services to residents of the greater Holland & Muskegon areas. 5 0 33 0 0 0 59728 256997 2016279 2642176 7 27 3107 10173 2079121 2909373 0 0 0 0 1666519 2027566 0 0 0 423789 489438 2090308 2517004 -11187 392369 730608 794855 545816 125762 184792 669093 To provide the highest level of care and support for those we serve by utilizing the values, unique gifts, and professional expertise of each Atrio Home Health Lakeshore team member. 0 0 2138957 2652349 Provide home health care services, including: skilled nursing, physical therapy, occupational therapy, speech language therapy, medical social services, home health aides, registered dieticians, and telehealth monitoring. 0 0 0 2138957 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 33 1 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MI X Adam Kinder 6162355015 2100 Raybrook St SE Suite 300 Grand Rapids MI 49546 Hermina Breuker Former President/Chairperson 2 50 X X 0 442257 0 Brian Pangle Director/Secretary 2 50 X X 0 302763 0 Troy Vugteveen Chairperson & President 2 50 X X 0 207268 0 Deedre Vriesman Director/Treasurer 2 50 X X 0 205905 0 Adam Kinder Director 2 50 X X 0 188036 0 Seth Weener Director 2 50 X 0 153403 0 Kelly Wierenga Administrator 50 0 X X 115568 0 4545 Casey Lauf Physical Therapist 50 0 X 115965 0 0 231533 1499632 4545 2 1 1 0 Holland Home 2100 Raybrook St SE Suite 300 Grand Rapids MI 49546 management services & other expenses 310124 1 0 0 0 0 256997 0 0 256997 Home Care Services 621610 2642176 2642176 0 0 0 0 0 0 2642176 27 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 Miscellaneous Revenue 621610 10173 10173 0 0 0 0 0 0 10173 2909373 2652349 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1748761 1633193 115568 0 27196 25399 1797 0 123728 115551 8177 0 127881 119430 8451 0 153424 0 153424 0 1667 0 1667 0 8175 0 8175 0 0 0 0 0 0 0 0 0 0 0 11496 11496 0 0 24464 24464 0 0 36090 34823 1267 0 67295 8026 59269 0 0 0 0 0 25648 25648 0 0 54012 51915 2097 0 0 0 0 0 1461 0 1461 0 0 0 0 0 0 0 0 0 20457 20457 0 0 12064 0 12064 0 Medical Supplies & Telehealth 17913 17913 0 0 License Fees 8560 8560 0 0 Miscellaneous 36800 36289 511 0 Dues & Memberships 4119 0 4119 0 5793 5793 0 0 2517004 2138957 378047 0 152779 225186 39645 23738 425852 461577 0 10658 1623 13247 10725 130000 83430 62991 46570 25436 25436 730608 794855 233470 17366 0 6706 48396 0 0 0 0 0 0 0 0 245640 0 60000 60000 545816 125762 X 184792 669093 0 0 184792 669093 730608 794855 X 392369 0 0 0 0 91932 X 0 1 X 1 0 X X 1 Atrio Home Care 813166606 10 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 130000 0 83430 46570 0 0 0 0 46570 Related party advance payable 60000 60000 2909373 0 0 0 0 0 2909373 0 0 0 2909373 2517004 0 0 0 0 0 2517004 0 0 0 2517004 X X X X 0 0 0 0 0 0 0 0 0 Adam Kinder Director 0 176329 0 11707 0 0 0 0 0 0 0 188036 0 0 Troy Vugteveen Chairperson & President 0 202377 0 4891 0 0 0 0 0 0 0 207268 0 0 Deedre Vriesman Director/Treasurer 0 205905 0 0 0 0 0 0 0 0 0 205905 0 0 Seth Weener Director 0 153403 0 0 0 0 0 0 0 0 0 153403 0 0 Brian Pangle Director/Secretary 0 302763 0 0 0 0 0 0 0 0 0 302763 0 0 Hermina Breuker Former President/Chairperson 0 442257 0 0 0 0 0 0 0 0 0 442257 0 0 Holland Home Parent Organization 153424 Management fee 1 Resthaven Parent Organization 25019 Facility rental 1 Schedule L, Part IV Effective April 1, 2017, Atrio Home Health Lakeshore entered into a management services agreement with Holland Home, a wholly owned subsidiary of Christian Living Services (an effectively, 60% owner of Atrio Home Health Lakeshore). The management services agreement provides for certain services, including human resources, information technology, finance, and executive leadership to be provided by Holland Home for the benefit of Atrio Home Health Lakeshore. Atrio Home Health Lakeshore, during 2017, entered into a facility lease agreement with Resthaven for administrative office space. All other transactions between the organization ownership or affiliates have been considered in the ordinary course of business and are considered and outlined within Schedule R. Form 990, Part VI, Section A, Line 6 Pursuant to its Articles of Incorporation, as amended, the organization is organized on a non-stock membership basis. Form 990, Part VI, Section A, Line 7b Pursuant to its Bylaws, as amended, the corporation consists of one class, and the only member of the corporation shall be Atrio Home Care, a Michigan nonprofit corporation. The power to adopt, amend and repeal the Bylaws of the corporation and except as provided in the Bylaws to elect all members of the Board of Directors of the corporation is reserved exclusively to the member. The Bylaws may require approval by the member for specified actions of the Board of Directors to be effective. Form 990, Part VI, Section B, Line 11b The Form 990 and appropriate schedules are prepared by the organization. A draft of the Form is reported to the organization's Finance Committee, which is given opportunity to review the form, prior to its submission to the Internal Revenue Service. Upon confirmation of review, the form is subsequently submitted and filed with the Internal Revenue Service. Form 990, Part VI, Section B, Line 12c On an annual basis each director, principal officer and member of a committee with board delegated powers must complete a statement that (1) they have received a copy of the Conflict of Interest Policy, (2) they have read and understand the policy, (3) they have agreed to comply with the policy, and (4) understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. Form 990, Part VI, Section B, Line 15 The organization purchases compensation surveys and establishes the executive compensation around the fiftieth percentile, (with some flexibility) of prevailing market rates for similar positions, market trends, and the financial resources of the organization. The organization is committed to balancing fiscal stewardship with a desire to competitively compensate its personnel. Executive compensation is reviewed within the compensation committee of the Board of Directors. Form 990, Part VI, Section C, Line 19 The organization does not generally make its governing documents or Conflicts of Interest policy available to the public; however, such documents would be subject to public inspection if so requested. Form 990, Part XI, Line 9 Receipt of transfer of net assets from Atrio Home Care and Atrio Home Health related to forgiveness of liabilities. Christian Living Services 2100 Raybrook St SE Grand Rapids MI 49546 261126816 senior living mgmt MI 501(c)(3) 12b N/A Resthaven 9 East 8th Street Holland MI 49423 381387113 IL/AL/SNF MI 501(c)(3) 10 N/A Clark Retirement Community Inc 1551 Franklin St SE Grand Rapids MI 49506 381366932 IL/AL/SNF MI 501(c)(3) 10 N/A Atrio Home Health 2100 Raybrook St SE Grand Rapids MI 49546 382660300 home care svcs MI 501(c)(3) 12b Atrio Home Care 1 Atrio Home Care 2100 Raybrook St SE Grand Rapids MI 49546 813166606 Home care svcs MI 501(c)(3) 10 N/A Holland Home 2100 Raybrook St SE Grand Rapids MI 49546 381366927 IL/AL/SNF MI 501(c)(3) 10 Christian Living Services Faith Hospice 2100 Raybrook St SE Grand Rapids MI 49546 383062893 hospice services MI 501(c)(3) 12b Christian Living Services Care Resources 4150 Kalamazoo Ave SE Grand Rapids MI 49508 300166828 PACE services MI 501(c)(3) 12b N/A 0 EHCO Group LLC Grand Rapids MI 2100 Raybrook St SE Grand Rapids MI 49546 health management MI N/A Related 0 0 0.4 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1 Resthaven k 25019 Facility rental Atrio Home Care p 8988 Reimbursement for expenses. Atrio Home Health p 125406 Reimbursement for expenses. Faith Hospice m 491 Purchased services Holland Home m 153424 Management services. Holland Home p 162635 Reimbursement of expenses. Atrio Home Care q 17504 Reimbursement of expenses. Atrio Home Health q 1983 Reimbursement for expenses. Care Resources m 19937 Purchased services. Schedule R, Part I Clark Retirement Community Inc and Holland Home each maintain a 20% interest in EHCO Group, LLC (dba Tandem365). Both Clark Retirement Community Inc and Christian Living Services (the sole member of Holland Home) hold a combined 80% interest in Atrio Home Care, which directly controls Atrio Home Health Lakeshore. Atrio Home Care provides contracted services to Tandem365 during the ordinary course of business.