2022-11-11T12:47:04-06:00 2021-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2021-01-01 262053830 PRAIRIE LANDING COMMUNITY INC PRAI 3178733371 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 ROGER E WEIDEMAN II DIRECTOR, SVP & CFO 3178733371 2022-11-08 1 ROGER WEIDEMAN II XXX-XX-XXXX AMY CIMINELLO P00796388 6148493000 2022-11-07 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z X THE BARRINGTON OF CARMEL ROGER E WEIDEMAN II 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 13961062 0 X WWW.THEBARRINGTONOFCARMEL.COM X 2007 IN TO ENHANCE THE QUALITY OF LIFE FOR OLDER ADULTS WITHIN A SECURE ENVIRONMENT WHICH SUPPORTS THEIR NEEDS, VALUES, INTEREST AND INDEPENDENCE. 14 12 229 20 0 0 609038 35378 13493305 11983530 -2544086 1570831 291690 371323 11849947 13961062 0 0 0 0 7048820 6547864 0 0 0 10013037 9655409 17061857 16203273 -5211910 -2242211 108651851 109459923 96329338 99379621 12322513 10080302 TO ENHANCE THE QUALITY OF LIFE FOR OLDER ADULTS WITHIN A SECURE ENVIRONMENT WHICH SUPPORTS THEIR NEEDS, VALUES, INTEREST AND INDEPENDENCE WHILE ENCOURAGING PERSONAL AND SPIRITUAL DEVELOPMENT. 0 0 14706099 0 11983530 PROVIDE QUALITY HOUSING, HEALTH CARE SERVICES AND OTHER PROGRAMS TO SENIOR CITIZENS 14706099 1 1 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 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 24 0 1 229 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IN X ROGER E WEIDEMAN II 3178733371 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 JOHN S DATTILO DIRECTOR & PRESIDENT/CEO 2.00 56.00 X X 0 337305 43198 ROGER WEIDEMAN II DIRECTOR & VICE-PRESIDENT/CFO 2.00 56.00 X X 0 304238 41658 JANE A SEIGEL DIRECTOR & CHAIRPERSON 2.00 4.50 X X 0 0 0 JANE RICHARDSON DIRECTOR & VICE CHAIRPERSON 2.00 4.50 X X 0 0 0 WENDY L MEREDITH DIRECTOR & SECRETARY 2.00 10.50 X X 0 0 0 JEFFREY A TERP DIRECTOR & ASSISTANT SECRETARY 2.00 4.50 X X 0 0 0 JEFFREY CALDWELL DIRECTOR 2.00 4.50 X 0 0 0 DEXTER H COOLEY DIRECTOR 2.00 4.50 X 0 0 0 SHAWNA GOTTLIEB DIRECTOR 2.00 4.50 X 0 0 0 WILLIAM R HURT DIRECTOR 2.00 10.50 X 0 0 0 L DEAN JONES DIRECTOR 2.00 4.50 X 0 0 0 HARRY H KENNERK DIRECTOR 2.00 4.50 X 0 0 0 JOHN LIPSON DIRECTOR 2.00 8.50 X 0 0 0 ROGER D MILLER DIRECTOR 2.00 8.50 X 0 0 0 KARA OWEN EXECUTIVE DIRECTOR 40.00 0.00 X 134425 0 13067 ANNA WEAVER DIRECTOR OF NURSING 40.00 0.00 X 103909 0 5269 238334 641543 103192 2 0 1 0 MORRISON COMMUNITY LIVING PO BOX 102289 ATLANTA GA 30368 FOOD PROVIDER 851372 HTS IN XII INC 1411 W COUNTY LNE ROAD STE A GREENWOOD IN 46142 THERAPY 558839 SYSCO PO BOX 7137 INDIANAPOLIS IN 46206 FOOD PROVIDER 229985 ENGLEDOW GROUP 1100 EAST 116TH ST CARMEL IN 46032 LANDSCAPING AND MAINTENANCE 156968 GORDON FOOD SERVICE INC PO BOX 88029 CHICAGO IL 60680 FOOD PROVIDER 152222 7 35378 35378 NET RESIDENT SERVICES 623000 12115869 12115869 ENTRANCE FEE AMORTIZATION 623000 -132339 -132339 11983530 1146 1146 1569685 0 1569685 1569685 1569685 DINING REVENUE 623000 186451 186451 BEAUTY SHOP 623000 72907 72907 LAUNDRY 623000 16935 16935 95030 95030 371323 13961062 11983530 0 1942154 5192492 4765979 426513 97288 86186 11102 831899 724540 107359 426185 392915 33270 660000 594000 66000 28062 28062 1120167 1087195 32972 37847 37347 500 255137 174038 81099 141431 10462 130969 508595 488113 20482 22866 22146 720 11840 1811 10029 2258469 2258469 2643614 2643614 138985 138985 RESIDENT EXPENSES 581538 581538 0 FOOD/DINING 510015 510015 TAXES & LICENSES 322193 322193 LAUNDRY 197851 197851 0 216799 129880 86919 16203273 14706099 1497174 0 2153281 4583110 3412239 4013359 410991 645342 46043 33147 95867215 6042067 67985880 89825148 34579427 10295827 63990 63990 108651851 109459923 2703692 4942216 4922050 6996920 48855129 48567129 39848467 38873356 96329338 99379621 X 12322513 10080302 12322513 10080302 108651851 109459923 -2242211 0 X X 0 1 X 1 1 1 X 609038 35378 644416 5046346 13691907 11983530 30721783 5046346 14300945 12018908 31366199 0 0 0 31366199 363687 8182 1146 373015 363687 8182 1146 373015 93088 371323 464411 5410033 14402215 12391377 32203625 0.97400 0.97650 0.01160 0.01880 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5700000 5700000 85421541 5070477 80351064 2543231 636139 1907092 2202443 335451 1866992 89825148 ROC RESERVE 35392138 REFUNDABLE PARKING GARAGE DEPOSITS 128250 ENTRANCE FEE DEPOSIT 2730000 INTEREST RATE SWAP LIABILITY 622968 38873356 X PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF DECEMBER 21, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. X X X 0 1 0 0 0 0 0 1 0 JOHN S DATTILO DIRECTOR & PRESIDENT/CEO 0 307305 0 30000 0 0 0 14500 0 28698 0 380503 0 0 ROGER WEIDEMAN II DIRECTOR & VICE-PRESIDENT/CFO 0 279238 0 25000 0 0 0 14177 0 27481 0 345896 0 0 PART I, LINE 3 COMPENSATION PAID BY BHI RETIREMENT COMMUNITIES IS DETERMINED BY THE REVIEW AND APPROVAL OF THE BOARD WHICH INCLUDES CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN: A 457(F) DEFERRED COMPENSATION PLAN WAS SET UP FOR JOHN DATILLO AND ROGER WEIDEMAN IN APRIL OF 2019. JOHN DATILLO'S PLAN BEGINS VESTING IN 2031 AND ROGER WEIDEMAN'S PLAN BEGINS VESTING IN 2034. PART I, LINE 7 ALL BONUSES ARE DISCRETIONARY AND BASED ON PERFORMANCE MEASURES. A FIFTH THIRD BANK 310281170 2019-08-30 49940000 ACQUISITION OF BARRINGTON 0 0 1 A 49940000 1152350 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 1 0 0 0 0 1 A 1 SCHEDULE K, PART I, BOND ISSUES: (A) ISSUER NAME: FIFTH THIRD BANK (F) DESCRIPTION OF PURPOSE: TO FINANCE AND REFINANCE PROJECTS FORM 990, PART VI, SECTION A, LINE 6 BHI RETIREMENT COMMUNITIES IS THE MEMBER OF THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A BHI RETIREMENT COMMUNITIES HAS THE RIGHT TO APPROVE/REMOVE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B BHI RETIREMENT COMMUNITIES HAS THE RIGHT TO APPROVAL OR REJECTION OF CERTAIN GOVERNANCE DECISIONS SUCH AS APPROVAL OF THE GOVERNING BODY'S ELECTION OR REMOVAL OF MEMBERS OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF THE ORGANIZATION'S FORM 990 PRIOR TO THE FILING OF THE RETURN IS MADE BY AN OFFICER OF THE MANAGING AGENT OF THE ORGANIZATION. THE FORM 990 IS ALSO REVIEWED BY THE BOARD OF DIRECTORS AND AN INDEPENDENT ACCOUNTING FIRM PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL BHI REPRESENTATIVES ARE REQUIRED TO IMMEDIATELY DISCLOSE ANY POTENTIAL OR PERCEIVED CONFLICT OF INTEREST AT THE TIME IT DEVELOPS BY SUBMITTING A COMPLETED CONFLICT OF INTEREST STATEMENT FORM. THE STATEMENT SHALL BE FORWARDED TO THE CORPORATE COMPLIANCE OFFICER FOR REVIEW BY THE CORPORATE COMPLIANCE, INTERNAL AUDIT, AND RISK MANAGEMENT COMMITTEE OF THE BHI BOARD OF DIRECTORS. IN ADDITION, BOARD OF DIRECTORS, OFFICERS, EXECUTIVE DIRECTORS, AND OTHER DESIGNATED PERSONS ARE REQUIRED TO COMPLETE THE CONFLICT OF INTEREST STATEMENT TO DISCLOSE OR RE-DISCLOSE ANY CONFLICT OF INTEREST ON AN ANNUAL BASIS. IN ADDITION, THE BOARD OF DIRECTOR MEMBERS SHALL REVIEW AND SUBMIT A SIGNED CODE OF PROFESSIONAL ETHICS STATEMENT ON AN ANNUAL BASIS. THE STATEMENTS WILL BE REVIEWED BY THE CORPORATE COMPLIANCE COMMITTEE AND WILL RESULT IN ONE OF THE FOLLOWING ACTIONS; THE DISCLOSED CONFLICT SHALL BE APPROVED AS SUBMITTED. THE DISCLOSED CONFLICT SHALL NOT BE APPROVED AS SUBMITTED AND SPECIFIC REQUIREMENTS SHALL BE DEVELOPED BY THE CORPORATE COMPLIANCE COMMITTEE REGARDING ACTIONS TO BE TAKEN BY THE INDIVIDUAL TO RESOLVE THE CONFLICT. THE DISCLOSED CONFLICT SHALL BE APPROVED WITH THE REQUIREMENT OF SPECIFIED PROCEDURES TO BE IMPLEMENTED AND THEREAFTER MONITORED BY THE CORPORATE COMPLIANCE COMMITTEE TO ENSURE PROPER MANAGEMENT OF THE IDENTIFIED CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 REVIEW OF CEO OR TOP MANAGEMENT OFFICIAL COMPENSATION: THE ORGANIZATION DOES NOT COMPENSATE ANY PERSON IN THESE ROLES. COMPENSATION PAID TO BHI SENIOR LIVING, INC. IS DETERMINED BY THE REVIEW AND APPROVAL OF THE BOARD WHICH INCLUDES CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. BHI SENIOR LIVING INC 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 350931432 ASST LIVING IN 501(C)(3) LINE 10 N/A 0 BHI FOUNDATION INC 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 351680796 ASST LIVING IN 501(C)(3) LINE 12A, I BHI SENIOR LIVING INC 1 BHI RETIREMENT COMMUNITIES INC 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 260262903 ASST LIVING IN 501(C)(3) LINE 12A, I BHI SENIOR LIVING INC 1 WESLEY MANOR INC 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 351020934 ASST LIVING IN 501(C)(3) LINE 10 BHI RETIREMENT COMMUNITIES INC 1 FOUR SEASONS VILLAS INC 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 311011187 SENIOR LIVING IN 501(C)(3) LINE 10 BHI SENIOR LIVING INC 1 HOOSIER MANOR INC 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 311011190 SENIOR LIVING IN 501(C)(3) LINE 10 BHI SENIOR LIVING INC 1 WESLEY MANOR SOUTHSIDE LP 1555 N MARKET STREET FRANKFORT IN 46041 RETIRE LIVING IN N/A 0 1 SLDEVELOPMENT INC 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 452664455 GOLF COURSE IN N/A C 1 BHI HOME CARE INC 8330 ALLISON POINTE TRAIL STE 300 INDIANAPOLIS IN 46250 475160712 HOME CARE IN N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0