2021-10-15T17:56:41-05:00 2020-12-31 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2020-01-01 481199065 VILLAGE SHALOM INC VILL 9133172600 5500 WEST 123RD STREET OVERLAND PARK KS 66209 MATTHEW E LEWIS PRESIDENT & CEO 9133172600 2021-10-13 1 MATTHEW LEWIS XXX-XX-XXXX KERRI N BOGDA CPA P00760402 7177404863 X 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MATTHEW E LEWIS 5500 WEST 123RD STREET OVERLAND PARK KS 66209 21108534 0 X WWW.VILLAGESHALOM.ORG X 1996 KS HIGH QUALITY RESIDENT CARE TO SENIORS TO SUPPORT THEIR HIGHEST LEVEL OF INDEPENDENCE. 25 25 347 95 0 0 2633199 4579593 14272143 14122276 290179 -132979 117942 33239 17313463 18602129 163962 228659 0 0 8677365 9078602 36298 0 239246 10216636 14346244 19094261 23653505 -1780798 -5051376 112833277 103191704 101339518 95897884 11493759 7293820 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 18764102 228659 14122276 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 ON VILLAGE SHALOM'S MAIN CAMPUS ARE RECIPIENTS OF MORE THAN $1.3 MILLION IN FINANCIAL ASSISTANCE. ALL RESIDENTS RECEIVING FINANCIAL ASSISTANCE ARE PROVIDED WITH THE SAME HIGH-QUALITY CARE AND SERVICES AS ANY OTHER VILLAGE SHALOM RESIDENT. THEIR DIGNITY, PRIVACY, AND LONG-TERM CARE ARE OUR PRIMARY CONCERN. 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, THEY ARE NOT REPORTED AS REVENUE.THE ORGANIZATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF BENEVOLENT CARE IT PROVIDES. CHARGES FORGONE, BASED ON ESTABLISHED RATES FOR SERVICES RENDERED AND SUPPLIES FURNISHED, WERE APPROXIMATELY $229,000 IN 2020 AND $164,000 IN 2019. THESE AMOUNTS ARE NOT MATERIALLY DIFFERENT THAN THE DIFFERENCE BETWEEN THE COST OF PROVIDING SERVICES TO RESIDENTS THAT QUALIFIED FOR BENEVOLENT CARE AND THE AMOUNTS THESE RESIDENTS PAID FOR SERVICES RENDERED. 18764102 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 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 55 0 347 1 0 0 0 0 0 0 0 0 0 0 0 0 X 25 25 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KS X MATTHEW LEWIS PRESIDENT CEO 9132668400 5500 WEST 123RD STREET OVERLAND PARK KS 66209 MATTHEW LEWIS PRESIDENT/CEO 40.00 X 327072 0 29267 NICOLE ANTHONY CFO 40.00 X 156565 0 28148 JILL ALLIN DIRECTOR OF SALES & MARKETING 40.00 X 149626 0 27431 ANGELA WHEELER VP OF HEALTHCARE SERVICES 40.00 X 127677 0 29026 PAUL HERDER VP OF HOSPITALITY 40.00 X 118986 0 8603 EDWARD SALINAS MAINTENANCE 40.00 X 108519 0 16853 LORA BAUGHER DIRECTOR OF INFORMATION TECHNOLOGY 40.00 X 114015 0 11300 FRANK LIPSMAN DIRECTOR/CHAIR 1.00 X X 0 0 0 BOB GERSHON DIRECTOR/VICE CHAIR 1.00 X X 0 0 0 DAVID SPIZMAN DIRECTOR/TREASURER 1.00 X X 0 0 0 ALLISON BEREY DIRECTOR/SECRETARY 1.00 X X 0 0 0 ALANA MULLER DIRECTOR 1.00 X 0 0 0 BARRY FINK DIRECTOR 1.00 X 0 0 0 BRUCE KERSHENBAUM DIRECTOR 1.00 X 0 0 0 HOWARD ROSENTHAL MD DIRECTOR 1.00 X 0 0 0 JAMES KLEIN DIRECTOR 1.00 X 0 0 0 JOSEPH HIERSTEINER DIRECTOR 1.00 X 0 0 0 KAREN GLICKSTEIN DIRECTOR 1.00 X 0 0 0 MICHAEL ABRAMS DIRECTOR 1.00 X 0 0 0 RODNEY MINKIN DIRECTOR 1.00 X 0 0 0 SHIRLEY HELZBERG DIRECTOR 1.00 X 0 0 0 TRACY SHAFTON DIRECTOR 1.00 X 0 0 0 IRENE BETTINGER DIRECTOR 1.00 X 0 0 0 RACHEL KRANTZ DIRECTOR 1.00 X 0 0 0 STEVE RUBEN DIRECTOR 1.00 X 0 0 0 TODD STETNER DIRECTOR 1.00 X 0 0 0 STEWART STEIN DIRECTOR 1.00 X 0 0 0 LESLIE MARKS DIRECTOR 1.00 X 0 0 0 SIMON ABRAHMS DIRECTOR 1.00 X 0 0 0 ROBERT BARAN DIRECTOR 1.00 X 0 0 0 NEAL SCHWARTZ DIRECTOR 1.00 X 0 0 0 ROSANNE ROSEN DIRECTOR 1.00 X 0 0 0 1102460 0 150628 8 0 1 0 PARIC CORPORATION PO BOX 790100 ST LOUIS MO 63179 GENERAL CONTRACTOR 19039227 MORRISON SENIOR LIVING 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 DINING SERVICES 2665628 HARKRADER CONSTRUCTION 1001 NW CHIPMAN ROAD LEES SUMMIT MO 64081 GENERAL CONTRACTOR 450972 HERMES COMPANY INC 13030 W 87TH STREET PARKWAY LENEXA KS 66215 LANDSCAPING 371054 15 2842930 1736663 4579593 RESIDENT CARE REVENUE 623000 14122276 14122276 14122276 58849 58849 2104 2104 2314577 2501239 5166 -186662 -5166 -191828 -191828 MEALS 623000 14859 14859 WELLNESS CENTER 623000 10177 10177 SALON REVENUE 623000 2800 2800 3299 3299 31135 18602129 14122276 0 -99740 X 228659 228659 541052 386965 141259 12828 6928607 4955401 1808933 164273 73863 51494 20685 1684 900007 627401 252095 20511 635073 443357 177210 14506 84460 84460 142952 142952 91898 91898 1764 1764 3448593 3154668 291304 2621 123252 227 123025 592387 257815 312773 21799 252766 6960 245806 1420814 1309950 110864 10902 10902 488 488 2096057 2096057 3869122 3869122 364465 364465 DIETARY 769705 769705 EMPLOYEE RECOGNITION 296472 7968 288504 COVID EXPENSES 238314 233192 5122 RECRUITMENT 113072 1379 111693 428761 268420 159317 1024 23653505 18764102 4650157 239246 5029 15497 956889 4524682 5492174 4013678 413547 287976 57535 106581 813914 486206 121037844 40410360 67194466 80627484 36847889 11975327 1051834 1154273 112833277 103191704 9298810 2513381 23353235 35226682 68449734 58067770 237739 90051 101339518 95897884 X -1907765 4075441 13401524 3218379 11493759 7293820 112833277 103191704 X -5051376 617410 234027 X 0 1 X 1 0 X 2997568 2715642 9011334 2633199 4579593 21937336 16219116 16161844 14670492 14272143 14122276 75445871 19216684 18877486 23681826 16905342 18701869 97383207 41551 69480 4666890 206544 4984465 1162698 1203687 2564367 2052581 8234242 15217575 1204249 1273167 7231257 2052581 8440786 20202040 77181167 163886 79946 116411 219042 60953 640238 163886 79946 116411 219042 60953 640238 9725 19329 107418 112204 31135 279811 19390295 18976761 23905655 17236588 18793957 98303256 0.78510 0.85500 0.00650 0.00600 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2016 AMOUNT: $ 9,725. 2017 AMOUNT: $ 19,329. 2018 AMOUNT: $ 4,982. 2019 AMOUNT: $ 2,177. 2020 AMOUNT: $ 775. WELLNESS CENTER - 2018 AMOUNT: $ 53,630. 2019 AMOUNT: $ 49,040. 2020 AMOUNT: $ 10,177. SALON REVENUE - 2018 AMOUNT: $ 6,676. 2019 AMOUNT: $ 6,695. 2020 AMOUNT: $ 2,800. MEALS - 2018 AMOUNT: $ 42,130. 2019 AMOUNT: $ 48,292. 2020 AMOUNT: $ 14,859. DEPOSITS - 2019 AMOUNT: $ 6,000. SETTLEMENT CLAIMS - 2020 AMOUNT: $ 984. FINANCE CHARGE REVENUE - 2020 AMOUNT: $ 805. MEDICAL RECORDS - 2020 AMOUNT: $ 375. RESIDENT INTEREST - 2020 AMOUNT: $ 360. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1764 1764 0 PART II-B, LINE 1: FOR 2020, $1,764 OF DUES PAID TO LEADINGAGE KANSAS AND LEADINGAGE NATIONAL WERE USED FOR LOBBYING/ADVOCACY EXPENDITURES. 1836330 200756 62565 1974521 1652322 215354 31346 1836330 1771492 50000 -110231 58939 1652322 1605654 50000 165385 42336 7211 1771492 1487889 50000 97822 28215 1842 1605654 0.00000 0.83140 0.16860 0 0 2252860 2252860 90207805 23546815 66660990 21500502 14717413 6783089 7076677 2146132 4930545 80627484 19224907 617410 5368 622778 18602129 0 18602129 23424846 0 23424846 228659 228659 23653505 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 31,327. CHANGE IN VALUE OF PLEDGES RECEIVABLE 202,700. GRANTS/OTHER ASSISTANCE TO INDIVIDUALS -228,659. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS/OTHER ASSISTANCE TO INDIVIDUALS 228,659. 1 FINANCIAL ASSISTANCE 4 228659 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 325822 0 1250 0 0 0 0 0 29267 0 356339 0 0 0 NICOLE ANTHONY CFO 155315 0 1250 0 0 0 4103 0 24045 0 184713 0 0 0 JILL ALLIN DIRECTOR OF SALES & MARKETING 109196 0 40430 0 0 0 3182 0 24249 0 177057 0 0 0 ANGELA WHEELER VP OF HEALTHCARE SERVICES 127177 0 500 0 0 0 3438 0 25588 0 156703 0 0 0 PART I, LINE 7 BONUSES ARE BASED ON A NUMBER OF FACTORS INCLUDING EXCEPTIONAL PERFORMANCE, OPERATIONAL AND ORGANIZATION-BASED GOALS, AND FINANCIAL AND FUNDRAISING GOALS. 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 5304208 12155000 12155000 2002 1 0 1 1 B 7290000 61340618 3778009 6878312 1183985 48693790 806523 2021 0 0 0 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 0 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 12: UNSPENT PROCEEDS ARE COMPRISED OF $705,978.52 ON DEPOSIT IN THE PROJECT FUND AND $100,544.34 ON DEPOSIT IN THE FUNDED INTEREST FUND. PART II, COLUMN B, LINE 16: ALL PROJECTS TO BE FINANCED BY THE BONDS WERE NOT COMPLETED AS OF THE 2020 FISCAL YEAR END. HOWEVER, THE INSTITUTION EXPECTS TO COMPLETE A FINAL WRITTEN ALLOCATION PRIOR TO FILING ITS RETURN FOR THE 2021 FISCAL YEAR END. 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 DIRECTOR OF FINANCE AND PRESIDENT OF VILLAGE SHALOM. PRIOR TO THE MAILING TO THE VILLAGE SHALOM BOARD, THE DIRECTOR OF FINANCE 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 5,299. MANAGEMENT AND GENERAL EXPENSES 118,516. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 123,815. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,079,940. MANAGEMENT AND GENERAL EXPENSES 107,486. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,187,426. CONTRACTED THERAPY SERVICES: PROGRAM SERVICE EXPENSES 304,869. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 304,869. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,658,005. MANAGEMENT AND GENERAL EXPENSES 65,302. FUNDRAISING EXPENSES 2,621. TOTAL EXPENSES 1,725,928. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 106,555. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 106,555. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 31,327. CHANGE IN VALUE OF PLEDGES RECEIVABLE 202,700.