2021-08-04T10:04:45-05:00 2020-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2020-01-01 361952520 CENTRAL BAPTIST VILLAGE CENT 7085838500 4747 N CANFIELD NORRIDGE IL 60706 LORI ALTMAN CHIEF FINANCIAL OFFICER 7085838500 2021-08-02 1 LORI ALTMAN XXX-XX-XXXX DAVID LOWENTHAL P00378651 3122071040 2021-08-02 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DAWN MONDSCHEIN 4747 N CANFIELD NORRIDGE IL 60706 36162521 0 X WWW.CBVILLAGE.ORG X 1896 IL CENTRAL BAPTIST VILLAGE IS A CONTINUING CARE RETIREMENT COMMUNITY WITH (CONT'D ON SCHEDULE O) MORE THAN A CENTURY OF DEDICATED SERVICE IN CARING FOR OLDER ADULTS. INSPIRED BY FAITH, WE SERVE AND CELEBRATE SENIORS. 13 13 379 0 0 0 397887 1354849 17554312 16983217 1570930 2167688 366834 173975 19889963 20679729 0 0 0 0 10643693 11685993 26825 15226 15226 8047985 7744322 18718503 19445541 1171460 1234188 64895708 67828859 20387817 22121680 44507891 45707179 X AS SET FORTH IN PART I, LINE 1, CENTRAL BAPTIST VILLAGE IS A CHARITABLE AND RELIGIOUS NOT-FOR-PROFIT ORGANIZATION, ESTABLISHED UNDER THE SPONSORSHIP OF NORTH AMERICAN BAPTIST CONFERENCE OF CHURCHES. OUR MISSION EMBRACES A FULL RANGE OF HUMAN NEEDS OF THE ELDERLY AND IS LIMITED ONLY BY OUR IMAGINATION, OUR SKILLS, OUR RESOURCES, AND OUR WILLINGNESS TO PROMOTE MEANINGFUL CHANGE. BEYOND CARING FOR THE ELDERLY'S COMFORT, SAFETY, SECURITY, AND GOOD HEALTH CARE, WE ATTEMPT TO PROMOTE THE QUALITY OF THEIR LIVES AND CREATE A BALANCE BETWEEN PROVIDING CARE TO THE ELDERLY AND DEALING EFFECTIVELY WITH PEOPLE AND SITUATIONS OF THE WORLD AROUND US. THIS INCLUDES GROWING IN SPIRITUAL WHOLENESS AND UNDERSTANDING THE MEANING OF LIFE, AGING, AND DEATH.FOR MORE DETAIL ON OUR COMMITMENT AND MISSION, PLEASE SEE THE ATTACHED CENTRAL BAPTIST VILLAGE MISSION STATEMENT. 0 0 14379146 17108157 AS PART OF OUR MISSION AT CENTRAL BAPTIST VILLAGE, WE PLEDGE TO SUPPORT OUR RESIDENTS WHEN THEY DEPLETE THEIR FUNDS. WE HAVE MAINTAINED IN RESIDENCE ALL RESIDENTS WHO HAVE BECOME, THROUGH NO FAULT OF THEIR OWN, UNABLE TO PAY THEIR REGULAR CHARGES. THROUGH OUR OWN ENDOWMENT PROGRAM (MADE POSSIBLE BY THE GENEROUS CONTRIBUTIONS OF OTHER CHURCHES, CHARITABLE ORGANIZATIONS, AND PEOPLE WHO BELIEVE IN AND SUPPORT THE PURPOSE, PROGRAMS, AND MISSION OF OUR COMMUNITY), WE EXTEND A HELPING HAND OF CHARITY IN THE TRUE EXAMPLE OF CHRIST AND HIS MINISTRY. OUR CHARITY APPLIES ALSO TO PERSONS OUTSIDE THE COMMUNITY WHO DO NOT HAVE THE FINANCIAL RESOURCES TO PAY THE COMMUNITY'S FEES AND CHARGES. WE ASSIST THEM, IN PART OR IN FULL, TO THE BEST OF OUR GOD GIVEN ABILITIES. IN ACCORDANCE WITH OUR BYLAWS, WE WILL WAIVE OR REDUCE, BASED ON AN INDIVIDUAL'S ABILITY TO PAY, ANY ENTRANCE FEE, ASSIGNMENT OF ASSETS, OR FEE FOR SERVICES. THIS CHARITY IS AVAILABLE TO ALL WHO NEED AND APPLY FOR IT. IN ADDITION, PROVIDING SERVICES TO OUR SKILLED NURSING RESIDENTS UNDER MEDICAID (9,113 MEDICAID DAYS IN 2020), PAYMENTS FOR WHICH DO NOT MEET OUR COSTS, WE FURTHER PRESERVE THEIR RESOURCES. OUTSIDE OF SKILLED NURSING, WE SUPPORT RESIDENTS IN OUR INDEPENDENT AND ASSISTED LIVING RESIDENCES WHO HAVE A NEED THROUGH OUR ENDOWMENT PROGRAM. IN ADDITION, WE HAVE FORGIVEN RESIDENTS' DEBT, DONATED CEMETERY PLOTS, AND PAID FOR FUNERALS AND MEMORIAL SERVICES IN OUR CHAPEL. CENTRAL BAPTIST VILLAGE ALSO EXTENDS ITS CHARITY TO THE LOCAL COMMUNITY AT LARGE. WE ARE A MAJOR CONTRIBUTOR TO THE SENIORS ASSISTANCE CENTER, SUPPORT THE HOME DELIVERED MEALS PROGRAM, HOST SAC VOLUNTEER LUNCHEONS, AND PROVIDE COMPLIMENTARY HEALTH SCREENING AND PRESENTATIONS FOR AREA OLDER ADULTS. ADDITIONALLY, CERTAIN CENTRAL BAPTIST VILLAGE EDUCATIONAL PROGRAMS ASSIST OUR LOCAL COMMUNITY TO LEARN AND MANAGE A MYRIAD OF RELEVANT TOPICS ON SUCCESSFUL AGING. EXAMPLES OF THOSE PROGRAMS ARE AGING CARE CONNECTIONS BENEFITS FAIR, TOTAL MEMORY WORKOUT, MEMORY SCREENING DAY, HEALTH CARE DECISIONS DAY, AND ANNUAL SENIOR HEALTH AND FITNESS DAY. WE SUPPORT MANY SCHOOLS WITH THEIR CNA TRAINING PROGRAMS, INTERNSHIP PLACEMENT SERVICES, AND PROFESSIONAL CONTINUING EDUCATIONAL SEMINARS, WHICH PROVIDE A COMPREHENSIVE EDUCATIONAL EXPERIENCE FOR INDIVIDUALS SEEKING TO WORK IN THE GERONTOLOGY FIELD. WE OFFER STIMULATING INTER-GENERATIONAL PROGRAMMING TO ENCOURAGE MUTUAL LEARNING, MENTORING, AND ENTERTAINMENT AND TO ENHANCE THE QUALITY OF LIFE FOR ALL PARTICIPANTS. IN OUR ON-GOING EFFORT TO SUPPORT A LOCAL CHURCH ON OUR PROPERTY, WE PROVIDE THE LAND FOR CHURCH OF OUR SAVIOR AND DONATE 20 PARKING SPOTS IN OUR COMMUNITY'S PARKING LOT FOR NORRIDGE COMMUNITY RESIDENTS' PARKING NEEDS. THESE EXAMPLES DO NOT CAPTURE ALL OF OUR ACTIVITIES, BUT THEY GIVE A PICTURE OF OUR CHARITABLE AND RELIGIOUS MISSION. THE PURPOSE OF ALL OF OUR ACTIVITIES IS TO CARRY FORWARD THAT MISSION. 14379146 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 0 1 0 0 0 0 0 0 1 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 13 0 1 379 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X LORI ALTMAN 7085838500 4747 N CANFIELD AVENUE NORRIDGE IL 60706 MARY COBAN PRESIDENT 1.00 0.00 X X 0 0 0 JAMES RENKE VICE PRESIDENT 1.00 0.00 X X 0 0 0 JULIE ADAMS TREASURER 1.00 0.00 X X 0 0 0 RICH GUSTAFSON SECRETARY 1.00 0.00 X X 0 0 0 RAYMOND MCGOVERN DIRECTOR 1.00 0.00 X 0 0 0 PAUL ODLYZKO DIRECTOR 1.00 0.00 X 0 0 0 DUSHYANT PATEL DIRECTOR 1.00 0.00 X 0 0 0 CARLO SALVADOR DIRECTOR 1.00 0.00 X 0 0 0 CONNIE LEEPER DIRECTOR 1.00 0.00 X 0 0 0 JOSHUA VIET NGUYEN DIRECTOR 1.00 0.00 X 0 0 0 CAROLYN JOHNSON DIRECTOR 1.00 0.00 X 0 0 0 JUDITH DUNNE BERNARDI DIRECTOR 1.00 0.00 X 0 0 0 DANIEL WITT DIRECTOR 1.00 0.00 X 0 0 0 DAWN MONDSCHEIN CHIEF EXECUTIVE OFFICER 40.00 0.00 X 211996 0 15260 LORI ALTMAN CHIEF FINANCIAL OFFICER 40.00 0.00 X 178307 0 8937 ANNA-LIISA LACROIX ADMINISTRATOR 40.00 0.00 X 141424 0 12216 KAREN HAEDO DIRECTOR OF NURSING 40.00 0.00 X 142015 0 8441 RACHEL TELLEEN DIRECTOR OF SALES & MARKET 40.00 0.00 X 103510 0 7709 777252 0 52563 5 0 1 0 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 OPERATIONS MANAGEMENT 1902715 SYMBRIA REHAB 28100 TORCH PARKWAY WARRENVILLE IL 60555 REHAB THERAPISTS 544160 0 288507 941616 124726 1354849 NURSING HOME FEES 623000 13210247 13210247 MEDICARE/MEDICAID PAYMENTS 623000 3772970 3772970 16983217 972539 972539 16677941 15482792 1195149 1195149 1195149 NON-REFUNDABLE DEPOSITS 900099 80450 80450 VILLAGE CAFE 900099 33585 33585 BEAUTY/BARBER SHOP 900099 15450 15450 44490 44490 173975 20679729 17108157 0 2216723 409839 409839 9207611 8180141 1027470 112428 54962 57466 1265530 1117442 148088 690585 587538 103047 46412 46412 58315 58315 15226 15226 123392 123392 1032285 918412 113873 41403 41403 84980 33709 51271 170036 9686 160350 1924394 623554 1300840 6139 5334 805 29818 6411 23407 18 18 1419243 972443 446800 280827 31429 249398 FOOD 986863 934480 52383 SUPPLIES 881416 877921 3495 PROVIDER TAX 280406 280406 DUES/FEES/LICENSES 42827 42827 335548 25684 309864 19445541 14379146 5051169 15226 1198229 1247014 1903468 1894035 3039269 3130697 247987 284219 40994793 21230034 20121969 19764759 38384786 41508135 64895708 67828859 1660916 1936239 18426183 17943115 0 1992700 300718 249626 20387817 22121680 X 26326040 27745104 18181851 17962075 44507891 45707179 64895708 67828859 X 1234188 -575630 540730 X 0 1 X 1 0 X 321267 331678 338552 397887 1354849 2744233 16195837 16924968 17440561 17921146 17157192 85639704 16517104 17256646 17779113 18319033 18512041 88383937 1085 1960 6965 5700 15710 0 1085 1960 6965 5700 15710 88368227 860299 923751 969274 1089639 972539 4815502 860299 923751 969274 1089639 972539 4815502 625 5360 5985 17377403 18181022 18753747 19408672 19484580 93205424 0.94810 0.94350 0.05170 0.05640 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: SPECIAL EVENT REVENUE - 2017 AMOUNT: $ 625. 2018 AMOUNT: $ 5,360. 2019 AMOUNT: $ 0. 2020 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18130689 996204 1175411 76444 17875039 17101570 2392542 1285117 78306 18130689 18726053 -779955 765788 78740 17101570 17628606 1920557 744489 78621 18726053 17521903 1329382 1146186 76493 17628606 1.00000 0 0 285820 285820 29120093 15689758 13430335 11323290 5540276 5783014 265590 265590 19764759 SECURITIES - NORTHERN TRUST 21004976 C PERPETUAL TRUSTS 17875042 C RESTRICTED FUNDS - AMALGAMATED 2492880 C CERTIFICATE OF DEPOSIT 135237 C 41508135 SECURITY DEPOSITS 144647 BOND PREMIUM 77410 RESIDENT CREDIT BALANCES 27569 249626 20521437 -575630 540730 -34900 20556337 123392 123392 20679729 19322149 0 19322149 123392 123392 19445541 PART V, LINE 4: THE ENDOWMENT AND ASSISTANCE FUND IS USED TO PROVIDE FINANCIAL ASSISTANCE TO RESIDENTS WHO LIVE IN INDEPENDENT OR ASSISTED LIVING WHO ARE NO LONGER ABLE TO AFFORD THEIR MONTHLY FEES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF PERPETUAL TRUSTS HELD BY OTHERS 540,730. X X X X 1 FUND INC 910 SKOKIE BLVD SUITE 206 NORTHBROOK IL 60062 ASSESSMENT OF DONOR BASE, DETERMINATION OF THEMES FOR APPEAL 0 123928 15226 108712 123928 15226 108712 IL X X X X 0 0 0 0 0 0 0 1 0 DAWN MONDSCHEIN CHIEF EXECUTIVE OFFICER 208496 0 3500 0 0 0 2542 0 12718 0 227256 0 0 0 LORI ALTMAN CHIEF FINANCIAL OFFICER 175307 0 3000 0 0 0 2119 0 6818 0 187244 0 0 0 ANNA-LIISA LACROIX ADMINISTRATOR 138424 0 3000 0 0 0 1724 0 10492 0 153640 0 0 0 KAREN HAEDO DIRECTOR OF NURSING 135865 0 6150 0 0 0 1623 0 6818 0 150456 0 0 0 PART I, LINE 7 AS INDICATED IN SCHEDULE J, PART II, THE CEO AND CFO RECEIVED A BONUS BASED UPON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THE BONUS WAS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. A ILLINOIS FINANCE AUTHORITY 861091967 45200B4K1 2007-06-14 23510440 SEE PART VI 0 0 0 A 5120000 24724398 2340303 470209 2345 1527275 21930801 2007 1 1 1 1 A 0 0 0 0 0 0 1 A 0 0 1 1 0 0 1 NATIXIS FUNDING COR 22.400000000000 1 0 1 A 1 SCH K, PART I, LINE A, COLUMN (F): RENOVATE FACILITY AND REFUND PRIOR ISSUES (11/10/1999). SCH K, PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. SCH K, PART II, LINE 3: THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4 - 12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. SCH K, PART IV, LINE 2C: DATE THE REBATE COMPUTATION WAS PERFORMED: 05/31/2017 SCH K, PART IV, LINE 5C, COLUMN A: THE GIC WAS TERMINATED ON 7/12/2012 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO PREPARE THE ORGANIZATION'S FORM 990. MANAGEMENT REVIEWS THE COMPLETED FORM 990 AND PROVIDES A FULL COPY TO ALL VOTING MEMBERS OF THE GOVERNING BODY. BOARD MEMBERS APPROVE THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS IS REQUIRED TO ANNUALLY DISCLOSE ANY PERSONS OR ENTITIES WHICH MAY PRESENT A POSSIBLE FUTURE CONFLICT OF INTEREST. THESE ARE REVIEWED BY THE EXECUTIVE DIRECTOR AND BOARD PRESIDENT AND FILED IN THE EXECUTIVE DIRECTOR'S BOARD MEMBER FILES. IN ADDITION, THE BOARD IS ASKED AT EACH MEETING IF THERE ARE ANY CONFLICTS OF INTEREST THAT NEED TO BE REPORTED. IF THERE ARE ANY DISCLOSED, THEY ARE DOCUMENTED IN THE MINUTES AND THE INTERESTED BOARD MEMBER IS PROHIBITED FROM PARTICIPATING IN DISCUSSIONS OR VOTES PERTAINING TO ANY TRANSACTION OR ARRANGEMENT. CENTRAL BAPTIST VILLAGE'S EMPLOYEE HANDBOOK CONTAINS A CONFLICT OF INTEREST POLICY AND ALL EMPLOYEES ARE REQUIRED TO SIGN A HANDBOOK RECEIPT ACKNOWLEDGMENT. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE ANNUAL REVIEW OF THE COMPENSATION OF THE OFFICERS OF THE ORGANIZATION. ALL MEMBERS OF THE COMMITTEE ARE INDEPENDENT IN DETERMINING THE COMPENSATION OF THE OFFICERS OF THE ORGANIZATION. THE COMMITTEE EVALUATES THE OFFICERS OF THE ORGANIZATION PERFORMANCE AGAINST PREVIOUSLY AGREED UPON CRITERIA, CONSIDERS COMPARABLE MARKET DATA, THEN DEBATES AND DOCUMENTS ITS RECOMMENDATION OF REASONABLE COMPENSATION. IN DETERMINING THE COMPENSATION OF OTHER OFFICERS, THE SAME PROCEDURES ARE PERFORMED; HOWEVER, THE COMMITTEE CONSIDERS THE CEO'S EVALUATION OF THE STAFF'S PERFORMANCE. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF PERPETUAL TRUSTS HELD BY OTHERS 540,730. ARTHUR E GENIUS PO BOX 803878 CHICAGO IL 60680 366038242 SUPPORTING ORGANIZATION IL 501(C)(3) LINE 12D, III-O 0 RICHARD M GENIUS SR TRUST FOR CENTRAL BAPTIST HOME PO BOX 803878 CHICAGO IL 60680 367035832 SUPPORTING ORGANIZATION IL 501(C)(3) LINE 12D, III-O 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ARTHUR E GENIUS C 79881 COST RICHARD M GENIUS SR TRUST FOR CENTRAL BAPTIST HOME C 208626 COST