2021-04-13T15:39:48-05:00 2018-12-31 990 2018-07-02 251364240 ROLLING FIELDS INC ROLL 8145872012 9108 STATE HWY 198 CONNEAUTVILLE PA 16406 RANDAL GERIG CHIEF FINANCIAL OFFICER 8145872012 2021-04-13 2018 2022-09-23 18:48:47Z X RANDAL GERIG 9108 STATE HWY 198 CONNEAUTVILLE PA 16406 7624693 0 X HTTPS://WWW.ROLLINGFIELDS.COM/ X 1979 PA THE OPERATION OF A NURSING HOME WITH EXTENDED CARE FACILITIES AND TO OTHERWISE GENERALLY ENGAGE IN AND DO ANY LAWFUL ACT CONCERNING ANY OR ALL LAWFUL BUSINESS FOR WHICH CORPORATIONS MAY BE INCORPORATED UNDER THE BUSINESS CORPORATION LAW. 9 9 440 20 0 0 14127 6972178 34645 603743 7624693 0 0 4311317 0 0 4054757 8366074 -741381 24874321 25541526 -667205 THE OPERATION OF A NURSING HOME WITH EXTENDED CARE FACILITIES AND TO OTHERWISE GENERALLY ENGAGE IN AND DO ANY LAWFUL ACT CONCERNING ANY OR ALL LAWFUL BUSINESS FOR WHICH CORPORATIONS MAY BE INCORPORATED UNDER THE BUSINESS CORPORATION LAW. 0 0 7081533 7575933 THE OPERATION OF A NURSING HOME WITH EXTENDED CARE FACILITIES AND TO OTHERWISE GENERALLY ENGAGE IN AND DO ANY LAWFUL ACT CONCERNING ANY OR ALL LAWFUL BUSINESS FOR WHICH CORPORATIONS MAY BE INCORPORATED UNDER THE BUSINESS CORPORATION LAW. 7081533 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 95 0 440 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X ORGANIZATION 7164876800 4600 ROUTE 60 GERRY NY 14740 WILLIAM RUSHIK CHAIR 1.00 X X 0 0 0 DAVID RISHELL TREASURER 1.00 X X 0 0 0 BERTHA SAHO SECRETARY 1.00 X X 0 0 0 BURTON JONES SECRETARY/TREASURER 1.00 X X 0 0 0 JANET SNYDER DIRECTOR 1.00 X 0 0 0 DAN JOHNSON DIRECTOR 1.00 X 0 0 0 RICHARD HILLIKER DIRECTOR 1.00 X 0 0 0 SUSAN WILSTON DIRECTOR 1.00 X 0 0 0 SUSANNE MOHNKERN DIRECTOR 1.00 X 0 0 0 DAVID SMELTZER PRESIDENT & CEO 1.00 37.50 X 0 380494 22362 RANDAL GERIG CHIEF FINANCIAL OFFICER 0.00 37.50 X 0 0 0 SHELLY SMITH RNAC 40.00 X 100104 0 2738 100104 380494 25100 1 0 1 0 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 60694 THERAPY 1089644 GORDON FOOD SERVICE PO BOX 88029 CHICAGO IL 60680 FOOD SERVICE 250028 CH REAMS & ASSOC INC 401 CRANBERRY STREET ERIE PA 16507 BENEFITS ADMIN 195795 MAPLEVALE FARMS 2063 ALLEN ST EXT FALCONER NY 14733 FOOD SERVICE 170783 DRS OF ERIE 2218 EAST 30TH ERIE PA 16510 CONSTRUCTION 166211 5 14127 14127 RESIDENT REVENUE 623000 6966622 6966622 ENTRANCE FEES 623000 5556 5556 6972178 34633 34633 12 0 12 12 12 OTHER NON-OP REVENUE/T 623000 519622 519622 CAFETERIA SALES 623000 72376 72376 OTHER INCOME 623000 10963 10963 782 782 603743 7624693 7575933 0 34633 3794855 3580967 213888 236959 223603 13356 279503 263749 15754 700096 700096 10350 10350 33280 33280 19041 19041 29809 28031 1778 43624 43624 127762 127762 25691 18116 7575 443617 378933 64684 201524 172140 29384 83747 82996 751 PURCHASED AND CONTRACTE 1478822 1446588 32234 SUPPLIES 756653 730172 26481 BAD DEBTS AND OTHER EXP 82759 26776 55983 RECRUITMENT 17777 1700 16077 205 205 8366074 7081533 1284541 0 903292 30887 2809299 54476 17932322 275653 0 17656669 0 3419698 0 24874321 799754 2883 15717594 0 9021295 0 25541526 X -667205 0 -667205 0 24874321 X -741381 74176 X X 0 1 X 1 0 X 14127 14127 7575933 7575933 7590060 7590060 0 0 0 7590060 34633 34633 34633 34633 7624693 7624693 X SCHEDULE A, PART III, PUBLIC SUPPORT CALCULATION: SCHEDULE A, PART III CONTAINS A SHORT YEAR'S DATA IN THE 2018 COLUMN AS THE CORPORATION WAS CONVERTED TO A NON-PROFIT EFFECTIVE JULY 2, 2018. DATA IN THIS COLUMN CONTAINS REVENUE FROM JULY 2, 2018 THROUGH DECEMBER 31, 2018. 832384 832384 14990630 187603 14803027 876616 43830 832786 1024730 44220 980510 207962 207962 17656669 DUE FROM THE KENNEY 27000 ASSETS LIMITED AS TO USE 3034264 GOODWILL 174516 RESIDENT FUNDS 183918 3419698 DUE TO ESCROW AGENT 1500000 DEPOSITS 500 ENTRANCE FEE 9000 RESIDENT FUNDS 183918 DUE TO RELATED COMPANIES 7327877 9021295 X PART X, LINE 2: THE ORGANIZATION AND ITS COMPONENTS, WITH THE EXCEPTION OF ROLLING FIELDS, ARE NOT-FOR-PROFIT CORPORATIONS AND ARE EXEMPT FROM INCOME TAXES AS ORGANIZATIONS QUALIFIED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO CLASSIFIED THE ORGANIZATION AND ITS COMPONENTS AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS. ROLLING FIELDS, WITH THE CONSENT OF ITS STOCKHOLDERS, HAS ELECTED TO HAVE ITS INCOME TAXED AS AN S CORPORATION UNDER SECTION 1362 OF THE INTERNAL REVENUE CODE. AS SUCH, ROLLING FIELDS DOES NOT PAY CORPORATION INCOME TAXES AND IS NOT ALLOWED NET OPERATING TAX LOSS CARRYBACKS OR CARRYOVERS AS DEDUCTIONS. INSTEAD, THE STOCKHOLDERS INCLUDE THEIR PROPORTIONATE SHARE OF ROLLING FIELDS' TAXABLE INCOME OR LOSS IN THEIR INDIVIDUAL INCOME TAX RETURNS. UPON ACQUISITION, ROLLING FIELDS APPLIED FOR NOT-FOR-PROFIT FILING STATUS AND AS DEEMED A NOT-FOR-PROFIT CORPORATION EXEMPT FROM INCOME TAXES QUALIFIED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE SERVICE EFFECTIVE JULY 2, 2018. 0 0 0 0 0 0 0 0 0 DAVID SMELTZER PRESIDENT & CEO 0 345494 0 35000 0 0 0 0 0 22362 0 402856 0 0 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION'S BYLAWS WERE AMENDED IN MARCH 2019 TO REFLECT THE STOCK PURCHASE AGREEMENT BETWEEN ROLLING FIELDS INC AND THE GERRY HOMES, IN WHICH THE GERRY HOMES BECAME THE SOLE CORPORATE MEMBER OF ROLLING FIELDS INC. SUBSEQUENTLY, IN JULY 2019, THE ORGANIZATION WAS GRANTED TAX EXEMPTION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 WAS PROVIDED TO MEMBERS OF THE GOVERNING BODY FOR REVIEW AND COMMENT PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE FINANCE COMMITTEE REVIEWS DISCLOSURES COMPLETED BY OFFICERS AND DIRECTORS ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 HUMAN RESOURCES GATHERS COMPENSATION INFORMATION FROM LOCAL FACILITIES SIMILAR TO THE ORGANIZATION THROUGH REVIEW OF PUBLIC 990S, FOR REVIEW WITH THE BOARD OF DIRECTORS. THE BOARD MEETS TO FINALIZE AND APPROVE FINAL COMPENSATION FIGURES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO BE MAILED OR SENT ELECTRONICALLY UPON REQUEST. FORM 990, PART XI, LINE 9: PRIOR NET ASSET BALANCES, PRIOR TO NFP STATUS 74,176. FORM 990, PART XII, LINE 2C: AS THIS IS THE ORGANIZATION'S FIRST YEAR AS A NON-PROFIT, THE ORGANIZATION APPOINTED A BOARD AND AUDIT COMMITTEE WHICH GOVERNS THE OVERSIGHT AND SELECTION PROCESS OF THE AUDIT. FORM 990, GENERAL INFORMATION, YEAR OF FORMATION: THE YEAR OF FORMATION, 1979, REPRESENTS THE ORIGINAL YEAR OF FORMATION FOR ROLLING FIELDS NURSING HOME, ORIGINALLY A FOR-PROFIT S CORPORATION. EFFECTIVE JULY 2, 2018, AFTER PURCHASE BY THE GERRY HOMES, ROLLING FIELDS, INC. WAS CONVERTED TO A 501(C)(3). HERITAGE MINISTRIES MANAGEMENT CO INC 4600 ROUTE 60 GERRY NY 14740 261590078 SUPPORTING ORGANIZATION NY 501(C)(3) LINE 12A, I N/A 0 WESTERN NEW YORK MENNONITE RETIREMENT COMMUNITY INC 5945 VINECROFT DRIVE CLARENCE CENTER NY 14032 161560655 HOUSING FOR SENIORS NY 501(C)(3) LINE 10 N/A 0 HERITAGE VILLAGE REHAB & SKILLED NURSING INC 4570 ROUTE 60 GERRY NY 14740 261231096 HEALTH CARE FOR THE ELDERLY NY 501(C)(3) LINE 10 N/A 0 HERITAGE MINISTRIES CHARITABLE CARE NETWORK 4600 ROUTE 60 GERRY NY 14740 261454957 PASSIVE PARENT ORGANIZATION NY 501(C)(3) LINE 12A, I N/A 0 HEARTHSTONE AT SERENITY CREEK 920 N SEMINARY AVENUE WOODSTOCK IL 60098 463825098 HEALTH CARE FOR THE ELDERLY IL 501(C)(3) LINE 10 N/A 0 WOODSTOCK CHRISTIAN LIFE SERVICES INC 920 N SEMINARY AVENUE WOODSTOCK IL 60098 363186415 HEALTH CARE FOR THE ELDERLY IL 501(C)(3) LINE 10 N/A 0 GERRY HOMES INC 4600 ROUTE 60 GERRY NY 14740 160755780 HEALTH CARE FOR THE ELDERLY NY 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0