2021-11-09T07:15:20-06:00 2020-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-01-01 350931432 BHI SENIOR LIVING INC BHIS 3178373371 5415 BEARBERRY LANE INDIANAPOLIS IN 46268 ROGER E WEIDEMAN II DIRECTOR, SVP, & CFO 3173733371 2021-11-02 1 ROGER WEIDEMAN II XXX-XX-XXXX AMY CIMINELLO P00796388 6148493000 2021-11-02 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROGER E WEIDEMAN II 5415 BEARBERRY LANE INDIANAPOLIS IN 46268 120964951 0 X BHISENIORLIVING.ORG X 1903 IN THE MISSION OF BHI SENIOR LIVING, INC. IS TO ENHANCE THE QUALITY OF LIFE FOR OLDER ADULTS WITHIN A SECURE ENVIRONMENT. 14 12 658 20 0 0 143769 1476477 50905411 49712813 3728551 2046678 0 120034 54777731 53356002 0 0 0 0 20412379 18313870 0 0 0 31036018 33861127 51448397 52174997 3329334 1181005 325556766 347696848 294055328 311603637 31501438 36093211 THE MISSION OF BHI SENIOR LIVING, INC. IS TO ENHANCE THE QUALITY OF LIFE FOR ADULTS WITHIN A SECURE ENVIRONMENT, WHICH SUPPORTS THEIR NEEDS, VALUES, INTERESTS, AND INDEPENDENCE WHILE ENCOURAGING SPIRITUAL DEVELOPMENT. 0 0 48824701 0 49712813 BHI SENIOR LIVING, INC IS A NOT-FOR-PROFIT CORPORATION, PROVIDING CONTINUING CARE SERVICES TO THE ELDERLY UNDER THE TERMS OF CONTINUING CARE AGREEMENTS. 48824701 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 1 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 1 1 0 0 1 171 0 1 658 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X ROGER E WEIDEMAN II 3178733371 5415 BEARBERRY LANE INDIANAPOLIS IN 46268 JOHN S DATTILO DIRECTOR & PRESIDENT/CEO 6.00 52.00 X X 0 319898 42948 ROGER E WEIDEMAN II DIRECTOR & SENIOR VP AND CFO 6.00 52.00 X X 0 297114 40927 DANIEL CARR VICE PRESIDENT AND COO 4.00 44.00 X 0 249747 36354 JOHN KOONTZ SALES DIRECTOR 40.00 0.00 X 178744 0 33111 MINDY KANTZ EXECUTIVE DIRECTOR 40.00 0.00 X 168085 0 34871 REBECCA STENNER EXECUTIVE DIRECTOR 40.00 0.00 X 140603 0 20121 AMY RIEGLING EXECUTIVE DIRECTOR 40.00 0.00 X 127576 0 25404 KEVIN WARD ASSOCIATE EXECUTIVE DIRECTOR 40.00 4.00 X 125000 0 15211 JANE RICHARDSON DIRECTOR & VICE-CHAIRPERSON 2.00 4.50 X X 0 0 0 JANE A SEIGEL DIRECTOR AND CHAIRPERSON 2.00 4.50 X X 0 0 0 JEFFERY A TERP DIRECTOR & ASSISTANT SECRETARY 2.00 4.50 X X 0 0 0 WENDY L MEREDITH DIRECTOR & SECRETARY 2.00 10.50 X X 0 0 0 WILLIAM R HURT DIRECTOR 2.00 10.50 X 0 0 0 DEXTER H COOLEY DIRECTOR 2.00 4.50 X 0 0 0 HARRY H KENNERK DIRECTOR 2.00 4.50 X 0 0 0 JOHN D LIPSON DIRECTOR 2.00 8.50 X 0 0 0 L DEAN JONES DIRECTOR 2.00 4.50 X 0 0 0 ROGER D MILLER DIRECTOR 2.00 8.50 X 0 0 0 JEFFREY W CALDWELL DIRECTOR 2.00 4.50 X 0 0 0 SHAWNA V GOTTLIEB DIRECTOR 2.00 4.50 X 0 0 0 740008 866759 248947 5 0 1 0 MEYER NAJEM CONSTRUCTION LLC 11787 LANTERN ROAD SUITE 100 FISHERS IN 46038 BLDG CONSTRUCTION 15821232 BEDROCK BUILDERS INC 14701 CUMBERLAND ROAD NOBLESVILLE IN 46060 BLDG CONSTRUCTION 14094750 SHAWNEE CONSTRUCTION & ENGINEERING INC 7701 OPPORTUNITY DRIVE FORT WAYNE IN 46825 BLDG CONSTRUCTION 8027982 MORRISON COMMUNITY LIVING PO BOX 102289 ATLANTA GA 30368 FOOD SERVICES MGMT 7230295 VALENTI-HELD CONDEV INC 3961 PERRY BLVD WHITESTOWN IN 46075 BLDG CONSTRUCTION 1541761 35 147590 1328887 1476477 SERVICE FEES 623000 41604629 41604629 ANCILLARY SERVICES 623000 4553861 4553861 ENTRANCE FEES 623000 3356323 3356323 PROCESS AND APPLICATION 623000 198000 198000 49712813 1390244 1390244 68255735 9648 67601637 7312 654098 2336 656434 656434 SAMARITAN ALLIANCE FUNDS 623000 116750 116750 REBATE FUNDS 623000 3284 3284 120034 53356002 49712813 0 2166712 X 14934993 13293001 1641992 346828 295522 51306 1933867 1657890 275977 1098182 995381 102801 3000000 3000000 29989 29989 153379 153379 8855395 8851115 4280 211868 208662 3206 991728 811293 180435 439741 13217 426524 2451605 2451605 83265 75075 8190 16907 13345 3562 6369275 6329292 39983 7685927 7462664 223263 683270 683270 RESIDENT EXPENSE 1494281 1494281 MEDICAL PURCHASES/SUPPL 571707 571707 REPAIRS AND RENOVATIONS 460689 460689 EMPLOYEE COSTS 97832 45464 52368 264269 111228 153041 52174997 48824701 3350296 0 3322 3322 6819753 20842161 8672543 8002025 117781 117781 216962 209488 307291576 80718378 180128794 226573198 49767970 51511387 2163133 5237123 77666508 35200363 325556766 347696848 7406183 12758401 87555025 101821445 199094120 197023791 294055328 311603637 X 31501438 36093211 31501438 36093211 325556766 347696848 1181005 3410768 0 X X 0 1 X 1 0 X 201287 260642 234119 143769 1476477 2316294 46364615 47643923 49264236 50905411 49712813 243890998 46565902 47904565 49498355 51049180 51189290 246207292 566022 1238403 1804425 0 566022 1238403 1804425 244402867 989721 1330797 1581004 1394290 1390244 6686056 989721 1330797 1581004 1394290 1390244 6686056 613 625 1238 120034 120034 47555623 49235362 51079972 52444095 52699568 253014620 0.96600 0.96550 0.02640 0.02720 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 808649 93933 41400 861182 711199 138250 40800 808649 799524 -47525 40800 711199 741911 97613 40000 799524 720613 60798 39500 741911 0.41940 0.58060 0.00000 0 1 1 14966765 14966765 196886754 56011922 140874832 27602752 16372837 11229915 67835305 8333619 59501686 226573198 ESCROW FUNDS FOR BONDS 11117893 INVESTMENT IN CCRRG 328945 WELLS 2018 PROJECT FUNDS 23753525 35200363 X PART V, LINE 4: THE ENDOWMENT IS HELD BY BHI FOUNDATION, INC., A RELATED ORGANIZATION, TO SUPPORT OPERATIONS OF BHI SENIOR LIVING, INC. THE $500,000 MUST BE PERMANENTLY HELD WITH THE EARNINGS TO BE USED FOR LANDSCAPING WAGES AND EXPENSES AT THE FOUR SEASONS CAMPUS IN COLUMBUS, IN. PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF DECEMBER 21, 2020 AND 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 2339010 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 1247574 0 0 0 0 0 0 3586584 0 3586584 0 0 0 0 0 0 PART III ACCOUNTING METHOD: 0 1 0 0 0 0 0 1 0 JOHN S DATTILO DIRECTOR & PRESIDENT/CEO 0 284898 0 35000 0 0 0 14250 0 28698 0 362846 0 0 ROGER E WEIDEMAN II DIRECTOR & SENIOR VP AND CFO 0 267114 0 30000 0 0 0 13446 0 27481 0 338041 0 0 DANIEL CARR VICE PRESIDENT AND COO 0 232247 0 17500 0 0 0 11587 0 24767 0 286101 0 0 JOHN KOONTZ SALES DIRECTOR 177244 0 1500 0 0 0 9241 0 23870 0 211855 0 0 0 MINDY KANTZ EXECUTIVE DIRECTOR 163085 0 5000 0 0 0 8834 0 26037 0 202956 0 0 0 REBECCA STENNER EXECUTIVE DIRECTOR 136603 0 4000 0 0 0 7171 0 12950 0 160724 0 0 0 AMY RIEGLING EXECUTIVE DIRECTOR 122576 0 5000 0 0 0 6528 0 18876 0 152980 0 0 0 SCHEDULE J, PART 1, LINE 3 METHODS USED TO DETERMINE COMPENSATION: COMPENSATION PAID BY BHI RETIREMENT COMMUNITIES IS DETERMINED BY THE REVIEW AND APPROVAL OF THE BHI SENIOR LIVING BOARD WHICH INCLUDES CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. SCHEDULE J, PART 1, 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. SCHEDULE J, PART 1, LINE 7 NONFIXED PAYMENTS: THE PERSONNEL NOMINATING COMMITTEE RECOMMENDS DISCRETIONARY BONUSES FOR THE TOP MANAGEMENT OFFICIALS, THAT ARE APPROVED BY THE FULL BOARD AS PART OF THE BUDGET PROCESS. IN THE PROCESS, THEY CONSIDER RESULTS FROM SURVEYS, PROJECTS, AND BOND ISSUES. THE REVIEW WAS CONDUCTED IN NOVEMBER 2020. THE OFFICERS ARE COMPENSATED THROUGH A RELATED ORGANIZATION, BHI RETIREMENT COMMUNITIES. A INDIANA FINANCE AUTHORITY 351602316 2011-10-11 28753388 CAPITAL IMPROVEMENTS/ADDITIONS, COSTS AND DEBT SERVICES FOR SERIES 2011 BOND 0 0 0 B INDIANA FINANCE AUTHORITY 351602316 2013-08-15 21687097 CAPITAL IMPROVEMENTS/ADDITIONS, COSTS AND DEBT SERVICES FOR SERIES 2013 BOND 0 0 0 C INDIANA FINANCE AUTHORITY 351602316 2014-12-04 34000000 TO ADVANCE REFUND 2005 BONDS, PAY FOR COSTS CONNECTED TO SERIES 2014 BONDS 1 0 0 D INDIANA FINANCE AUTHORITY 351602316 2016-12-15 35349740 TO FINANCE COSTS OF ACQUIRING/RENOVATING/CONSTRUCTING SENIOR LIVING FACILITY 0 0 0 A 11807707 28753388 2107800 565057 18492211 0 0 1 1 B 6915038 21687097 2634300 433742 18619055 0 0 1 1 C 16025 34000000 34000000 0 0 1 1 D 3457487 35349740 694260 30792540 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART 1, LINE A(F) TO MAKE CERTAIN CAPITAL ADDITIONS AND IMPROVEMENTS TO THE ORGANIZATION'S FACILITIES; TO FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2011 BONDS; AND TO PAY FOR CERTAIN COST IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2011 BONDS. SCHEDULE K, PART 1, LINE B(F) TO MAKE CERTAIN CAPITAL ADDITIONS AND IMPROVEMENTS TO THE ORGANIZATION'S FACILITIES; TO FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2013 BONDS; AND TO PAY FOR CERTAIN COSTS IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2013 BONDS. SCHEDULE K, PART 1, LINE C(F) TO ADVANCE REFUND THE 2005 BONDS AND TO PAY FOR CERTAIN COSTS IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2014 BONDS. SCHEDULE K, PART 1, LINE D(F) TO FINANCE THE COSTS OF ACQUIRING, CONSTRUCTING, RENOVATING AND EQUIPPING SENIOR LIVING FACILITIES CONSTITUTING HEALTH FACILITY PROPERTY AND TO PAY CERTAIN COSTS ASSOCIATED WITH THE ISSUANCE OF BONDS. SCHEDULE K, PART IV, LINE 2C REBATE COMPUTATION DATE OCTOBER 11, 2016. SCHEDULE K, PART 1, LINE A(F) FOR CONSTRUCTION OF HOOSIER VILLAGE - 13 OAKS PHASE 3, HOOSIER VILLAGE - 80 POPLAR CHASE ILU'S, HOOSIER VILLAGE - 80 NEW LICENSED RESIDENTIAL CARE UNITS, THE TOWN HOUSE 60 NEW ILU'S, AND, FOUR SEASONS - 60 NEW ILU'S. A INDIANA FINANCE AUTHORITY 351602316 2018-12-12 98120000 FOR CONSTRUCTION OF HOOSIER VILLAGE 0 0 0 A 98120000 12642567 98120000 635000 62503593 23601419 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND THE CEO HAVE REVIEWED THE 990 PRIOR TO FILING. A DRAFT COPY OF THE 990 IS MADE AVAILABLE TO ALL DIRECTORS FOR THEIR REVIEW BEFORE FILING. THE FORM 990 IS ALSO REVIEWED BY 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 THE PERSONNEL COMMITTEE RECOMMENDS SALARIES OF THE CEO, CFO, AND TOP MANAGEMENT OFFICIALS TO THE BOARD OF DIRECTORS FOR APPROVAL. THE COMMITTEE REVIEWS SALARIES IN THE CONTEXT OF SIMILAR NOT-FOR-PROFIT ORGANIZATIONS, PERFORMANCE AND JOB DESCRIPTIONS. THIS PROCESS WAS LAST CONDUCTED NOVEMBER OF 2020. THE OFFICERS ARE COMPENSATED THROUGH A RELATED ORGANIZATION, BHI RETIREMENT COMMUNITIES. FORM 990, PART VI, SECTION C, LINE 19 THE FORM 990 IS AVAILABLE UPON REQUEST AT THE MAIN OFFICE, 5415 BEARBERRY LANE, INDIANAPOLIS, IN 46268. THE ORGANIZATION HAS NOT MADE THE OTHER GOVERNING DOCUMENTS GENERALLY AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,327,498. MANAGEMENT AND GENERAL EXPENSES 4,370. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,331,868. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 7,523,617. MANAGEMENT AND GENERAL EXPENSES -90. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,523,527. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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