2021-11-10T15:50:48-06:00 2020-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-01-01 262053830 PRAIRIE LANDING COMMUNITY INC PRAI 3178733371 5415 BEARBERRY LANE INDIANAPOLIS IN 46268 ROGER E WEIDEMAN II DIRECTOR, SVP & CFO 3178733371 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 THE BARRINGTON OF CARMEL ROGER E WEIDEMAN II 5415 BEARBERRY LANE INDIANAPOLIS IN 46268 14402215 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 12 313 20 0 0 0 609038 5046346 13493305 363687 -2544086 0 291690 5410033 11849947 0 0 0 0 2462122 7048820 0 0 0 3413488 10013037 5875610 17061857 -465577 -5211910 111993929 108651851 94459506 96329338 17534423 12322513 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 14614488 0 13493305 PROVIDE QUALITY HOUSING, HEALTH CARE SERVICES AND OTHER PROGRAMS TO SENIOR CITIZENS 14614488 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 8 0 1 313 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 5415 BEARBERRY LANE INDIANAPOLIS IN 46268 JOHN S DATTILO DIRECTOR & PRESIDENT/CEO 2.00 56.00 X X 0 319898 42948 ROGER WEIDEMAN II DIRECTOR & VICE-PRESIDENT/CFO 2.00 56.00 X X 0 297114 40927 JESSE SIAS EXECUTIVE DIRECTOR (PAST) 40.00 0.00 X 143502 0 23215 KARA OWEN EXECUTIVE DIRECTOR 40.00 0.00 X 120062 0 10732 ANNA WEAVER DIRECTOR OF NURSING 40.00 0.00 X 115472 0 5847 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 379036 617012 123669 3 0 1 0 HTS IN XII INC 1411 W COUNTY LNE ROAD STE A GREENWOOD IN 46142 THERAPY 645360 SYSCO PO BOX 7137 INDIANAPOLIS IN 46206 FOOD PROVIDER 573946 PIAZZA PRODUCE PO BOX 68931 INDIANAPOLIS IN 46268 FOOD PROVIDER 220180 GORDON FOOD SERVICE INC PO BOX 88029 CHICAGO IL 60680 FOOD PROVIDER 135260 ENGLEDOW GROUP 1100 EAST 116TH ST CARMEL IN 46032 LANDSCAPING AND MAINTENANCE 134352 6 609038 609038 NET RESIDENT SERVICES 623000 13189090 13189090 ENTRANCE FEE AMORTIZATION 623000 304215 304215 13493305 8182 8182 2552268 -2552268 -2552268 -2552268 DINING REVENUE 623000 157839 157839 BEAUTY SHOP 623000 54404 54404 LAUNDRY 623000 23561 23561 55886 55886 291690 11849947 13493305 0 -2248531 5656125 5046280 609845 96071 78848 17223 849061 679518 169543 447563 401055 46508 640200 576180 64020 18551 18551 4750 4750 748429 717711 30718 81999 81602 397 331823 310635 21188 191802 34647 157155 520341 507878 12463 6130 6130 19086 5648 13438 2309543 2309543 2711881 1896681 815200 107613 107613 FOOD/DINING 823127 823127 RESIDENT EXPENSES 591093 591093 TAXES & LICENSES 314317 314317 REPAIRS AND RENOVATIONS 159536 120169 39367 432816 320130 112686 17061857 14614488 2447369 0 3249915 2153281 2904058 3412239 632936 410991 27887 46043 70496334 2510454 69360901 67985880 35394627 34579427 423605 63990 111993929 108651851 3043627 2703692 5326349 4922050 48820962 48855129 37268568 39848467 94459506 96329338 X 17534423 12322513 17534423 12322513 111993929 108651851 -5211910 0 X X 0 1 X 1 0 X 609038 609038 5046346 13691907 18738253 5046346 14300945 19347291 0 0 0 19347291 363687 8182 371869 363687 8182 371869 93088 93088 5410033 14402215 19812248 0.97650 0.93280 0.01880 0.06720 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5700000 5700000 61103753 2039394 59064359 2158798 319228 1839570 1533783 151832 1381951 67985880 ROC RESERVE 36010689 REFUNDABLE PARKING GARAGE DEPOSITS 145125 ENTRANCE FEE DEPOSIT 1500000 INTEREST RATE SWAP LIABILITY 2192653 39848467 X 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. X X X 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 WEIDEMAN II DIRECTOR & VICE-PRESIDENT/CFO 0 267114 0 30000 0 0 0 13446 0 27481 0 338041 0 0 JESSE SIAS EXECUTIVE DIRECTOR (PAST) 141502 0 2000 0 0 0 7383 0 15832 0 166717 0 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. 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