2020-02-28T12:05:33-06:00 2019-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2018-07-01 231409664 THE BRETHREN HOME COMMUNITY BRET 7176242161 2990 CARLISLE PIKE NEW OXFORD PA 17350 SCOTT A SOWERS VP OF FINANCE 7176242161 2020-02-27 1 KERRI N BOGDA CPA P00760402 7177404863 96.89.178.154 2020-02-27 11:53:23 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AE0C272A69DD34E2EDF3B6A185DE1CF90EACE8A4 2018 2021-01-29 14:40:06Z CROSS KEYS VILLAGE - TBHC JEFFREY M EVANS 2990 CARLISLE PIKE NEW OXFORD PA 17350 60343524 0 X WWW.CROSSKEYSVILLAGE.ORG X 1908 PA THE BRETHREN HOME COMMUNITY PROVIDES HEALTH CARE AND RESIDENTIAL HOUSING TO ELDERLY INDIVIDUALS. 5 5 823 675 0 0 948607 1009891 45999771 46729148 969536 4734166 356250 333544 48274164 52806749 0 0 0 0 28226020 26692804 0 0 0 19578460 21444278 47804480 48137082 469684 4669667 174240809 180541719 96466905 100901040 77773904 79640679 X THE BRETHREN HOME COMMUNITY'S MISSION IS TO BE A BRETHREN MINISTRY DEDICATED TO ENRICHING THE LIVES OF OLDER ADULTS WITH A VISION TO BE A LEADING INNOVATOR OFFERING OLDER ADULTS A LIFE INFUSED WITH QUALITY AND PURPOSE. 0 0 21461690 0 23975338 NURSING - PROVIDE QUALITY NURSING CARE IN A COMFORTABLE HEALTH CARE CENTER. PERFORM CONTINUAL ASSESSMENT OF PROGRAMS AND SERVICES IN THE MIDST OF HEALTHCARE REFORM. ACKNOWLEDGED FOR EXCELLENCE IN WOUND CARE AND MEMORY CARE. TOTAL CENSUS DAYS FOR THIS PROGRAM DURING THE FISCAL YEAR 2019 WERE 68,168. 15384123 0 17185951 RESIDENTIAL LIVING- PROVIDE COMPREHENSIVE, INDEPENDENT LIVING SERVICES FOR OLDER ADULTS. PROVIDE LIFELONG LEARNING OPPORTUNITIES TO ENGAGE RESIDENTS IN MENTAL, CULTURAL AND SPIRITUAL ACTIVITIES PROMOTING OVERALL WELLNESS. TOTAL CENSUS DAYS FOR THIS PROGRAM DURING THE FISCAL YEAR 2019 WERE 259,347. 4984108 0 5567859 PERSONAL CARE AND ADULT DAY SERVICES - PROVIDE INTERMEDIATE LEVEL OF CARE WHEN INDIVIDUALS NEED HELP WITH SOME ACTIVITIES OF DAILY LIVING, BUT DO NOT REQUIRE 24 HOUR SKILLED NURSING. DESIGNED AND DEVELOPED NEW STATE-OF-THE-ART RESIDENCE FOR MEMORY CARE. THESE PROGRAMS PROVIDED 48,027 CENSUS DAYS OF SERVICE DURING THE FISCAL YEAR 2019. 0 0 0 THE COMMUNITY MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE ESTIMATED COSTS OF PROVIDING CHARITY CARE ARE BASED UPON THE DIRECT AND INDIRECT COSTS IDENTIFIED WITH THE SPECIFIC CHARITY CARE SERVICES PROVIDED. THE COMMUNITY PROVIDES CHARITY CARE, SUBSIDIES, AND OTHER SUPPORT OF THOSE IN NEED. UNCOMPENSATED CARE TOTALED $8,012,118 INCLUDING SERVICES TO MEDICAL ASSISTANCE BENEFICIARIES WHOSE COSTS EXCEEDED REIMBURSEMENT. 0 0 0 41829921 1 1 0 1 0 0 0 0 1 1 1 0 1 0 1 0 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 93 0 823 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X JEFFREY M EVANS PRESIDENT 7176242161 2990 CARLISLE PIKE NEW OXFORD PA 17350 MARK R HENRY CHAIR 1.00 1.00 X X 0 0 0 JENNIFER W BOWES VICE CHAIR 1.00 1.00 X X 0 0 0 DIANNE S HOLLINGER SECRETARY 1.00 1.00 X X 0 0 0 BONNIE G FERRENCE DIRECTOR 1.00 1.00 X 0 0 0 DONNA J LEREW DIRECTOR 1.00 1.00 X 0 0 0 JEFFREY M EVANS PRESIDENT & CHIEF EXECUTIVE OFFICER 39.00 1.00 X 334155 0 33838 SCOTT A SOWERS VP OF FINANCE 39.00 1.00 X 139407 0 22805 JOY BODNAR CHIEF OPERATING OFFICER 40.00 X 179317 0 15199 OLIVER HAZAN VP OF MARKETING 40.00 X 113507 0 21030 KELLEY MITCHELL VP OF HUMAN RESOURCES 40.00 X 139948 0 22312 ANN MARIE STARR-LOE HEALTH CARE ADMINISTRATOR 40.00 X 150003 0 6281 1056337 0 121465 9 0 1 0 JS CONSTRUCTION INC 515 PENN ST HANOVER PA 17331 CONSTRUCTION SERVICES 5589667 UNIDINE CORPORATION 1000 WAHINGTON ST STE 510 BOSTON MA 02118 FOOD AND CONSULTING SERVICES 2394973 BENCHMARK THERAPIES INC PO BOX 870 HUNTINGDON PA 16652 THERAPY SERVICES 1818932 YORK EXCAVATING COMPANY LLC 3180 E PROSPECT RD YORK PA 17402 EXCAVATING SERVICES 1722604 SFCS INC 305 S JEFFERSON ST ROANOKE VA 240112003 ARCHITECTURE/ ENGINEERING SERVICES 539169 18 1009891 1009891 RESIDENT & PATIENT SERVICE REV. 623000 46729148 46729148 46729148 1148836 1148836 759674 614175 145499 145499 145499 10500000 7930 6777085 145515 3722915 -137585 3585330 3585330 BEAUTY/BARBER SHOP 623000 127992 127992 SPECIAL FUNCTIONS INCOME 623000 33762 33762 SEMINAR FEE 900099 6594 6594 19697 19697 188045 52806749 46729148 0 5067710 699017 699017 19901872 17174363 2727509 600981 508531 92450 4008972 3591537 417435 1481962 1247859 234103 61481 61481 67534 67534 1211 1211 130259 130259 3799023 3664488 134535 146611 146611 1691829 1288066 403763 469109 469109 2668354 2189343 479011 104798 79688 25110 1516435 1516435 7260284 7260284 FOOD 1575668 1551260 24408 MEDICAL SUPPLIES 1119930 1119930 UNCOLLECTIBLE EXPENSE 208197 208197 REPAIRS EXPENSE 199269 174975 24294 424286 254965 169321 48137082 41829921 6307161 0 3839 3632 4729852 2137963 2959581 3323482 696697 743869 207011186 106958391 89633287 100052795 48349602 46395313 264783 264783 26542852 27137698 462105 407207 598211 74977 174240809 180541719 4648465 4312378 45808867 53252554 43812400 40727759 118397 57207 2078776 2551142 96466905 100901040 X 66814822 68597517 3717842 3775583 7241240 7267579 77773904 79640679 174240809 180541719 X 4669667 -2795911 -6981 X X 0 1 X 1 0 X 707317 1359875 1260927 948607 1009891 5286617 43807821 45234385 44705864 45999771 46729148 226476989 257941 353244 235763 220527 188045 1255520 44773079 46947504 46202554 47168905 47927084 233019126 0 0 0 233019126 1669261 1703399 1619199 1893182 1908510 8793551 1669261 1703399 1619199 1893182 1908510 8793551 46442340 48650903 47821753 49062087 49835594 241812677 0.96360 0.96470 0.03640 0.03530 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1211 1211 0 PART II-B, LINE 1: THE BRETHREN HOME COMMUNITY PAYS DUES TO THE ORGANIZATIONS LEADINGAGE AND LEADINGAGE PA. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS ALLOCABLE TO LOBBYING EXPENSES. THE TOTAL AMOUNT OF DUES PAID BY THE BRETHREN HOME COMMUNITY THAT IS ALLOCABLE TO LOBBYING IS $1,211. 0 1 X 21162870 59049 1145413 336837 22030495 19843975 66494 1641828 389427 21162870 17402875 80861 2718968 358729 19843975 18404931 124721 -770006 356771 17402875 18782166 172468 -239711 309992 18404931 0.69840 0.26070 0.04090 0 1 1 6959067 6959067 155009368 82356658 72652710 18882181 14297497 4584684 26160570 10304236 15856334 100052795 INTEREST IN NET ASSETS OF THE BRETHREN HOME FOUNDATION 27137698 F 27137698 OTHER LIABILITIES 42020 INTEREST RATE SWAP AGREEMENT 1657107 ENTRANCE FEES PAYABLE 852015 2551142 50618032 -2795911 -6981 -2802892 53420924 -614175 -614175 52806749 48751257 614175 614175 48137082 0 48137082 PART IV, LINE 2B: THE BRETHREN HOME COMMUNITY HOLDS RESIDENT FUNDS IN A CUSTODIAL ACCOUNT. RESIDENTS MAY CHOOSE TO DEPOSIT FUNDS IN THE "RESIDENT'S BANK". FUNDS ARE MAINTAINED IN A SEPARATE ACCOUNT EARNING INTEREST IF THE BALANCE IS AT LEAST $50. STATEMENTS ARE PROVIDED ON A MONTHLY BASIS. ANY BALANCE REMAINING AT DEATH OR DISCHARGE IS RETURNED WITHIN 30 DAYS. PART V, LINE 4: THE ENDOWMENT FUNDS ARE USED TO BENEFIT RESIDENTS OF THE BRETHREN HOME COMMUNITY THROUGH CHARITY CARE, MAINTENANCE OF THE NICARRY MEETING HOUSE AND WELLNESS CENTER, AND ASSISTANCE TOWARD HOUSING COSTS OF RETIRED MINISTERS AND OTHER CHURCH WORKERS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT -601,828. CHANGE IN INTEREST OF NET ASSETS OF AFFILIATES 594,847. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -614,175. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 614,175. X X X 0 0 0 0 0 0 0 1 0 JEFFREY M EVANS PRESIDENT & CHIEF EXECUTIVE OFFICER 308451 0 25704 0 0 0 10699 0 23139 0 367993 0 0 0 SCOTT A SOWERS VP OF FINANCE 139407 0 0 0 0 0 5373 0 17432 0 162212 0 0 0 JOY BODNAR CHIEF OPERATING OFFICER 179317 0 0 0 0 0 6966 0 8233 0 194516 0 0 0 KELLEY MITCHELL VP OF HUMAN RESOURCES 139948 0 0 0 0 0 5397 0 16915 0 162260 0 0 0 ANN MARIE STARR-LOE HEALTH CARE ADMINISTRATOR 150003 0 0 0 0 0 5892 0 389 0 156284 0 0 0 PART I, LINE 7 THE PRESIDENT RECEIVED A BONUS BASED ON OVERALL PERFORMANCE GOALS. THE BONUS WAS APPROVED BY THE BOARD. A ADAMS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 232988777 2015-11-12 32705000 SEE PART VI 0 0 0 B ADAMS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 232988777 2015-11-12 9800000 SEE PART VI 0 0 0 C ADAMS COUNTY GENERAL AUTHORITY 813735002 2016-09-08 10000000 SEE PART VI 0 0 0 A 10820000 32705000 32705000 2015 1 0 1 1 B 444414 9800000 91945 296350 7300353 2203297 2016 0 0 1 1 C 567327 10000000 19792 36648 9943560 2016 0 0 1 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 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 1 WELLS FARGO BANK NA 14.000000000000 0 0 0 0 1 B 0 1 0 0 1 1 FULTON BANK 9.000000000000 0 0 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 SCHEDULE K PART I, COLUMN F - DESCRIPTION OF PURPOSE: ISSUE A: REFINANCE EXISTING TAX-EXEMPT BONDS ISSUE B: PAY OFF LINE OF CREDIT AND CONSTRUCTION OF MEMORY CARE SUPPORT FACILITY AND PURCHASE OF EQUIPMENT ISSUE C: CONSTRUCTION OF MEMORY CARE SUPPORT FACILITY AND PURCHASE OF EQUIPMENT IN ADDITION TO CONSTRUCTION OF RESIDENTIAL LIVING COTTAGES FORM 990, PART VI, SECTION A, LINE 6 THE BRETHREN HOME FOUNDATION SERVES AS THE MEMBER OF THE BRETHREN HOME COMMUNITY. FORM 990, PART VI, SECTION A, LINE 7A THE BRETHREN HOME FOUNDATION IS THE CONTROLLING CORPORATION AND SERVES AS THE "MEMBER" OF CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY. THE BOARD OF DIRECTORS OF THE BRETHREN HOME FOUNDATION ELECTS THE MAJORITY OF THE BOARD MEMBERS OF CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY. FORM 990, PART VI, SECTION A, LINE 7B CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY: THE BOARD OF DIRECTORS OF THE CONTROLLING CORPORATION, THE BRETHREN HOME FOUNDATION, IS REQUIRED TO APPROVE AMENDMENTS TO ARTICLES OF INCORPORATION AND CHANGES TO BYLAWS OF CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY. THE FOUNDATION'S BOARD OF DIRECTORS ALSO MANAGES ALL ASPECTS OF THE CORPORATION'S INVESTMENT PORTFOLIO. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCE AND VICE PRESIDENT OF FINANCE BEFORE IT IS SHARED WITH THE PRESIDENT/CEO. THE FINAL VERSION OF THE FORM 990 WILL THEN BE DISTRIBUTED TO EACH BOARD MEMBER FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A BOARD CONFLICT OF INTEREST POLICY WHICH REQUIRES ANNUAL DISCLOSURE AND CERTIFICATION BY BOARD MEMBERS OF COMPLIANCE WITH THE POLICY. IN ADDITION, ALL EMPLOYEES RECEIVE ANNUAL CORPORATE COMPLIANCE TRAINING WHICH INCLUDES THE CONFLICT OF INTEREST POLICY AND ARE REQUIRED TO CERTIFY THEY ARE IN COMPLIANCE WITH THE CORPORATE COMPLIANCE PLAN. THE COMPLIANCE PLAN COVERS EMPLOYEES, VENDORS, CONTRACTORS, VOLUNTEERS, DIRECTORS, AND OFFICERS. ANY POTENTIAL CONFLICT OF INTEREST ISSUES WHICH MAY ARISE ARE REVIEWED BY THE CORPORATE COMPLIANCE LIAISON OR COMPLIANCE OFFICE, AND APPROPRIATE SAFEGUARDS ARE PUT IN PLACE. THE PROCESS IS MONITORED BY THE CORPORATE COMPLIANCE LIAISON OR COMPLIANCE OFFICE. FORM 990, PART VI, SECTION B, LINE 15 SALARY FOR THE CEO IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE WITH COMPARISONS MADE TO AN ANNUAL SALARY SURVEY OF SIMILAR NON-PROFIT ORGANIZATIONS IN PENNSYLVANIA TO ENSURE THAT SALARIES ARE IN LINE WITH THE FAIR MARKET VALUE FOR THE INDUSTRY. THE DECISION IS DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. A SIMILAR PROCESS IS USED FOR OTHER KEY EMPLOYEES WITH THE REVIEW BEING DONE BY THE VICE PRESIDENT OF HUMAN RESOURCES IN CONSULTATION WITH THE CEO AND VICE PRESIDENT OF FINANCE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT -601,828. CHANGE IN INTEREST OF NET ASSETS OF AFFILIATES 594,847. FORM 990 PAGE 12, PART XII, LINE 2C: AUDIT OVERSIGHT: THE PROGRAM AND FINANCE COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS, FUNCTIONS IN THE ROLE OF THE AUDIT COMMITTEE. THIS COMMITTEE RECEIVES THE PROPOSAL(S) FOR AUDIT SERVICES ANNUALLY AND TAKES ACTION TO APPROVE ENGAGING THE AUDIT FIRM. THE VICE PRESIDENT OF FINANCE GIVES REGULAR UPDATES TO THE COMMITTEE AS THE AUDIT PROGRESSES. THE COMPLETED AUDIT REPORT AND RELATED REPORTING ITEMS ARE PRESENTED BY THE AUDITORS TO THE FULL BOARD OF DIRECTORS. IN ADDITION, THE AUDITORS MEET IN PRIVATE WITH THE BOARD WITH STAFF MEMBERS NOT PRESENT, TO ADDRESS ANY QUESTIONS THE BOARD HAS IN REGARDS TO THE AUDIT. THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. THE BRETHREN HOME FOUNDATION 2990 CARLISLE PIKE NEW OXFORD PA 17350 232454835 FUNDRAISING ACTIVITIES PA 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1