2020-11-12T15:10:19-06:00 2019-12-31 420714325 RSM US LLP 6 S PATTERSON BLVD DAYTON OH 45402 990 2019-01-01 237085581 GRACE BRETHREN VILLAGE INC GRAC 9378364011 1010 TAYWOOD RD ENGLEWOOD OH 453222400 MICHAEL D MCKINNISS EXECUTIVE DIRECTOR/ADMINISTRATOR 9378364011 2020-11-06 1 KAREN O CRIM P00368385 9372980201 2020-11-06 99.47.223.22 2020-11-06 10:35:38 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1FE4833BCF5172B54418EDCA2EA979E2B6C03562 2019 2021-01-29 14:40:06Z MICHAEL D MCKINNISS 1010 TAYWOOD RD ENGLEWOOD OH 453222400 4491534 0 X WWW.GBVILLAGE.COM X 1969 OH TO PROVIDE THE LOVE OF CHRIST THROUGH OUR STAFF BY SHARING THEMSELVES DAILY WITH RESIDENTS THROUGH COMPASSIONATE PHYSICAL, EMOTIONAL, AND SPIRITUAL CARE TO ENHANCE THE CELEBRATION OF LIFE BY "ADDING LIFE TO YEARS." 9 9 94 38 2704 1704 6636 8455 4396460 4430606 50177 36804 1956 2704 4455229 4478569 0 0 0 0 2038848 2100772 0 0 0 2179008 2395556 4217856 4496328 237373 -17759 7288804 7459070 5315258 5446578 1973546 2012492 TO PROVIDE THE LOVE OF CHRIST THROUGH OUR STAFF BY SHARING THEMSELVES DAILY WITH RESIDENTS THROUGH COMPASSIONATE PHYSICAL, EMOTIONAL, AND SPIRITUAL CARE TO ENHANCE THE CELEBRATION OF LIFE BY "ADDING LIFE TO YEARS." 0 0 3940079 4430606 GRACE BRETHREN VILLAGE (GBV) IS A FAITH-BASED NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY. GBV HAS BEEN SERVING AREA SENIORS WITH HOUSING AND SERVICES FOR INDEPENDENT LIVING, ASSISTED LIVING AND SKILLED NURSING SINCE 1971. OUR GOAL IS MUCH GREATER THAN TO PROVIDE JUST HOUSING AND SERVICES TO OUR RESIDENTS. OUR GOAL IS TO EXEMPLIFY THE VALUES OF THE CHRISTIAN TRADITION WHILE FULFILLING RESIDENTS' PHYSICAL, INTELLECTUAL, SOCIAL, EMOTIONAL AND SPIRITUAL NEEDS. THE CAMPUS CONSISTS OF A 50-BED NURSING HOME , FOUR ASSISTED-LIVING APARTMENTS, IN ADDITION TO 82 INDEPENDENT-LIVING UNITS. SINCE 2006 THE ORGANIZATION HAS BEEN DUALLY CERTIFIED FOR MEDICAID AND MEDICARE FOR 45 NURSING HOME BEDS. 3940079 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4 0 1 94 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 0 0 X MICHAEL D MCKINNISS 9378364011 1010 TAYWOOD ROAD ENGLEWOOD OH 45322 TIM MIHOJEVICH CHAIRMAN 2.00 X X 0 0 0 R DOUGLAS HAINES VICE CHAIRMAN 2.00 X X 0 0 0 TIMOTHY STUMP TREASURER 2.00 X X 0 0 0 MARCIA FLORKEY SECRETARY 2.00 X 0 0 0 MARSHALL GIPE MEMBER 2.00 X 0 0 0 STEVE HANGEN MEMBER 2.00 X 0 0 0 RICHARD HARTLEY MEMBER 2.00 X 0 0 0 JOHN MILLER MEMBER 4.00 X 0 0 0 BILL NANCE MEMBER 2.00 X 0 0 0 MIKE MCKINNISS EXECUTIVE DIRECTOR 40.00 X 90992 0 10642 90992 0 10642 0 0 0 0 BRETHREN RETIREMENT COMMUNITY 750 CHESTNUT ST GREENVILLE OH 45331 MANAGEMENT SERVICES 341943 ABSOLUTE REHABILITATION & CONSULTING 339 E MAPLE ST NORTH CANTON OH 44720 CONTRACT THERAPY SERVICES 164650 SYSCO CINCINNATI LLC 10510 EVENDALE DRIVE CINCINNATI OH 45241 FOOD DELIVERY SERVICES 102207 3 8455 8455 RESIDENT SERVICES 623000 4430606 4430606 4430606 49469 49469 3004 300 2704 2704 2704 12665 -12665 -12665 -12665 4478569 4430606 2704 36804 208781 198335 10446 1599988 1524814 75174 83536 70745 12791 208467 202257 6210 868 868 30200 30200 5916 5916 29593 9905 19688 287191 249495 37696 254023 248513 5510 1070 1070 85834 85834 397023 388906 8117 111311 111311 CONTRACT SERVICES 728064 695798 32266 FRANCHISE & INCOME TAX 236641 236641 REPAIRS & MAINTENANCE 109606 109606 MISCELLANEOUS 83676 83676 34540 5064 29476 4496328 3940079 556249 0 29717 118588 905194 1170742 390501 260859 2447 2447 39820 35568 12389003 7351757 5178502 5037246 724723 815720 17900 17900 7288804 7459070 610627 683954 3017357 3414166 2418 2353 1625110 1234083 59746 112022 5315258 5446578 X 1824507 1863453 149039 149039 1973546 2012492 7288804 7459070 -17759 56705 0 X X 0 1 X 1 0 X 9298 1475 9076 6636 8455 34940 3433121 3851785 4079159 4398416 4433310 20195791 3442419 3853260 4088235 4405052 4441765 20230731 0 0 0 20230731 38487 21707 46260 50177 49469 206100 38487 21707 46260 50177 49469 206100 3480906 3874967 4134495 4455229 4491234 20436831 0.98990 0.98940 0.01010 0.01060 X 0 1 X 39558 39558 10566431 5976039 4590392 551022 917149 -366127 1231992 458569 773423 5037246 MUTUAL FUNDS 815720 F 815720 COST REPORT SETTLEMENTS PAYABLE 112022 112022 X 4535274 56705 56705 4478569 0 4478569 4496328 0 4496328 0 4496328 PART IV, LINE 2B: THE ORGANIZATION HOLDS DEPOSITS FROM RESIDENTS TO BE USED BY THE RESIDENTS FOR INCIDENTAL EXPENSES. PART X, LINE 2: A PROVISION FOR INCOME TAXES HAS NOT BEEN INCLUDED IN THE FINANCIAL STATEMENTS SINCE THE ORGANIZATION HAS RECEIVED TAX-EXEMPT STATUS FROM THE INTERNAL REVENUE SERVICE UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2015. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE A SEPARATE COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WILL BE MADE AVAILABLE TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF TRUSTEES SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY. THIS STATEMENT IS REVIEWED ANNUAL AND EVERY BOARD OF TRUSTEES SIGNS AN UPDATED CONFLICT OF INTEREST STATEMENT. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION IS REVIEWED BY THE FINANCE COMMITTEE WITH FINAL APPROVAL BY THE BOARD OF TRUSTEES. FOR 2019, NO COMPENSATION WAS REVIEWED BECAUSE THERE WERE NO COMPENSATION CHANGES IN 2019. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF TIME AS SET FORTH IN THE INTERNAL REVENUE CODE SECTION 6104(D). FORM 990, PART XII, LINE 2C: THE PROCESS BY WHICH THE ORGANIZATION SELECTS AN INDEPENDENT ACCOUNTANT TO CONDUCT ITS AUDIT HAS NOT CHANGED SINCE THE PRIOR YEAR