2018-05-23T11:20:50-05:00 2017-09-30 420714325 RSM US LLP 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2016-10-01 371079626 COMMUNITY LIVING OPTIONS INC COMM 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 JOHN CROCK PRESIDENT 3093431550 2018-05-15 1 MICHAEL BASS P00458970 3093428026 2016 2022-09-23 18:48:47Z JOHN CROCK 285 SOUTH FARNHAM STREET GALESBURG IL 61401 33242255 0 X N/A X 1979 IL TO PROVIDE & OPERATE LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED AND THE ELDERLY. 5 5 765 0 0 0 22573 13089 32378883 32399160 272514 306221 0 0 32673970 32718470 193741 246416 0 0 12360860 12376651 0 0 0 19777674 25484141 32332275 38107208 341695 -5388738 164445993 162835285 95213820 98788742 69232173 64046543 X THE MISSION OF THE ORGANIZATION IS ARTICULATED IN ITS ARTICLES OF INCORPORATION AS FOLLOWS:THE CORPORATION IS ORGANIZED EXCLUSIVELY FOR CHARITABLE PURPOSES AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN FURTHERANCE OF THOSE CHARITABLE PURPOSES, THE CORPORATION SHALL BE EMPOWERED TO BUILD, LEASE, ACQUIRE AND OTHERWISE OWN AND OPERATE RESIDENTIAL FACILITIES, NURSING FACILITIES AND OTHER RELATED FACILITIES AND SERVICES FOR THE ELDERLY, MENTALLY RETARDED, MENTALLY ILL, DEVELOPMENTALLY DISABLED AND OTHER LIKE CONDITIONS WITHOUT REGARD TO RACE, RELIGION, COLOR, SEX, CREED OR NATIONAL ORIGIN OF SAID PERSONS. THE CORPORATION WILL NOT ENGAGE IN THE PRACTICE OF MEDICINE NOR RENDER ANY LICENSED PROFESSIONAL SERVICES. 0 0 30489038 246416 32399160 ALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING LONG-TERM CARE FACILITIES AND OTHER RELATED SERVICES TO THE DEVELOPMENTALLY DISABLED AND THE ELDERLY. THE ORGANIZATION OWNS 53 FACILITIES AND OPERATES A COMBINED TOTAL OF 528 BEDS WITHIN THOSE FACILITIES. 30489038 1 0 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 0 1 77 0 765 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 IL X RON WILSON RFMS INC 3093431550 285 SOUTH FARNHAM GALESBURG IL 61401 X JOHN CROCK PRESIDENT 1.00 1.00 X X 6000 0 0 JOHN THOMPSON SECRETARY 1.00 1.00 X X 6000 0 0 ROBERT MARSHALL DIRECTOR 1.00 1.00 X 6000 0 0 GENE FRIOLI DIRECTOR 1.00 1.00 X 6000 0 0 FORREST LANGENFELD DIRECTOR 1.00 1.00 X 6000 0 0 RON WILSON RFMS INC CFO 40.00 X 0 0 0 30000 0 0 0 0 0 0 RFMS INC 285 SOUTH FARNHAM ST GALESBURG IL 61401 ADMINISTRATIVE SERVICES 1184238 LTC SUPPORT SERVICES LLC 285 SOUTH FARNHAM ST GALESBURG IL 61401 SUPPORT SERVICES 857182 RSM US LLP 5155 PAYSPHERE CIRCLE CHICAGO IL 60674 ACCOUNTING SERVICES 632085 M & T HOME BUILDERS 18540 CAIN LANE RUSHVILLE IL 62681 CONSTRUCTION 146645 CRAIN MILLER & WERNSMAN LTD 623 EAST BROADWAY CENTRALIA IL 62801 LEGAL SERVICES 125345 5 13089 13089 MEDICARE & MEDICAID 623000 17390036 17390036 FACILITY LEASE INCOME 623000 10258248 10258248 PRIVATE PAY RESIDENT S 623000 4412201 4412201 AID TRAINING 623000 323639 323639 ACTIVITY FUND INCOME 623000 15036 15036 32399160 279267 279267 260407 290332 226527 297258 33880 -6926 26954 26954 32718470 32399160 0 306221 246416 246416 28500 28500 10424505 10053421 371084 54332 52398 1934 1047183 1009906 37277 822131 792865 29266 2055515 1376459 679056 65068 65068 282410 282410 9768 9768 26098 26098 615081 610942 4139 65728 59155 6573 265118 209229 55889 28941 23153 5788 2351050 2282450 68600 345817 338104 7713 196875 176908 19967 3487624 3382995 104629 6750942 5427068 1323874 109598 109598 UNCOLLECTIBLE CHARGES 4475054 4475054 SUPPLIES & SMALL EQUIP. 2678676 2678676 MEDICAID ASSESSMENT TAX 1247556 1247556 EQUIPMENT RENT & MAINTE 317326 317035 291 109896 68606 41290 38107208 30489038 7618170 0 2247955 2271814 5854424 2899914 1921071 3613374 543991 541125 184863181 56862587 123746634 128000594 6531473 6926412 600000 400000 20454714 18036263 2545731 145789 164445993 162835285 4203776 6360594 150384 82327 90859660 92285840 0 59981 95213820 98788742 X 69232173 64046543 69232173 64046543 164445993 162835285 -5388738 203108 0 X X 0 1 X 1 0 X 35184 15013 13459 22573 13089 99318 32794158 32407256 32174315 32378883 32399160 162153772 32829342 32422269 32187774 32401456 32412249 162253090 0 0 0 162253090 401125 382969 250525 279921 279267 1593807 401125 382969 250525 279921 279267 1593807 33230467 32805238 32438299 32681377 32691516 163846897 0.99030 0.98910 0.00970 0.01090 X 9768 9768 30489038 30498806 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 11175 11751 9768 32694 250000 250000 250000 250000 1000000 1500000 8369492 8369492 159425528 44846469 114579059 4147324 2420458 1726866 8525948 6633087 1892861 4394889 2962573 1432316 128000594 MEMBER INTEREST - LTC SUPPORT SERVICES, LLC 10000 C STANDBY LOAN AGREEMENT RECEIVABLE FROM UNRELATED 501(C)(3) ORGANIZATIONS 3990000 C RESTRICTED MORTGAGE ESCROW DEPOSITS 980536 F RESTRICTED REPLACEMENT RESERVE DEPOSITS 6252403 F ADVANCE RECEIVABLE FROM KEOKUK VILLAGE CIRCLE, LTD., NFP, A SUBSIDIARY 6516640 C ADVANCE RECEIVABLE FROM UNLIMITED DEVELOPMENT, INC., A SUBSIDIARY 286684 C 18036263 OTHER PAYABLES 32322 CONSTRUCTION PAYABLE 27659 59981 X PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OR SECTION 501(C)(2) OF THE INTERNAL REVENUE CODE; THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2013. 1 FLORIDA LIVING OPTIONS INC 851 WEST LUMSDEN ROAD BRANDON FL 33511 364467489 501(C)(3) 70795 FORGIVEN INTEREST ON DEBT UNLIMITED DEVELOPMENT INC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 364094409 501(C)(3) 172158 TO SUPPORT EXEMPT PURPOSE FACILITY OPERATIONS 2 0 PART I, LINE 2: GRANT FUNDS ARE ONLY GIVEN TO ORGANIZATIONS WHO CONFIRM THE USE OF SUCH MONIES IN THE UNITED STATES. THE GRANT TO FLORIDA LIVING OPTIONS, INC. REPRESENTS FORGIVEN INTEREST ON DEBT. FLORIDA LIVING OPTIONS, INC. IS A 501(C)(3) ORGANIZATION DOING BUSINESS AND LOCATED IN THE UNITED STATES. LTC SUPPORT SERVICES (LTC) A SINGLE DIRECTOR COMMON TO BOTH CLO & LTC IS JOHN CROCK. 871752 SUPPORT SERVICES IN THE AMOUNT OF $871,752 ARE PROVIDED BY LTC SUPPORT SERVICES, LLC., AS DESCRIBED IN SCHEDULE O RELATIVE TO PART VI, SECTION A, LINE 3. JOHN CROCK, WHO IS A DIRECTOR OF COMMUNITY LIVING OPTIONS, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $3,000 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2017. 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION RECEIVES SUPPORT SERVICES FROM LTC SUPPORT SERVICES, LLC, AN UNRELATED COMPANY. THESE SERVICES INCLUDE OVERSIGHT, TRAINING, REGULATORY COMPLIANCE, QUALITY ASSURANCE PROGRAMS, HUMAN RESOURCE SUPPORT, MARKETING AND MAINTENANCE. COMMUNITY LIVING OPTIONS, INC., OWNS 14.28% OF LTC SUPPORT SERVICES, LLC, AND UNLIMITED DEVELOPMENT, INC., (A SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC.) OWNS 14.28% OF LTC SUPPORT SERVICES, LLC. THE REMAINING 71.44% OF LTC SUPPORT SERVICES, LLC, IS OWNED BY UNRELATED EXEMPT ORGANIZATIONS. THE ORGANIZATION ALSO HAS A NEGOTIATED ARMS LENGTH ADMINISTRATIVE SERVICES CONTRACT WITH RFMS, INC., AN UNRELATED COMPANY, TO OBTAIN SERVICES SUCH AS CASH MANAGEMENT, ACCOUNTING AND FINANCIAL REPORTING, PAYROLL AND EMPLOYEE BENEFITS, INFORMATION TECHNOLOGY, REGULATORY MATTERS, AND OTHER GENERAL BUSINESS AND FINANCIAL MANAGEMENT SERVICES AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 11B EACH MEMBER OF THE BOARD OF DIRECTORS RECEIVES A PAPER COPY OF FORM 990 FOR THEIR REVIEW AND COMMENT PRIOR TO ITS FILING. THE BOARD ALSO REVIEWS IN DETAIL EACH FORM 990 FILED BY THE ORGANIZATION AT ITS REGULARLY SCHEDULED BOARD MEETINGS. ON AN ANNUAL BASIS, EACH BOARD MEMBER ATTENDS A TRAINING SESSION THAT PROVIDES UPDATES ON CURRENT EXEMPT ORGANIZATION TAX COMPLIANCE MATTERS. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO ATTEST TO THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. THE BOARD OF DIRECTORS REVIEWS ALL COMPLETED CONFLICT OF INTEREST STATEMENTS TO DETERMINE IF ANY CONFLICTS EXIST WHICH WOULD REQUIRE RESTRICTION ON PARTICIPATION IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN ANY TRANSACTIONS INVOLVING THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 18 A PAPER COPY OF FORM 990 IS PROVIDED UPON REQUEST. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE VIA THE GUIDESTAR.ORG WEBSITE AND THROUGH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXCEPT THROUGH PUBLIC FILING REQUIREMENTS. FORM 990, PART VII, SECTION A, COLUMN F: RON WILSON IS EMPLOYED BY RFMS, INC., AN UNRELATED ORGANIZATION WHICH HAS AN ADMINISTRATIVE SERVICES CONTRACT WITH COMMUNITY LIVING OPTIONS, INC. THE TYPE OF SERVICES PROVIDED BY RFMS, INC., ARE DETAILED IN THE SCHEDULE O EXPLANATION ABOVE RELATIVE TO FORM 990, PART VI, SECTION A, LINE 3. RON WILSON IS THE CHIEF FINANCIAL OFFICER OF RFMS, INC. HIS COMPENSATION REPORTED ON HIS RFMS, INC. FORM W-2, BOX 5 FOR CALENDAR YEAR 2016 IS $173,548. RON WILSON'S COMPENSATION AMOUNT AND HOURS HAVE NOT BEEN PRORATED BASED ON TIME SPENT FOR EACH OF THE SEVENTEEN ORGANIZATIONS TO WHOM SERVICES ARE PROVIDED BY RFMS, INC. FORM 990, PART VII, SECTION A, COLUMN B: APPROXIMATELY ONE HALF OF THE AVERAGE HOURS PER WEEK ESTIMATED FOR EACH DIRECTOR IS DEVOTED TO RELATED ORGANIZATIONS LISTED ON SCHEDULE R. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XII, LINE 2B: THE FINANCIAL STATEMENTS OF COMMUNITY LIVING OPTIONS, INC., WERE AUDITED AS PART OF THE CONSOLIDATED FINANCIAL REPORT ISSUED FOR COMMUNITY LIVING OPTIONS, INC. AND SUBSIDIARIES. MARION WILLIAMSON COUNTY PARKWAY LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 352259772 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 792352 13226676 N/A LEROY SOUTH BUCK LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 611485632 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 419143 3810188 N/A 2245 SEMINARY STREET LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 364568737 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 402569 4045969 N/A CENTRALIA EAST MCCORD LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 201313879 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 902976 8184052 N/A GALESBURG NORTH SEMINARY LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 201334252 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 845027 8192537 N/A PEKIN EL CAMINO LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 300330354 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 564120 6340616 N/A JERSEYVILLE NORTH STATE LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 383715772 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 862036 7973418 N/A SHELBYVILLE ROUTE 128 LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 201334393 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 491918 5300840 N/A PITTSFIELD LOWRY LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 201334359 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 487520 5818257 N/A ABINGDON WEST MARTIN LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 364560809 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 180000 80708 N/A MARYVILLE VADALABENE LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 201334411 NO ACTIVITY DURING FISCAL YEAR ENDING 9/30/2017 IL 0 0 N/A ELKO RUBY VISTA LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 272887649 OWNS FACILITY OPERATED BY UNRELATED 501(C)(3) ORGANIZATION NV 992555 21338908 N/A OCALA 33RD AVENUE LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 275109607 OWNS FACILITY OPERATED BY UNRELATED 501(C)(3) ORGANIZATION FL 775804 14898814 N/A LAKELAND HIGHLANDS ROAD FACILITY LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 275084554 OWNS FACILITY OPERATED BY UNRELATED 501(C)(3) ORGANIZATION FL 418732 7566253 N/A KENSINGTON SLF LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 812375730 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 495251 10009773 N/A UNLIMITED DEVELOPMENT INC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 364094409 OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIES IL 501(C)(3) LINE 10 N/A 1 KEOKUK VILLAGE CIRCLE LTD NFP 285 SOUTH FARNHAM STREET GALESBURG IL 61401 262341634 ACQUIRING & HOLDING TITLE TO PROPERTY; REMITTING ALL INCOME TO 501(C)(3) IL 501(C)(2) N/A 1 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 UNLIMITED DEVELOPMENT INC A 7929333 CASH TRANSACTION BASED ON FMV UNLIMITED DEVELOPMENT INC D 286684 CASH TRANSACTION BASED ON FMV KEOKUK VILLAGE CIRCLE LTD NFP - (A 501(C)(2) ORGANIZATION) D 6516640 CASH TRANSACTION BASED ON FMV UNLIMITED DEVELOPMENT INC B 172158 CASH TRANSACTION BASED ON FMV SCHEDULE R, PART II: UNLIMITED DEVELOPMENT, INC. AND KEOKUK VILLAGE CIRCLE, LTD., NFP, ARE SUBSIDIARIES OF COMMUNITY LIVING OPTIONS, INC. SCHEDULE R, PART V, LINE 1A: ALL AMOUNTS RECEIVED FROM UNLIMITED DEVELOPMENT, INC. AND KEOKUK VILLAGE CIRCLE, LTD., NFP, ARE RELATED TO THE ORGANIZATION'S EXEMPT PURPOSE. UNLIMITED DEVELOPMENT, INC., A 501(C)(3) SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC., FILES A SEPERATE FORM 990 AND REPORTED THESE ITEMS AS PROGRAM-RELATED EXPENSES ACCORDINGLY. KEOKUK VILLAGE CIRCLE, LTD., NFP, A 501(C)(2) SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC., FILES A SEPERATE FORM 990 AND REPORTED THESE ITEMS AS PROGRAM-RELATED EXPENSES ACCORDINGLY. NEITHER UNLIMITED DEVELOPMENT, INC. OR KEOKUK VILLAGE CIRCLE, LTD., NFP, REPORT ANY UNRELATED BUSINESS TAXABLE INCOME ON THEIR RESPECTIVE FORM 990, AND NEITHER ENTITY IS REQUIRED TO FILE FORM 990-T.