2017-11-15T09:24:57-06:00 2017-03-31 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2016-04-01 471545753 PRESBYTERIAN HOMES PRES 8479793904 8707 SKOKIE BOULEVARD SUITE 400 SKOKIE IL 60077 TODD F SWORTZEL CHIEF EXECUTIVE OFFICER 8479793904 2017-11-14 1 GREGORY S ADAMS P00095597 6305738600 2017-11-14 67.137.57.251 2017-11-14 10:25:34 CS P 49C78CA456FC69BC203EAED2C25D47719A2DC5E6 B0B82EE3E858863B5AFDA9227FC05760300C7D48 2016 2017-02-10 21:41:12Z X TODD F SWORTZEL 8707 SKOKIE BOULEVARD SUITE 400 SKOKIE IL 60077 253756743 0 X WWW.PRESBYTERIANHOMES.ORG X 2014 IL PRESBYTERIAN HOMES, A FAITH BASED NOT FOR PROFIT, CREATES VIBRANT COMMUNITIES FOR OLDER ADULTS THAT INSPIRE WELLNESS, INDEPENDENCE, JOY, AND SECURITY - ENRICHING THE LIVES OF RESIDENTS AND THEIR FAMILIES. 16 16 806 192 0 0 343158 6657868 19606749 62730926 4461644 4623827 1276166 3547930 25687717 77560551 0 0 0 0 10379130 30921739 0 0 0 10895377 32108545 21274507 63030284 4413210 14530267 327060072 379757828 281167633 314899267 45892439 64858561 X PRESBYTERIAN HOMES, A FAITH BASED NOT FOR PROFIT, CREATES VIBRANT COMMUNITIES FOR OLDER ADULTS THAT INSPIRE WELLNESS, INDEPENDENCE, JOY, AND SECURITY - ENRICHING THE LIVES OF RESIDENTS AND THEIR FAMILIES. 0 0 24655378 34257042 LAKE FOREST PLACE AND THE MOORINGS OF ARLINGTON HEIGHTS ("THE MOORINGS") ARE NOT-FOR-PROFIT INDEPENDENT LIVING, LIFE PLAN COMMUNITIES (FORMERLY KNOWN AS CONTINUING CARE RETIREMENT COMMUNITIES). INDEPENDING LIVING FACILITIES AT LAKE FOREST PLACE AND THE MOORINGS CONSIST OF A TOTAL OF 555 APARTMENTS, VILLAS AND COTTAGES, INCLUDING 14 NEW COTTAGES OPENED IN SEPTEMBER 2016 AT LAKE FOREST PLACE. AVAILABLE RESIDENTIAL SERVICES INCLUDE FLEXIBLE DINING OPTIONS, HOUSEKEEPING AND COMPLETE MAINTENANCE SERVICES, TRANSPORTATION AS WELL AS PLANNED SOCIAL AND EDUCATIONAL ACTIVITIES AND PROGRAMS. TEN TWENTY GROVE IS AN INDEPENDENT LIVING FACILITY CONSISTING 46 APARTMENTS. DURING THE FILING YEAR, THE THREE INDEPENDENT LIVING FACILITIES SERVED 786 INDEPENDENT LIVING RESIDENTS IN TOTAL, OCCUPIED 584 INDEPENDENT LIVING UNITS. 4497288 5798003 ASSISTED LIVING FACILITIES AT LAKE FOREST PLACE AND THE MOORINGS CONSIST OF 31 AND 42 UNITS, RESPECTIVELY. THE PROGRAM PROVIDES CARE TO OLDER ADULTS WHO NEED ASSISTENCE WITH PERSONAL CARE AND DAILY ACTIVITIES. THE FACILITIES SERVED A TOTAL OF 98 ASSISTED LIVING RESIDENTS DURING THE FILING YEAR. 21385118 22583269 LAKE FOREST PLACE AND THE MOORINGS HEALTH CARE CENTERS PROVIDE INTERMEDIATE AND SKILLED NURSING FOR BOTH SHORT AND LONG TERM STAYS. RESPITE, REHABILITATION, AND PROGRAMS TO CARE FOR THOSE WITH ALZHEIMER'S DISEASE AND OTHER COGNITIVE IMPAIRMENTS ARE ALSO AVAILABLE. LAKE FOREST PLACE HEALTH CARE CENTER CONSISTS OF 50 SKILLED, MEDICARE-CERTIFIED NURSING BEDS AND 20 MEMORY CARE BEDS. THE MOORINGS HEALTH CARE CENTER CONSISTS OF 60 SKILLED, MEDICARE-CERTIFIED NURSING BEDS AND 39 INTERMEDIATE AND MEMORY CARE BEDS. THE TWO HEALTH CARE CENTERS SERVED A TOTAL OF 783 RESIDENTS DURING THE FILING YEAR. 92612 REVENUE IS RELATED TO INCOME FROM PARKING/GARAGE/TRANSPORTATION, GUEST ROOM RENTAL AND OTHER INCOME. 92612 50537784 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 1 1 1 1 0 0 1 79 0 806 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X MARK HAVRILKA 8479793904 8707 SKOKIE BOULEVARD SUITE 400 SKOKIE IL 60077 CHARLES DENISON DIRECTOR 1.00 2.00 X 0 0 0 GEORGE DROST DIRECTOR 1.00 2.00 X 0 0 0 GREG HUMMEL DIRECTOR 1.00 2.00 X 0 0 0 LEE HUTCHINSON CHAIR 1.00 2.00 X X 0 0 0 DENNIS MARX DIRECTOR 1.00 2.00 X 0 0 0 BETSY NICHOLS DIRECTOR 1.00 2.00 X 0 0 0 MONICA HEENAN DIRECTOR 1.00 2.00 X 0 0 0 PAULA NOBLE SECRETARY 1.00 2.00 X X 0 0 0 MARSHALL PECK TREASURER 1.00 2.00 X X 0 0 0 HARLAN STANLEY DIRECTOR 1.00 2.00 X 0 0 0 MARK TOLEDO DIRECTOR 1.00 2.00 X 0 0 0 JANE WESTERN DIRECTOR 1.00 2.00 X 0 0 0 DENNIS MURPHY DIRECTOR 1.00 2.00 X 0 0 0 MICHAEL KIRBY DIRECTOR 1.00 2.00 X 0 0 0 MARK DENNIS DIRECTOR 1.00 2.00 X 0 0 0 FRAN CARROLL DIRECTOR 1.00 2.00 X 0 0 0 TODD F SWORTZEL CEO 15.00 22.50 X 578828 0 30397 MARK HAVRILKA CFO 24.50 13.00 X 325289 0 44926 NADIM M ABI-ANTOUN COO 21.50 16.00 X 319876 0 23784 DAVID L BENNI VP/EXEC. DIR. THE MOORINGS 37.50 0.00 X 159877 0 8075 ROBERT A WERDAN VP MARKETING 25.50 12.00 X 212883 0 40944 RICHARD B BERLIN EXEC. DIR. LFP 37.50 0.00 X 216088 0 17046 ANDREW T WISSEL VP HUMAN RESOURCES 20.50 17.00 X 179882 0 29758 NANCY TOLAN VP FACILITIES MANAGEMENT 28.50 9.00 X 178099 0 31377 LISA J VANDERMARK EXEC. DIR. THE MOORINGS 37.50 0.00 X 149765 0 15374 DANIEL M WEINBERGER VP OF INFORMATION TECHNOLOGY 25.50 12.00 X 141458 0 30412 MARY ANN ANICHINI VP QUALITY IMPROVEMENT 24.50 13.00 X 156638 0 9155 JOHN DENKERT DIR. HEALTHCARE-THE MOORIN 37.50 37.50 X 138425 0 20946 VINCENT CONNOLLY DIRECTOR OF ENVIRONMENTAL SERVICES, THE MOORINGS 37.50 0.00 X 134883 0 7446 2891991 0 309640 26 0 1 0 POWER CONSTRUCTION COMPANY 8750 W BRYN MAWR AVENUE SUITE 500 CHICAGO IL 60631 CONSTRUCTION 6121253 GREAT HAVEN BUILDERS PO BOX 3076 BARRINGTON IL 60010 CONSTRUCTION 4812487 MORRISON COMMUNITY LIVING PO BOX 102289 ATLANTA GA 30368 DINING/FOOD SERVICES 3966795 GREENLEAF CABINETS INC 1100 FLORENCE EVANSTON IL 60202 CONSTRUCTION 2110859 EXECUTIVE CONSTRUCTION INC 235 FENCL LANE HILLSIDE IL 60162 CONSTRUCTION 1855183 41 6657868 6657868 INDEPENDENT LIVING FEES 623311 22991965 22991965 HEALTHCARE FEES 623311 22583269 22583269 DEFERRED ENTRANCE FEE INCOME 623311 11265077 11265077 ASSISTED LIVING FEES 623311 5798003 5798003 PARKING/GARAGE/TRANSPORTATION 623311 92612 92612 62730926 2431025 2431025 45420 0 45420 45420 45420 178037402 175844600 2192802 2192802 2192802 444606 351592 93014 93014 MANAGEMENT FEES 561000 3409496 3409496 3409496 77560551 62730926 0 8171757 2380989 2380989 22268594 18048799 4219795 1068092 693682 374410 3501857 2982637 519220 1702207 1296762 405445 5752389 5752389 484467 484467 185420 185420 2274397 1824094 450303 1134610 1134610 206272 27842 178430 721201 721201 247097 86232 160865 24139 287 23852 2671640 2671640 11993685 11942879 50806 472919 152265 320654 UTLITIES & TELEPHONE 2301779 2129789 171990 DRUGS & MED SUPPLIES 1285691 1285691 ENVIRONMENTAL SERVICES 1169880 1169880 REAL ESTATE TAXES 640988 640988 541971 472916 69055 63030284 50537784 12492500 0 12052259 25902186 24589189 1326038 1717042 2199224 732904 603808 352020039 115453789 198565230 236566250 82484676 104126467 6918772 9033855 327060072 379757828 10963009 24987789 76722355 79215519 90415000 103183450 103067269 107512509 281167633 314899267 X 45892439 64858561 45892439 64858561 327060072 379757828 X 14530267 2125048 2310807 X X 0 1 X 1 0 X 343158 6657868 7001026 19606749 62730926 82337675 194281 444606 638887 20144188 69833400 89977588 343158 6657868 7001026 0 343158 6657868 7001026 82976562 894048 2476445 3370493 894048 2476445 3370493 1184529 3409496 4594025 22222765 75719341 97942106 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MANAGEMENT FEE - 2015 AMOUNT: $ 1,184,529. 2016 AMOUNT: $ 3,409,496. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 26919254 26919254 269292167 100253602 169038565 26065155 15200187 10864968 29743463 29743463 236566250 SAFEKEEPING 406887 DEPOSITS - ENTRANCE FEES 2017417 REFUNDABLE ENTRANCE FEES 102566056 PENSION LIABILITY 1932630 OTHER 589519 107512509 X PART X, LINE 2: PRESBYTERIAN HOMES IS A NOT-FOR-PROFIT CORPORATION EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE(IRC). LAKE FOREST PLACE, LLC, THE MOORINGS LLC, TEN TWENTY GROVE, LLC, PH MANAGER, LLC, AND PH OUTPATIENT REHABILITATION, LLC ARE SINGLE MEMBER LIMITED LIABILITY COMPANIES AND THEREFORE ARE CONSIDERED DISREGARDED ENTITIES FOR TAX PURPOSES. PRESBYTERIAN HOMES FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. PREBYTERIAN HOMES FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. THE INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 TODD F SWORTZEL CEO 448442 0 104064 0 26322 0 15900 0 14497 0 609225 0 0 0 MARK HAVRILKA CFO 260087 0 63960 0 1242 0 15900 0 29026 0 370215 0 0 0 NADIM M ABI-ANTOUN COO 270736 0 48600 0 540 0 12935 0 10849 0 343660 0 0 0 DAVID L BENNI VP/EXEC. DIR. THE MOORINGS 72275 0 10000 0 77602 0 4335 0 3740 0 167952 0 0 0 ROBERT A WERDAN VP MARKETING 184288 0 26860 0 1735 0 12141 0 28803 0 253827 0 0 0 RICHARD B BERLIN EXEC. DIR. LFP 123092 0 35326 0 57670 0 7245 0 9801 0 233134 0 0 0 ANDREW T WISSEL VP HUMAN RESOURCES 156893 0 22244 0 745 0 10934 0 18824 0 209640 0 0 0 NANCY TOLAN VP FACILITIES MANAGEMENT 154776 0 22828 0 495 0 11120 0 20257 0 209476 0 0 0 LISA J VANDERMARK EXEC. DIR. THE MOORINGS 131389 0 17260 0 1116 0 7381 0 7993 0 165139 0 0 0 DANIEL M WEINBERGER VP OF INFORMATION TECHNOLOGY 137445 0 3750 0 263 0 9022 0 21390 0 171870 0 0 0 MARY ANN ANICHINI VP QUALITY IMPROVEMENT 141189 0 13648 0 1801 0 8022 0 1133 0 165793 0 0 0 JOHN DENKERT DIR. HEALTHCARE-THE MOORIN 118395 0 19048 0 982 0 8340 0 12606 0 159371 0 0 0 PART I, LINE 1A TODD F. SWORTZEL, CEO, RECEIVES A $24,000 TAXABLE HOUSING ALLOWANCE WHICH IS INCLUDED IN W-2 WAGES. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED SECTION 457(F) DEFERRED COMPENSATION PLAN: TODD SWORTZEL, MARK HAVRILKA, NADIM ABI-ANTOUN, NANCY TOLAN, ROBERT WERDAN, ANDREW WISSEL, RICHARD BERLIN, DAVID BENNI, LISA VANDERMARK, DANIEL WEINBERGER, MARY ANN ANICHINI AND JOHN DENKERT. DURING THE YEAR TODD SWORTZEL RECEIVED PAYMENTS TOTALING $60,000 FROM A NON-QUALIFIED SECTION 457(F) DEFERRED COMPENSATION PLAN. DURING THE YEAR NADIM ABI-ANTOUN RECEIVED PAYMENTS TOTALING $7,129 FROM A NON-QUALIFIED SECTION 457(F) DEFERRED COMPENSATION PLAN. DURING THE YEAR NANCY TOLAN RECEIVED PAYMENTS TOTALING $14,997 FROM A NON-QUALIFIED SECTION 457(F) DEFERRED COMPENSATION PLAN. DURING THE YEAR ROBERT WERDAN RECEIVED PAYMENTS TOTALING $17,975 FROM A NON-QUALIFIED SECTION 457(F) DEFERRED COMPENSATION PLAN. A ILLINOIS FINANCE AUTHORITY 861091967 45204EBD9 2016-04-27 114484316 TO REFUND THE SERIES 1996A, 2001, 2006 AND 2007 BONDS 0 0 0 B ILLINOIS FINANCE AUTHORITY 861091967 2016-09-30 69615000 TO FUND CAMPUS EXPANSION AT THE MOORINGS OF ARLINGTON HEIGHTS 0 0 0 A 1532475 100253916 90415000 1586771 8252145 2016 1 0 1 1 B 69215000 400000 8009042 61205958 2016 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 1 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR, THE VICE CHAIR, THE SECRETARY, THE TREASURER, AND SUCH ADDITIONAL MEMBERS OF THE BOARD AS FROM TIME TO TIME MAY BE DETERMINED BY THE BOARD OF DIRECTORS. THE PRESIDENT/CEO SHALL BE A NON-VOTING ATTENDEE AT ALL MEETINGS OF THE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD OF DIRECTORS IN EMERGENCIES WHEN CONVENING THE FULL BOARD IS NOT PRACTICABLE AND SHALL REPORT ITS ACTIONS TO THE BOARD AT THE EARLIEST OPPORTUNITY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND IS THEN PRESENTED TO THE AUDIT COMMITTEE, WHICH ACTS AS A REPRESENTATIVE OF THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. THIS IS ACCOMPLISHED PRIOR TO THE FILING OF THE FORM 990. THE AUDIT COMMITTEE FORWARDS ITS RECOMMENDATION FOR ACCEPTANCE OF THE FORM 990 TO THE BOARD OF DIRECTORS. COPIES OF THE FORM 990 ARE ALSO FORWARDED TO THE ENTIRE BOARD FOR THEIR REVIEW AND COMMENT PERIOD. THE BOARD THEN ACTS ON THE RECOMMENDATION OF THE AUDIT COMMITTEE PRIOR TO THE 990'S BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PRESBYTERIAN HOMES EMPLOY MULTIPLE PRACTICES TO ENSURE SENIOR STAFF AND MEMBERS OF THE BOARD OF DIRECTORS FOLLOW BEST GOVERNANCE PRACTICES. AN EXTENSIVE CONFLICTS OF INTEREST POLICY WAS ADOPTED IN APRIL 2001, REVISED IN APRIL 2004 AND FURTHER REVISED IN 2011. ALL DIRECTORS AND SENIOR STAFF ARE REQUIRED TO FILE AN ANNUAL STATEMENT RELATED TO CONFLICTS OF INTEREST. IN ACCORDANCE WITH PRESBYTERIAN HOME'S ACCREDITATION BY THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES-CONTINUING CARE ACCREDITATION COMMISSION (CARF-CCAC), A CODE OF ETHICS WAS ADOPTED IN APRIL 2007 AND ALL DIRECTORS ARE REQUIRED TO FILE AN ANNUAL STATEMENT CONFIRMING THEIR ACCEPTANCE OF THE CODE. FINALLY, PRESBYTERIAN HOMES ADMINISTERS THE IRS RELATIONSHIP SURVEY TO ALL DIRECTORS AND KEY EMPLOYEES ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNANCE COMMITTEE OF PRESBYTERIAN HOMES IS RESPONSIBLE FOR ALL COMPENSATION AND BENEFIT MATTERS FOR SENIOR MANAGEMENT AND KEY EMPLOYEES. PRESBYTERIAN HOMES ANNUALLY PARTICIPATES IN AN INDUSTRY SPECIFIC EXECUTIVE COMPENSATION SURVEY. THE RESULTS OF THIS SURVEY IS REVIEWED BY MANAGEMENT AND SHARED WITH THE COMMITTEE AS NECESSARY. IN ADDITION THE COMMITTEE REGULARLY ENGAGES AN EXTERNAL COMPENSATION CONSULTING FIRM TO ASSIST IN ITS REVIEW OF THE LEVEL OF COMPENSATION, INCENTIVES AND BENEFITS FOR SENIOR EXECUTIVES AND KEY EMPLOYEES EVERY THREE YEARS. THE COMPENSATION CONSULTANTS ACCUMULATE AND PRESENT TO THE GOVERNANCE COMMITTEE MARKET INFORMATION FOR EACH SENIOR EXECUTIVE POSITION, SUMMARIZE INDIVIDUAL EXECUTIVE COMPENSATION, INCENTIVE AND BENEFITS PACKAGES AND BENCHMARK THAT INFORMATION TO THE INDUSTRY DATA THEY HAVE ACCUMULATED. ANNUALLY, THE ORGANIZATION'S STAFF AND/OR THE BOARD OF DIRECTORS PREPARES PERFORMANCE REVIEWS FOR ALL SENIOR MANAGERS AND KEY EMPLOYEES AND MAKES A RECOMMENDATION TO THE GOVERNANCE COMMITTEE REGARDING COMPENSATION, INCENTIVES AND BENEFITS ADJUSTMENTS. THE GOVERNANCE COMMITTEE CONSIDERS THE PERFORMANCE RECOMMENDATION, COMPARISONS OF TOTAL COMPENSATION BY EXECUTIVE TO MARKET COMPENSATION PERCENTILE FOR INDUSTRY EXECUTIVES WITH SIMILAR JOB TITLES AND/OR SKILL SETS, AND ORGANIZATIONAL NEEDS IN TERMS OF MEETING THE CHALLENGES OF THE UNIQUE BUSINESS OF PROVIDING SENIOR CARE SERVICES. THE GOVERNANCE COMMITTEE MAKES A RECOMMENDATION REGARDING COMPENSATION AND BENEFITS CHANGES FOR SENIOR MANAGEMENT WHICH IS APPROVED ANNUALLY BY THE FULL BOARD OF DIRECTORS WITHIN THE BUDGET PROCESS. THE GOVERNANCE COMMITTEE PROCEEDINGS ARE CONTEMPORANEOUSLY DOCUMENTED AND MINUTES ARE MAINTAINED AND ON FILE AT THE CORPORATE OFFICE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO THE PUBLIC. CONTACT FOR THE INFORMATION IS THE CHIEF FINANCIAL OFFICER, MARK HAVRILKA AT PRESBYTERIAN HOMES, 8707 SKOKIE BOULEVARD, SUITE 400, SKOKIE, IL 60077. THE FINANCIAL STATEMENTS ARE AVAILABLE THROUGH THE ILLINOIS ATTORNEY GENERAL'S OFFICE. FORM 990, PART XI, LINE 9: CHANGE IN MARKET VALUE OF SWAP 1,973,039. PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -173,492. NET ASSETS TRANSFERED FROM AFFILIATE 511,260. FORM 990, PART XII, LINE 2C THE CONSOLIDATED FINANCIAL STATEMENTS OF PRESBYTERIAN HOMES AND AFFILIATES ARE AUDITED BY AN INDEPENDENT AUDITOR. THERE HAS BEEN NO CHANGE TO THE PROCESS WHEN COMPARED TO THE PRIOR YEAR. 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