2016-11-15T14:26:34-06:00 2015-12-31 990 2015-01-01 201835089 TIMOTHY PLACE NFP TIMO 7083428100 18601 NORTH CREEK DRIVE TINLEY PARK IL 60477 VANDERGENUGTEN BARRY CFO 7083428100 2016-11-15 LARRY J OTTE P01427347 2016-11-15 2015 2017-02-10 21:41:12Z PARK PLACE CHRISTIAN COMM ELMHURST DEYOUNG WILLIAM 18601 N CREEK DR TINLEY PARK IL 60477 15309870 false X PROVIDENCELIFESERVICES.COM X 2004 IL TO PROVIDE HOUSING AND THE FULL CONTINUUM OF CARE FOR SENIORS. 7 7 354 25 0 4905 2950 12809868 15192394 145695 114526 0 12960468 15309870 0 0 6544505 6359363 0 0 23459923 23782169 30004428 30141532 -17043960 -14831662 162327656 158404096 245000447 248099558 -82672791 -89695462 TO PROVIDE HOUSING AND THE FULL CONTINUUM OF CARE FOR SENIORS. false false 29638084 TO PROVIDE HOUSING AND CARE FOR THE ELDERLY AND SICK. 29638084 true false false false false false false false false false true false false true true true true false false false false false false false false false false false false true true false false false false false false false false true false false false false false false true false false false true 35 0 true 354 true false false false false false false X 7 7 false true false false true true true true true false false false true true true true true true true false IL X PROVIDENCE LIFE SERVICES 7083428100 18601 NORTH CREEK DR TINLEY PARK IL 60477 CLOUSING SHARON ASST SECR/TR 1.00 2.00 X X 0 0 0 TAMELING CAL VICE CHAIR 1.00 2.00 X X 0 0 0 VAN HATTEM RICH TRUSTEE 1.00 2.00 X 0 0 0 KATS JUSTIN TRUSTEE 1.00 2.00 X 0 0 0 BREEMS TIM CHAIR 1.00 2.00 X X 0 0 0 SCHOON KEN TRUSTEE 1.00 2.00 X 0 0 0 VANDYK DON TRUSTEE 1.00 2.00 X 0 0 0 SCHUTT RICHARD CEO 5.00 50.00 X 0 505834 144643 DEYOUNG WILLIAM CFO 5.00 50.00 X 0 335109 72468 MARY BETH FRITZ MARKETING DI 40.00 X 230665 0 21075 ENGELSMAN DONALD ADMINISTRATO 40.00 X 162272 0 39072 SMITH SHELLY HEALTHCARE D 40.00 X 126954 0 31558 KATHLEEN LORENZ SR LIVING CO 40.00 X 122559 0 16396 SLEEZER DREW SR LIVING CO 40.00 X 114581 0 464 757031 840943 325676 5 false true false MARIANJOY REHABILITATION 26 W 171 ROOSEVELT WHEATON IL 60187 THERAPY 1024447 GLYNNDEVINS ADVERTISING 11230 COLLEGE BLVD OVERLAND PARK KS 66210 MARKETING 702699 GORDON FOOD SERVICE PO BOX 88029 CHICAGO IL 60680 DIETARY 556026 SYMBRIA RX SERVICES 28100 TORCH PARKWAY WARRENVILLE IL 60555 PHARMACY 524496 AEP ENERGY DEPT CH 19346 PALATINE IL 60055 UTILITY 423047 14 2950 2950 ROUTINE REVENUE 623000 14863105 14863105 ANCILLARY REVENUE 623000 329289 329289 15192394 114526 114526 15309870 15192394 114526 5564227 5564227 56108 56108 333835 333835 405193 405193 503448 503448 191508 191508 99703 99703 821822 821822 75824 75824 1173023 1173023 11792328 11792328 4421269 4421269 354264 354264 THERAPY 977472 977472 DIETARY SERVICES 754604 754604 MAINTENANCE & REPAIR 687039 687039 PHARMACY 467220 467220 1462645 1462645 30141532 29638084 503448 0 1251648 870074 5572948 5377138 13953 12980 22832 63740 137284278 13000924 127397052 124283354 10145456 10125106 17923767 17671704 162327656 158404096 8299150 9010614 63308403 70204250 146125000 146125000 27267894 22759694 245000447 248099558 X -82672791 -89695462 -82672791 -89695462 162327656 158404096 -14831662 -6260 7815251 X false true X true false X 96978 4905 2950 104833 2440191 10084559 12809868 15192394 40527012 2440191 10181537 12814773 15195344 40631845 40631845 638866 350501 145695 114526 1249588 638866 350501 145695 114526 1249588 3079057 10532038 12960468 15309870 41881433 0.97020 0.95730 0.03000 0.04000 X 14600000 14600000 119808038 11679891 108128147 2876240 1321033 1555207 124283354 ASSETS LIMITED TO USE 17671704 17671704 OBLIGATION TO PROVIDE FUTURE SERVICE 24559000 RESIDENT DEPOSITS 293395 ORIGINAL ISSUE DISCOUNT -2092701 22759694 X 16288503 -6260 984893 978633 15309870 15309870 25446242 -4695290 -4695290 30141532 30141532 SCHEDULE D, PAGE 3, PART X ASC 740 FOOTNOTE THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC SUBTOPIC 740-10, INCOME TAXES - GENERAL, WHICH ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER ACS SUBTOPIC 740-10 THE CORPORATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECONGITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES AND ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AS OF DECEMBER 31, 2015, THE CORPORATION DOES NOT HAVE A LIABILITY FOR ANY UNRECOGNIZED TAX BENEFITS. SCHEDULE D, PAGE 4, PART XI, LINE 2D PROVISION FOR UNCOLLECTIBLE ACCOUNTS -81,290 AMORTIZATION OF ENTRANCE FEES 1,066,183 SCHEDULE D, PAGE 4, PART XII, LINE 2D CHANGE IN FSO -4,614,000 PROVISION FOR UNCOLLECTIBLE ACCOUNTS -81,290 X X true true X X X X X X false false false false false false false false false SCHUTT RICHARD CEO 451063 37762 17009 121751 22892 650477 DEYOUNG WILLIAM CFO 297262 25490 12357 38573 33895 407577 MARY BETH FRITZ MARKETING DIRECTOR 155769 74500 396 9211 11864 251740 ENGELSMAN DONALD ADMINISTRATOR 152859 9413 6413 32659 201344 SMITH SHELLY HEALTHCARE DIRECTOR 126236 300 418 5061 26497 158512 SCHEDULE J, PART III QUESTION 1A THE ORGANIZATION PROVIDES AN ALLOWANCE FOR UP TO 10 BOARD MEMBERS TO ATTEND THE ANNUAL ASSOCIATION CONVENTION TO PROVIDE MORE IN DEPTH KNOWLEDGE OF THE SENIOR CARE INDUSTRY. THE COST OF TRAVEL FOR SPOUSES IS PERMITTED AS LONG AS THE TOTAL DOES NOT EXCEED THE ESTABLISHED ALLOWANCE AMOUNT. DOCUMENTATION OF ATTENDANCE AT THE ANNUAL CONVENTION IS REQUIRED. THE ORGANIZATION HAS ESTABLISHED A SENIOR EXECUTIVE MANAGEMENT PROGRAM WHICH ALLOWS STATED EMPLOYEES TO JOIN A FITNESS CENTER. ELIGIBLE EMPLOYEES THAT ENROLL ARE REQUIRED TO BE ACTIVELY UTILIZING THE FITNESS CENTER. QUESTION 4B REST HAVEN HAS ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN IN AN EFFORT TO RETAIN SELECTED OFFICERS ON A LONG TERM BASIS. THE FOLLOWING IS A SCHEDULE OF THE OFFICERS AND THE ANNUAL CONTRIBUTION TO THE PLAN: RICHARD SCHUTT 111,151 WILLIAM DEYOUNG 27,973 IN 2005, THE BOARD OF DIRECTORS ESTABLISHED A RETENTION INCENTIVE PLAN FOR CERTAIN OFFICERS. THIS PLAN RECOGNIZES THE HISTORIC CONTRIBUTION OF THE EXECUTIVES WITH THE ORGANIZATION UNTIL NORMAL RETIREMENT AGE. AMONG VARIOUS CRITERIA, IN ORDER TO QUALIFY FOR THE BENEFIT, THE EXECUTIVE WILL NEED TO BE CONTINOUSLY EMPLOYED THRU AND UNTIL FUTURE DATE. THE ORGANIZATIONS PAYMENTS INTO THE PLAN ARE RECORDED ON THE 990 AS DEFERRED COMPENSATION. HOWEVER, THE EXECUTIVE HAS NOT RECEIVED THESE MONIES AND WILL ONLY BE ELIGIBLE TO RECEIVE THE MONIES BASED UPON ACHIEVEMENT OR SATISFACTION OF SOME FUTURE EVENTS. THE PLAN CONTRIBUTIONS ARE NOT UNDER THE CONTROL OF THE EXECUTIVES, THEY REMAIN THE ASSET OF THE ORGANIZATION, AND THE ENTIRE PLAN IS SUBJECT TO A FULL RISK FORFEITURE BY THE INDIVIDUAL. QUESTIONS 5A AND 6A THE EXECUTIVE COMPENSATION PROGRAM HAS TWO MAJOR ELEMENTS: SALARY, OR BASE PAY, AND VARIABLE PAY. THE SALARY REFLECTS THE VALUE OF AN EXECUTIVE'S CAPABALITIES AND EXPERIENCE. THE VARIABLE PAY REFLECTS THE ORGANIZATIONS COMMITMENT TO PAY FOR SPECIFIC PERFORMANCE TOWARDS THE ORGANIZATIONS GOALS. THE VARIABLE PAY IS AWARDED BASED UPON A SPECIFIC REVIEW OF GOALS AND OBJECTIVES (INCLUDING THOSE WHICH RELATE TO MISSION, OPERATIONAL EFFICIENCY, FINANCIAL EFFECTIVENESS, AND STRATEGIC GOALS). SEMI-ANNUALLY THE COMPENSATION COMMITTEE REVIEWS, ASSESSES AND DETERMINES ANY AWARD UNDER THE VARIABLE PAY COMPONENT. EXECUTIVE EMPLOYEE BENEFITS ARE REVIEWED BY THE COMPENSATION COMMITTEE AND OUTSIDE CONSULTANTS TO INSURE THEY ARE COMPETITIVE AND IN LINE WITH COMMON PRACTICE FOR SIMILAR POSITIONS IN SIMILARLY SIZED AND TYPE ORGANIZATIONS. THE COMMITTEE RECIEVES AN EXECUTIVE COMPENSATION OPINION NOTING THAT THE ORGANIZATIONS EXECUTIVE COMPENSATION FALLS WITHIN THE RANGE OF COMPARABLE POSITIONS WITHIN THE SAME INDUSTRY. THE REPORT/OPINION ALSO NOTES THAT THE STATED REQUIREMENTS OF ENSURING INDEPENDENCE OF COMPENSATION DELIBERATIONS FOR SENIOR EXECUTIVES ARE MET. A ILLINOIS FINANCE AUTHORITY 861091967 45200F3D9 2010-05-27 4725000 CONSTRUCT RETIREMENT HOUSING false false false B ILLINOIS FINANCE AUTHORITY 861091967 45200F3E7 2010-05-27 18590000 CONSTRUCT RETIREMENT HOME false false false C ILLINOIS FINANCE AUTHORITY 861091967 45200F3F4 2010-05-27 40365000 CONSTRUCT RETIREMENT HOME false false false D ILLINOIS FINANCE AUTHORITY 861091967 45200F3C1 2010-05-27 45435000 CONSTRUCT RETIREMENT HOME false false false A 4647194 385634 645807 92944 4599562 2012 false false false true B 18283879 1517236 2540859 365678 18096476 2012 false false false true C 39700312 3294417 5603244 794006 39293398 2012 false false false true D 44686824 3708209 6404065 893736 44228800 2012 false false false true A false false false false false false false B false false false false false false false C false false false false false false false D false false false false false false false A true false false false false true B true false false false false true C true false false false false true D true false false false false true A true B true C true D true LINDA SCHUTT SPOUSE OF CEO 100715 EMPLOYMENT COMP false BONNIE HEIRENDT SISTER OF CEO 51702 EMPLOYMENT COMP false ALLISON OLESHKO DAUGHTER OF CEO 54828 EMPLOYMENT COMP false SCHEDULE L, PART V THE TRANSACTIONS REPORTED ABOVE INVOLVING INTERESTED PERSONS ARE REVIEWED ANNUALLY BY THE BOARDS COMPENSATION COMMITTEE AND HAVE BEEN DEEMED APPROPRIATE BASED ON THE POSITIONS EMPLOYED. FORM 990, PAGE 6, PART VI, LINE 3 PROVIDENCE LIFE SERVICES FORM 990, PAGE 6, PART VI, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME. THE AFFAIRS, BUSINESS AND ALL LEGAL MATTERS OF THE CORPORATION SHALL BE MANAGED BY ITS BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 7A THE MEMBER SHALL HAVE AND EXERCISE THE THE FOLLOWING RESERVE POWERS:(1)TO APPOINT OR REMOVE DIRECTORS; (2) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (3) TO REVIEW ALL ANNUAL BUDGETS AND AUDITED FINANCIAL STATEMENTS AND TO APPROVE ANY DEFICIT BUDGET; (4) TO APPROVE THE CONSTRUCTION OF ANY NEW OR THE ALTERATION OF ANY EXISTING FACILITY INVOLVING AN EXPENDITURE OF 500,000 OR MORE; (5) TO SELL, MORTGAGE, PLEDGE OR ALIENATE ALL OR ANY PART OF THE REAL ESATE OR SUBSTANTIALLY ALL OF THE OTHER ASSETS OF THE CORPORATION; (6) TO DISSOLVE THE CORPORATION. FORM 990, PAGE 6, PART VI, LINE 7B THE MEMBER SHALL HAVE AND EXERCISE THE THE FOLLOWING RESERVE POWERS:(1)TO APPOINT OR REMOVE DIRECTORS; (2) TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (3) TO REVIEW ALL ANNUAL BUDGETS AND AUDITED FINANCIAL STATEMENTS AND TO APPROVE ANY DEFICIT BUDGET; (4) TO APPROVE THE CONSTRUCTION OF ANY NEW OR THE ALTERATION OF ANY EXISTING FACILITY INVOLVING AN EXPENDITURE OF 500,000 OR MORE; (5) TO SELL, MORTGAGE, PLEDGE OR ALIENATE ALL OR ANY PART OF THE REAL ESATE OR SUBSTANTIALLY ALL OF THE OTHER ASSETS OF THE CORPORATION; (6) TO DISSOLVE THE CORPORATION. FORM 990, PAGE 6, PART VI, LINE 11B A DRAFT OF THE 990 IS PREPARED AND REVIEWED BY THE CONTROLLER AND CFO. UPON THEIR REVIEW AND APPROVAL, THE FINAL DRAFT IS FORWARDED TO THE EXECUTIVE COMMITTEE BEFORE SUBMISSION. A COMPLETED COPY OF THE 990 IS PROVIDED TO THE FULL BOARD AT THE SUBSEQUENT BOARD MEETING, AFTER FILING. FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS/TRUSTEES ARE REQUIRED TO SUBMIT A CONFLICT OF INTEREST STATEMENT UPON BEGINNING THEIR POSITION. THEREAFTER, THE CONFLICT OF INTEREST STATEMENTS ARE UPDATED ON AN ANNUAL BASIS AND REVIEWED BY THE BOARD. ANY POTENTIAL CONFLICTS ARE REVIEWED AND ADDRESSED AS NECESSARY. FORM 990, PAGE 6, PART VI, LINE 15A THE EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIP TALENT IN ORDER TO ACHIEVE THE ORGANIZATIONS MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECTUIVE COMPENSATION RANGES THROUGH A WRITTEN POLICY AND BY COMPARING ITSELF TO ORGANIZATIONS OF SIMILAR SIZE AND TYPE - USING OBJECTIVE, THIRD-PARTY DATA. A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS RECOMMENDS, AND THE BOARD OF DIRECTORS APPROVES, THE SALARY RANGES AND REVIEWS TOTAL COMPENSATION FOR EXECUTIVES ON AN ANNUAL BASIS. THE ORGANIZATION ROUTINELY USES KNOWLEDGEABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR REASONABLENESS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. FORM 990, PAGE 6, PART VI, LINE 15B THE EXECUTIVE COMPENSATION PROGRAMS PRIMARY OBJECTIVE IS TO PROVIDE COMPETITIVE TOTAL PAY OPPORTUNITIES THAT HELP ATTRACT, REWARD AND RETAIN CRITICAL LEADERSHIP TALENT IN ORDER TO ACHIEVE THE ORGANIZATIONS MISSION AND STRATEGIC INITIATIVES. REST HAVEN ESTABLISHES ITS EXECTUIVE COMPENSATION RANGES THROUGH A WRITTEN POLICY AND BY COMPARING ITSELF TO ORGANIZATIONS OF SIMILAR SIZE AND TYPE - USING OBJECTIVE, THIRD-PARTY DATA. A COMPENSATION COMMITTEE OF INDEPENDENT DIRECTORS RECOMMENDS, AND THE BOARD OF DIRECTORS APPROVES, THE SALARY RANGES AND REVIEWS TOTAL COMPENSATION FOR EXECUTIVES ON AN ANNUAL BASIS. THE ORGANIZATION ROUTINELY USES KNOWLEDGEABLE EXTERNAL CONSULTANTS TO ADVISE ON THE PROCESS AND HAS RECEIVED AFFIRMATION OF COMPLIANCE WITH IRS GUIDELINES FOR REASONABLENESS OF EXECUTIVE COMPENSATION IN TAX-EXEMPT ENTITIES. FORM 990, PAGE 6, PART VI, LINE 19 AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 CHANGE IN FSO OBLIGATION 4,614,000 AMORTIZATION OF ENTRANCE FEES 1,066,183 LIQUID SUPPORT AGREEMENT RELEASED 2,135,068 TOTAL 7,815,251 REST HAVEN ILLIANA CHRISTIAN REST HAVEN ILLIANA CHRISTIAN 18601 N CREEK DRIVE TINLEY PARK IL 60477 362382853 HEALTHCARE IL 501C3 7 N/A false CHRISTIAN HEALTHCARE FOUNDATION CHRISTIAN HEALTHCARE FOUNDATION 18601 N CREEK DRIVE TINLEY PARK IL 60477 200722359 RESEARCH IL 501C3 7 N/A false PROVIDENCE MANAGEMENT & DEVELOPMENT PROVIDENCE MANAGEMENT & DEVELOPMENT 18601 N CREEK DR TINLEY PARK IL 60477 363774205 MANAGEMENT IL N/A false false false false false false false false false false false false false false false true true false false false REST HAVEN ILLIANA CHRISTIAN P 503448 FMV PROVIDENCE MANAGEMENT P 149800 FMV