2016-05-11T12:23:44-05:00 2015-09-30 420714325 RSM US LLP 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2014-10-01 371138846 DESERT HEALTH CARE FACILITIES INC DESE 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 GERALD DUBOIS PRESIDENT 3093431550 2016-05-10 1 MICHAEL BASS P00458970 3093428026 2014 2016-08-17 19:52:53Z GERALD DUBOIS 285 SOUTH FARNHAM STREET GALESBURG IL 61401 24064661 0 X N/A X 1984 NV DHCF, INC. PROVIDES & OPERATES NURSING & ASSISTED LIVING FACILITIES FOR THE ELDERLY. 4 4 726 17 0 0 15577 54836 23145851 24009531 0 294 0 0 23161428 24064661 10000 325 0 0 11613773 11938517 0 0 0 14626778 14159688 26250551 26098530 -3089123 -2033869 6856600 6034670 11103540 12315479 -4246940 -6280809 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 24060963 325 24009825 ALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING SKILLED NURSING FACILITIES, HEALTH CARE, ASSISTED AND SEMI-INDEPENDENT LIVING FACILITIES, AND OTHER RELATED SERVICES TO THE ELDERLY. THE ORGANIZATION OPERATES 5 FACILITIES WITH A COMBINED TOTAL OF 576 BEDS. 24060963 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 1 23 0 726 1 0 0 0 0 0 0 0 0 0 0 X 4 4 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X RON WILSON RFMS INC 3093431550 285 SOUTH FARNHAM GALESBURG IL 61401 X CHARLES MCARTHUR DIRECTOR 2.00 X 1500 0 0 CHARLES PERRY SECRETARY/DIRECTOR 2.00 X X 3000 0 0 GERALD DUBOIS PRESIDENT/DIRECTOR 2.00 X X 3000 0 0 JIM TOOMEY DIRECTOR 2.00 X 1500 0 0 ROBERT WERNSMAN DIRECTOR 2.00 X 3000 0 0 RON WILSON RFMS INC CFO 40.00 X 0 0 0 12000 0 0 0 0 0 0 SYNERTX REHABILITATION 7540 N 19TH AVENUE STE 200 PHOENIX AZ 85021 THERAPY 1255734 RFMS INC 285 SOUTH FARNHAM GALESBURG IL 61401 ADMINISTRATIVE SERVICES 315640 MESA VIEW PHYSICAL THERAPY PO BOX 202 ELKO NV 89803 THERAPY 269740 MAVES CONSTRUCTION INC PO BOX 3357 MESQUITE NV 89024 CONTRACTOR 163047 LTC SUPPORT SERVICES LLC 285 SOUTH FARNHAM GALESBURG IL 61401 SUPPORT SERVICES 145846 5 54836 54836 MEDICARE & MEDICAID 623000 15820241 15820241 RESIDENT PRIVATE PAY 623000 8116638 8116638 RESIDENT THERAPY 623000 50847 50847 OTHER INCOME 623000 21305 21305 AID TRAINING INCOME 623000 500 500 24009531 294 294 24064661 24009531 0 294 325 325 22500 22500 10202536 9969937 232599 56336 55052 1284 694821 678980 15841 962324 940385 21939 400080 243528 156552 116736 116736 61105 61105 4332 4332 1796872 1796872 49188 44269 4919 139022 108735 30287 93213 74570 18643 4390309 4260645 129664 69763 67098 2665 13559 9326 4233 91615 91615 280397 266377 14020 216917 203567 13350 SUPPLIES & SMALL EQUIP. 2629913 2629913 MEDICAID ASSESSMENT TAX 2487588 2487588 UNCOLLECTIBLE CHARGES 1058857 1058857 EQUIPMENT RENT & MAINT. 160146 159612 534 100076 64184 35892 26098530 24060963 2037567 0 83782 134154 1392 6038 4725792 3971761 336675 341918 4584047 3168475 1543732 1415572 10000 10000 155227 155227 6856600 6034670 2014736 2318807 8195429 8195429 893375 1801243 11103540 12315479 X -4246940 -6280809 -4246940 -6280809 6856600 6034670 -2033869 0 X X 1 X 0 1 0 X 1890 1077 949 15577 54836 74329 22711095 22786860 23814030 23145851 24064955 116522791 22712985 22787937 23814979 23161428 24119791 116597120 0 0 0 116597120 2526 1371 276 294 4467 2526 1371 276 294 4467 22715511 22789308 23815255 23161428 24120085 116601587 1.00000 0.99990 0.00000 0.00010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4332 4332 24060963 24065295 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 4270 3998 4227 4332 16827 250000 250000 250000 250000 1000000 1500000 1094599 355255 739344 3166223 2553280 612943 323225 259940 63285 1415572 RESIDENT SECURITY DEPOSITS 136235 DUE TO RESIDENTS, TRUST ACCOUNTS 71227 OUTSTANDING CHECKS IN EXCESS OF BANK BALANCE 1593781 1801243 X PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) 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 ADJUSTMENTS 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 2011. LTC SUPPORT SERVICES (LTC) ONE DIRECTOR COMMON TO DHCF & LTC IS GERALD DUBOIS 108720 SUPPORT SERVICES ARE PROVIDED BY LTC SUPPORT SERVICES, LLC, AS DESCRIBED IN SCHEDULE O RELATIVE TO PART VI, SECTION A, LINE 3. CHARLES PERRY, WHO IS A DIRECTOR OF DESERT HEALTH CARE FACILITIES, INC. (DHCF), AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $0 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2015. GERALD DUBOIS, WHO IS A DIRECTOR OF DESERT HEALTH CARE FACILITIES, INC. (DHCF), AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $1,500 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2015. 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. DESERT HEALTH CARE FACILITIES, INC. OWNS 12.5% OF LTC SUPPORT SERVICES, LLC. THE REMAINING 87.5% 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 11 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. 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 DESERT HEALTH CARE FACILITIES, 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 2014 IS $173,518. 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 XII, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE COMPILATION AND SELECTION OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. ELKO HEALTH CARE LLC 285 S FARNHAM STREET GALESBURG IL 61401 275439926 OPERATES A NURSING HOME & ASSISTED LIVNG FACILITY FOR THE ELDERLY. NV 10714596 2978379 N/A FALLON HEALTH CARE LLC 285 S FARNHAM STREET GALESBURG IL 61401 275440284 OPERATES A NURSING HOME & ASSISTED LIVNG FACILITY FOR THE ELDERLY. NV 7847032 1887240 N/A MESQUITE HEALTH CARE LLC 285 S FARNHAM STREET GALESBURG IL 61401 275440122 OPERATES A NURSING HOME FOR THE ELDERLY. NV 5450417 1082123 N/A RFMS INC MEDICAL BENEFIT PLAN TRUST 285 S FARNHAM STREET GALESBURG IL 61401 367042729 MEDICAL, ST DISABILITY & DEATH BENEFITS FOR ELIGIBLE EMPLOYEES IL 501(C)(9) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RFMS INC MEDICAL BENEFIT PLAN TRUST R 352136 COST OF PREMIUMS SCHEDULE R, PART II AND PART V: THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST IS A SELF-INSURED BENEFIT PROGRAM FUNDED BY THE EMPLOYERS AND PARTICIPANTS WITHIN THE PLAN. PARTICIPANTS IN THE PLAN ARE CURRENT AND FORMER EMPLOYEES OF THE FOLLOWING SPONSORS: RFMS, INC., LTC SUPPORT SERVICES, LLC, COMMUNITY LIVING OPTIONS, INC., SMSLC, LLC, FRANCES HOUSE, INC., UNLIMITED DEVELOPMENT, INC., KENSINGTON OF GALESBURG, INC., ACHIEVEMENT UNLIMITED, INC., PINNACLE OPPORTUNITIES, INC., PIONEER CONCEPTS, INC., RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., DESERT HEALTHCARE FACILITIES, INC., FLORIDA LIVING OPTIONS, INC., AND HIGHLAND ESTATES RESORT, LLC. PLAN ASSETS ARE HELD IN A VOLUNTARY EMPLOYEES' BENEFIT ASSOCIATION (VEBA) TRUST. THE PLAN IS SUBJECT TO THE PROVISIONS OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA), AS AMENDED. NO TRUSTEE FEES OR MANAGEMENT FEES ARE PAID BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST. THE AMOUNT OF PREMIUMS RECEIVED BY THE RFMS, INC. MEDICAL BENEFIT PLAN TRUST IS FOR THE PLAN'S FISCAL YEAR ENDING OCTOBER 31, 2015.