2014-05-12T09:27:37-05:00 2013-06-30 420714325 MCGLADREY LLP 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2012-07-01 371223609 COMMUNITY RESIDENTIAL CENTERS INC COMM 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 STAN SYDLOWSKI 3093431550 2014-05-06 1 BEN MCMAHAN P00702421 3093428026 2012 2015-11-30 17:44:51Z STAN SYDLOWSKI 285 SOUTH FARNHAM STREET GALESBURG IL 61401 9933265 0 X N/A X 1987 IL TO PROVIDE & OPERATE LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED. 4 4 378 49 0 0 16940 25070 9563561 9906456 10206 1739 0 0 9590707 9933265 0 0 0 0 6722525 6570058 0 0 0 3458068 3245569 10180593 9815627 -589886 117638 10408095 9633437 7633578 6741282 2774517 2892155 X THE MISSION OF THE ORGANIZATION IS ARTICULATED IN ITS ARTICLES OF INCORPORATION AS FOLLOWS:THE CORPORATION IS ORGANIZED EXCLUSIVELY FOR CHARTIABLE 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 9255776 9906456 ALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING LONG-TERM CARE FACILITIES AND OTHER RELATED SERVICES TO THE DEVELOPMENTALLY DISABLED AND ELDERLY. THE ORGANIZATION OPERATES ONE, 255-BED FACILITY. 9255776 1 1 0 0 0 0 0 0 0 0 1 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 0 0 0 0 0 0 1 1 0 1 0 1 14 0 1 378 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 IL X X RON WILSON RFMS INC 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 X GARY BRUINGTON 2.00 0.00 X 5000 0 0 STAN SYDLOWSKI 2.00 0.00 X X 4750 0 0 CHARLES WESTBAY 2.00 0.00 X X 4750 0 0 DAVID BEVERSDORF 2.00 0.00 X 5000 0 0 RON WILSON RFMS INC 40.00 X 0 0 0 19500 0 0 0 0 0 0 RFMS INC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 ADMINISTRATIVE SERVICES 279510 1 25070 188 25070 MEDICARE & MEDICAID 623000 8283503 8283503 RESIDENT PRIVATE PAY 623000 1484094 1484094 AID TRAINING INCOME 623000 120187 120187 SUPPORT SERVICES INCOM 623000 18672 18672 9906456 1739 1739 9933265 9906456 0 1739 19800 19800 5335993 5253939 82054 36156 35600 556 773323 761431 11892 404786 398561 6225 365580 217686 147894 51124 51124 152193 152193 69917 69917 19705 17735 1970 56780 44533 12247 3623 2898 725 630957 589056 41901 36138 35838 300 1177 1059 118 339498 322523 16975 49950 42458 7492 SUPPLIES & SMALL EQUIP. 820427 820427 MEDICAID ASSESSMENT TAX 567412 567412 EQUIPMENT RENT & MAINT. 61280 61280 SUBSCRIPTIONS & FEES 12329 6615 5714 7479 6808 671 9815627 9255776 559851 0 113789 167925 851920 278131 2636967 2634718 76170 66519 8963231 3625840 5662919 5337391 10000 10000 1056330 1138753 10408095 9633437 794459 579020 4954904 4770576 1884215 1391686 7633578 6741282 X 2774517 2892155 2774517 2892155 10408095 9633437 117638 0 X 0 0 0 X 19811 16802 20620 16940 25070 99243 10149763 10042712 9949772 9563561 9906456 49612264 10169574 10059514 9970392 9580501 9931526 49711507 0 0 0 49711507 8149 2376 171160 10206 1739 193630 8149 2376 171160 10206 1739 193630 4776 5969 2615 13360 10182499 10067859 10144167 9590707 9933265 49918497 0.99590 0.99530 0.00390 0.00440 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 184000 184000 6351515 2084525 4266990 1567665 910945 656720 529007 390245 138762 331044 240125 90919 5337391 FIDUCIARY TRUST ACCOUNTS 66686 DEFERRED FINANCING COSTS 93178 ESCROW DEPOSITS 29143 REPLACEMENTS RESERVE 920530 OTHER RECEIVABLES 29216 1138753 REFUNDABLE BALANCE PAYABLE TO 501(C)(3) UNRELATED PARTY 1325000 DUE TO RESIDENTS, TRUST ACCOUNTS 66686 1391686 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 RESIDENTIAL CENTERS, 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 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 RESIDENTIAL CENTERS, 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 2012 IS $174,379. RON WILSON'S COMPENSATION AMOUNT AND HOURS HAVE NOT BEEN PRORATED BASED ON TIME SPENT FOR EACH OF THE NINETEEN ORGANIZATIONS TO WHOM SERVICES ARE PROVIDED BY RFMS, INC. CRC CHERRY STREET FACILITY LLC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 421578299 OWNS FACILITY OPERATED BY COMMUNITY RESIDENTIAL CENTERS, INC. IL 528 5548726 N/A RFMS INC MEDICAL BENEFIT PLAN TRUST 285 SOUTH 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 560111 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 RESIDENTIAL CENTERS, INC., COMMUNITY LIVING OPTIONS, INC., FRANCES HOUSE, INC., UNLIMITED DEVELOPMENT, INC., KENSINGTON OF GALESBURG, INC., ACHIEVEMENT UNLIMITED, INC., CONCEPTS PLUS, INC., PINNACLE OPPORTUNITIES, INC., PIONEER CONCEPTS, INC., RESIDENTIAL ALTERNATIVES OF ILLINOIS, INC., RESIDENTIAL ALTERNATIVES OF IOWA, DESERT HEALTHCARE FACILITIES, INC., FLORIDA LIVING OPTIONS, INC., AND HIGHLAND ESTATES RESORT, LLC. 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, 2012.