2014-11-11T08:25:33-06:00 2014-06-30 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2013-07-01 231409664 THE BRETHREN HOME COMMUNITY BRET 7176242161 2990 CARLISLE PIKE NEW OXFORD PA 17350 KENT A SHISLER VP OF FINANCE 7176242161 2014-11-10 1 JULIUS C GREEN CPA JD P00350393 2159720701 2014-11-10 2013 2015-11-30 17:44:51Z CROSS KEYS VILLAGE - TBHC JEFFREY M EVANS 2990 CARLISLE PIKE NEW OXFORD PA 17350 44923411 0 X WWW.CROSSKEYSVILLAGE.ORG X 1908 PA THE BRETHREN HOME COMMUNITY PROVIDES HEALTH CARE AND RESIDENTIAL HOUSING TO ELDERLY INDIVIDUALS. 3 3 858 705 0 0 555715 673075 39204216 42106775 1211021 903596 311306 360442 41282258 44043888 0 0 0 0 24916499 26244274 0 0 0 15663139 16875174 40579638 43119448 702620 924440 134455676 142133472 74036835 74469818 60418841 67663654 X THE BRETHREN HOME COMMUNITY'S MISSION IS TO BE A BRETHREN MINISTRY DEDICATED TO ENRICHING THE LIVES OF OLDER ADULTS WITH A VISION TO BE A LEADING INNOVATOR OFFERING OLDER ADULTS A LIFE INFUSED WITH QUALITY AND PURPOSE. 0 0 24836676 27686482 NURSING - PROVIDE QUALITY NURSING CARE IN A COMFORTABLE HEALTH CARE CENTER. IMPLEMENTED ELECTRONIC HEALTH RECORD (EHR) AND ELECTRONIC MEDICINE ADMINISTRATION RECORD (EMAR) TO IMPROVE EFFICIENCY AND ACCURACY OF CARE DELIVERY. CONTINUAL ASSESSMENT OF PROGRAMS AND SERVICES IN THE MIDST OF HEALTHCARE REFORM. TOTAL CENSUS DAYS FOR THE PROGRAM WAS 94,586. 8599084 9585759 RESIDENTIAL LIVING- PROVIDE COMPREHENSIVE, INDEPENDENT LIVING SERVICES FOR AGING PEOPLE. PROVIDE LIFELONG LEARNING OPPORTUNITIES TO ENGAGE RESIDENTS IN MENTAL, CULTURAL AND SPIRITUAL ACTIVITIES PROMOTING OVERALL WELLNESS. TOTAL CENSUS DAYS FOR THIS PROGRAM DURING THE JUNE 30, 2014 FISCAL YEAR WAS 208,474. 4336909 4834534 PERSONAL CARE AND ADULT DAY SERVICES - PROVIDE INTERMEDIATE LEVEL OF CARE WHEN INDIVIDUALS NEED HELP WITH SOME ACTIVITIES OF DAILY LIVING, BUT DO NOT REQUIRE 24 HOUR SKILLED NURSING CARE. OFFERED SECURE MEMORY SUPPORT NEIGHBORHOOD WITH SPECIALIZED PROGRAMMING FOR THOSE WITH COGNITIVE AND SAFETY AWARENESS. THESE PROGRAMS PROVIDED 34,554 CENSUS DAYS OF SERVICE DURING THE YEAR. THE COMMUNITY MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE ESTIMATED COSTS OF PROVIDING CHARITY CARE ARE BASED UPON THE DIRECT AND INDIRECT COSTS IDENTIFIED WITH THE SPECIFIC CHARITY CARE SERVICES PROVIDED. THE COMMUNITY PROVIDES CHARITY CARE, SUBSIDIES, AND OTHER SUPPORT OF THOSE IN NEED. UNCOMPENSATED CARE TOTALED $5,109,386 INCLUDING SERVICES TO MEDICAL ASSISTANCE AND MEDICARE BENEFICIARIES WHOSE COSTS EXCEEDED REIMBURSEMENT. 37772669 1 1 0 1 0 0 0 0 1 0 1 0 1 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 0 1 0 0 0 1 66 0 1 858 1 0 0 0 0 0 0 0 0 0 0 X 3 3 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X JEFFREY M EVANS 7176242161 2990 CARLISLE PIKE NEW OXFORD PA 17350 HAROLD H HORST CHAIR 1.00 1.00 X X 0 0 0 ERIC J BORTNER VICE CHAIR 1.00 1.00 X X 0 0 0 JENNIFER W BOWES SECRETARY 1.00 1.00 X X 0 0 0 JEFFREY M EVANS PRESIDENT/CEO 39.00 1.00 X 172193 0 21828 KENT A SHISLER VP OF FINANCE 39.00 1.00 X 90799 0 21352 262992 0 43180 1 0 1 0 MORRISON MANAGEMENT 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 FOOD AND CONSULTING SERVICE 1419541 MOREFIELD COMMUNICATIONS 35 NORTH 35TH STREET CAMP HILL PA 17011 TELECOMMUNICATIONS 315550 KIMPLE CARPET LLC 1064 BIGLERVILLE ROAD GETTYSBURG PA 17325 FLOOR FURNISHINGS AND INSTALLATION 279543 TRANE 3600 PAMMEL CREEK ROAD LA CROSSE WI 54601 MAINTENANCE 201574 GLYNNDEVINS ADVERTISING 11230 COLLEGE BLVD OVERLAND PARK KS 66210 PRINTING, ADVERTISING, AND CONSULTING 160509 10 673075 673075 RESIDENT AND PATIENT SERVICE REVE 623000 42106775 42106775 42106775 974553 974553 488492 391170 97322 97322 97322 400000 17396 324695 163658 75305 -146262 -70957 -70957 BEAUTY/BARBER SHOP 623000 151819 151819 SPECIAL FUNCTIONS INCOME 623000 40571 40571 MEDICAL EQUIP REIMB 900099 33200 33200 37530 37530 263120 44043888 42106775 0 1264038 367211 367211 19682221 17690542 1991679 630196 548537 81659 3556619 3203934 352685 2008027 1832337 175690 77963 77963 38199 38199 1914 1914 128071 128071 1051237 857886 193351 105968 105968 1647732 1191951 455781 241888 241888 2558707 2225924 332783 92490 78191 14299 989792 989792 5728616 5728616 FOOD 1401225 1377587 23638 MEDICAL SUPPLIES 1137411 1137411 MAINTENANCE 653117 653117 UNCOLLECTIBLE EXPENSE 542045 542045 478799 254930 223869 43119448 37772669 5346779 0 3428 3416 3597371 1603485 3228755 4914603 647871 629160 142509456 78856534 64263218 63652922 39365750 45631848 264783 264783 22618690 25072016 196008 171263 269802 189976 134455676 142133472 3855374 4706538 28031743 30757440 38035000 35425000 146596 81095 3968122 3499745 74036835 74469818 X 50176145 56612677 3775809 4118239 6466887 6932738 60418841 67663654 134455676 142133472 X 924440 3655999 2664374 X X 0 1 X 1 0 X 557528 729566 694295 555715 673075 3210179 38949532 40148118 39939018 39204216 42106775 200347659 277147 286346 253832 227008 263120 1307453 39784207 41164030 40887145 39986939 43042970 204865291 0 0 0 204865291 830206 1019743 1304291 1427306 1463045 6044591 830206 1019743 1304291 1427306 1463045 6044591 40614413 42183773 42191436 41414245 44506015 210909882 0.97130 0.97360 0.02870 0.02640 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1914 1914 0 PART II-B, LINE 1: THE BRETHREN HOME COMMUNITY PAYS DUES TO THE ORGANIZATIONS LEADING AGE AND LEADING AGE PA. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS ALLOCABLE TO LOBBYING EXPENSES. THE TOTAL AMOUNT OF DUES PAID BY THE BRETHREN HOME COMMUNITY THAT IS ALLOCABLE TO LOBBYING IS $1,914. 0 1 X 3564331 3564331 112295155 60309713 51985442 12451516 9977950 2473566 14198454 8568871 5629583 63652922 INTEREST IN NET ASSETS OF THE BRETHREN HOME FOUNDATION 25072016 C 25072016 OTHER LIABILITIES 29605 INTEREST RATE SWAP AGREEMENT 2390738 ENTRANCE FEES PAYABLE 1079402 3499745 X 50755431 3655999 2664374 6320373 44435058 -391170 -391170 44043888 43510618 391170 391170 43119448 0 43119448 PART IV, LINE 2B: THE BRETHREN HOME COMMUNITY HOLDS RESIDENT FUNDS IN A CUSTODIAL ACCOUNT. RESIDENTS MAY CHOOSE TO DEPOSIT FUNDS IN THE "RESIDENT'S BANK". FUNDS ARE MAINTAINED IN A SEPARATE ACCOUNT EARNING INTEREST IF THE BALANCE IS AT LEAST $50. STATEMENTS ARE PROVIDED ON A MONTHLY BASIS. ANY BALANCE REMAINING AT DEATH OR DISCHARGE IS RETURNED WITHIN 30 DAYS. PART X, LINE 2: THE ORGANIZATION FOLLOWS THE PROVISIONS OF ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES WHICH PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT HAS DETERMINED THAT THESE PROVISIONS DO NOT HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS. THE COMMUNITY'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2013, 2012, AND 2011 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT 211,048. CHANGE IN INTEREST OF NET ASSETS OF AFFILIATES 2,453,326. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -391,170. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 391,170. X X X 0 0 0 0 0 0 0 0 0 JEFFREY M EVANS PRESIDENT/CEO 172193 0 0 0 0 0 7678 0 14150 0 194021 0 0 0 A ADAMS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 232988777 006116AL1 2007-11-20 50275000 REFINANCE TAX-EXEMPT BONDS & CONST OF RESIDENTIAL APRTMNTS/WELLNESS CNTR 0 0 0 A 14850000 50562815 787859 318142 40098 18537902 30878814 2009 1 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 1 1 WELLS FARGO BANK NA 18.000000000000 0 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: ADAMS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/20/2012 SCHEDULE K PART II, LINE 3: TOTAL PROCEEDS REPORTED ON PART II LINE 3 TOTAL PROCEEDS ISSUED EXCEEDS THE ISSUE PRICE IN PART I DUE TO INVESTMENT INCOME AND LOC FEES. SCHEDULE K PART III LINE 9, PART IV LINE 7 AND PART V THE COMMUNITY HAS PROCEDURES IN PLACE TO MONITOR COMPLIANCE WITH BOND REQUIREMENTS AND THEY ARE WORKING TO FORMALIZE THESE PROCEDURES IN WRITING. FORM 990, PART VI, SECTION A, LINE 4 THE CORPORATION'S BYLAWS WERE REVISED TO STREAMLINE THE GOVERNANCE PROCESS AND REALIGN SOME FUNCTIONS WITH THE PARENT CORPORATION, THE BRETHREN HOME FOUNDATION. THE TOTAL NUMBER OF BOARD MEMBERS WAS REDUCED FROM 13 TO 5 MEMBERS. WITH THIS CHANGE MORE REGULAR REPORTING IS DONE TO THE PARENT CORPORATION. FORM 990, PART VI, SECTION A, LINE 6 THE BRETHREN HOME FOUNDATION SERVES AS THE MEMBER OF THE BRETHREN HOME COMMUNITY. FORM 990, PART VI, SECTION A, LINE 7A THE BRETHREN HOME FOUNDATION IS THE CONTROLLING CORPORATION AND SERVES AS THE "MEMBER" OF CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY. THE BOARD OF DIRECTORS OF THE BRETHREN HOME FOUNDATION ELECTS THE MAJORITY OF THE BOARD MEMBERS OF CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY. FORM 990, PART VI, SECTION A, LINE 7B CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY: THE BOARD OF DIRECTORS OF THE CONTROLLING CORPORATION, THE BRETHREN HOME FOUNDATION, IS REQUIRED TO APPROVE AMENDMENTS TO ARTICLES OF INCORPORATION AND CHANGES TO BYLAWS OF CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE SENIOR FINANCIAL ACCOUNTANT, THE CONTROLLER, AND VICE PRESIDENT OF FINANCE BEFORE IT IS SHARED WITH THE PRESIDENT/CEO. THE FINAL VERSION OF THE FORM 990 WILL THEN BE DISTRIBUTED TO EACH BOARD MEMBER FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A BOARD CONFLICT OF INTEREST POLICY WHICH REQUIRES ANNUAL DISCLOSURE AND CERTIFICATION BY BOARD MEMBERS OF COMPLIANCE WITH THE POLICY. IN ADDITION, ALL EMPLOYEES RECEIVE ANNUAL CORPORATE COMPLIANCE TRAINING WHICH INCLUDES THE CONFLICT OF INTEREST POLICY AND ARE REQUIRED TO CERTIFY THEY ARE IN COMPLIANCE WITH THE CORPORATE COMPLIANCE PLAN. THE COMPLIANCE PLAN COVERS EMPLOYEES, VENDORS, CONTRACTORS, VOLUNTEERS, DIRECTORS, AND OFFICERS. ANY POTENTIAL CONFLICT OF INTEREST ISSUES WHICH MAY ARISE ARE REVIEWED BY THE CORPORATE COMPLIANCE LIAISON OR COMPLIANCE OFFICE, AND APPROPRIATE SAFEGUARDS ARE PUT IN PLACE. FORM 990, PART VI, SECTION B, LINE 15 SALARY FOR THE CEO IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD OF DIRECTORS' EXECUTIVE COMMITTEE WITH COMPARISONS MADE TO AN ANNUAL SALARY SURVEY OF SIMILAR NON-PROFIT ORGANIZATIONS IN PENNSYLVANIA. THE DECISION IS DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. A SIMILAR PROCESS IS USED FOR OTHER KEY EMPLOYEES WITH THE REVIEW BEING DONE BY THE VICE PRESIDENT OF HUMAN RESOURCES IN CONSULTATION WITH THE CEO AND VICE PRESIDENT OF FINANCE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT 211,048. CHANGE IN INTEREST OF NET ASSETS OF AFFILIATES 2,453,326. FORM 990 PAGE 12, PART XII, LINE 2C AUDIT OVERSIGHT: THE PROGRAM AND FINANCE COMMITTEE, WHICH CONSISTS OF BOARD MEMBERS, FUNCTIONS IN THE ROLE OF THE AUDIT COMMITTEE. THIS COMMITTEE RECEIVES THE PROPOSAL(S) FOR AUDIT SERVICES ANNUALLY AND TAKES ACTION TO APPROVE ENGAGING THE AUDIT FIRM. THE VICE PRESIDENT OF FINANCE GIVES REGULAR UPDATES TO THE COMMITTEE AS THE AUDIT PROGRESSES. THE COMPLETED AUDIT REPORT AND RELATED REPORTING ITEMS ARE PRESENTED BY THE AUDITORS TO THE FULL BOARD OF DIRECTORS. IN ADDITION, THE AUDITORS MEET IN PRIVATE WITH THE BOARD WITH STAFF MEMBERS NOT PRESENT, TO ADDRESS ANY QUESTIONS THE BOARD HAS IN REGARDS TO THE AUDIT. THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. THE BRETHREN HOME FOUNDATION 2990 CARLISLE PIKE NEW OXFORD PA 17350 232454835 FUNDRAISING ACTIVITIES PA 501(C)(3) 7 N/A 0 THE BRETHREN MANAGEMENT SERVICES CORP 2990 CARLISLE PIKE NEW OXFORD PA 17350 222426313 PROPERTY MANAGEMENT SVC. PA N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0