2013-02-12T13:00:03-06:00 2012-06-30 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2011-07-01 231409664 THE BRETHREN HOME COMMUNITY (DBA CROSS KEYS VILLAGE - TBHC) BRET 7176242161 2990 CARLISLE PIKE NEW OXFORD PA 17350 KENT SHISLER 7176242161 2013-02-12 1 JULIUS C GREEN CPA JD P00350393 2159720701 2013-02-11 2011 2016-03-07 17:11:31Z JEFFREY M EVANS 2990 CARLISLE PIKE NEW OXFORD PA 17350 43832463 0 X WWW.CROSSKEYSVILLAGE.ORG X 1908 PA THE BRETHREN HOME COMMUNITY PROVIDES HEALTH CARE AND RESIDENTIAL HOUSING TO ELDERLY INDIVIDUALS. 13 12 868 786 0 0 729566 694295 40148118 39939018 1239807 1030227 359008 334806 42476499 41998346 15500 0 0 0 24139973 26382169 0 0 0 15309666 15163795 39465139 41545964 3011360 452382 133280684 129574287 78128641 76783954 55152043 52790333 X CROSS KEYS VILLAGE - THE BRETHREN HOME COMMUNITY, A VESSEL FOR CHRISTIAN MINISTRY REFLECTING THE CHURCH OF THE BRETHREN VALUE OF COMPASSIONATE SERVICE, PROMOTES HEALTH AND WHOLENESS, PROVIDES NURSING CARE, REHABILITATION SERVICES, AND ADULT RESIDENTIAL HOUSING TO INDIVIDUALS OF ALL FAITHS. 0 0 8277482 8892129 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, 2012 FISCAL YEAR WAS 199,395. 24770921 26610292 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. TOTAL CENSUS DAYS FOR THE PROGRAM WAS 94,359. 4129928 4436597 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. THESE PROGRAMS PROVIDED 34,437 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 LEVEL OF CHARITY CARE PROVIDED BY THE COMMUNITY AMOUNTED TO $823,258. THE COMMUNITY PROVIDES SERVICES TO MEDICAL ASSISTANCE AND MEDICARE BENEFICIARIES AT RATES DIFFERENT FROM ITS ESTABLISHED CHARGES. THE TOTAL DIFFERENCES RELATED TO THESE SERVICES WERE $3,698,827. 37178331 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 0 1 57 0 1 868 1 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 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 WAYNE T SCOTT 1.00 X X 0 0 0 BRETT A HOFFACKER 1.00 X X 0 0 0 ROSEMARY L STONER 1.00 X X 0 0 0 LEROY M KEENEY 1.00 X X 0 0 0 JACOB E HERSHEY 1.00 X 0 0 0 BONNIE G FERRENCE 1.00 X 0 0 0 JAMES W BALTHASER 1.00 X 0 0 0 JULIA T HITCHCOCK 1.00 X 0 0 0 JENNIFER W BOWES 1.00 X 0 0 0 VERNON KING 40.00 X X 160053 0 11477 DONALD N ZIGLER 1.00 X 0 0 0 PAUL E SCHILDT 1.00 X 0 0 0 MELVIN FLEMING 1.00 X 0 0 0 KENT A SHISLER 40.00 X 98369 0 21223 258422 0 32700 2 0 1 0 KIMPLE CARPET LLC 1064 BIGLERVILLE ROAD GETTYSBURG PA 17325 FLOOR FURNISHINGS/FLOORING 268288 CB FLOORING LLC 9515 GERWIG LANE SUITE 130 COLUMBIA MD 21046 FLOOR FURNISHINGS/FLOORING 240955 TRANE 3600 PAMMEL CREEK ROAD LACROSSE WI 546017599 HVAC MAINTENANCE 159405 MOREFIELD COMMUNICATIONS 35 NORTH 35TH STREET CAMP HILL PA 17011 TELECOMMUNICATIONS 156447 ANSTEY HODGE ADVERTISING 120 COMMONWEALTH AVE NE ROANOKE VA 240161919 MARKETING CONSULTANTS 151495 6 694295 694295 RESIDENT AND PATIENT S 623000 39939018 39939018 39939018 965305 965305 338986 258012 80974 80974 80974 1629510 11517 1473704 102401 155806 -90884 64922 64922 BEAUTY/BARBER SHOP 623000 141440 141440 SPECIAL FUNCTIONS INCO 623000 80348 80348 BED RENTAL DME 900099 9830 9830 22214 22214 253832 41998346 39948848 0 1355203 299583 174751 124832 19804711 17863723 1940988 657384 575479 81905 3462653 3119797 342856 2157838 1987211 170627 40094 40094 36532 36532 2025 2025 118490 118490 294557 146244 148313 53550 53550 3864273 3346035 518238 254310 254310 3587700 3263613 324087 111614 89358 22256 5812698 5812698 MAINTENANCE EXPENSE 365615 365615 HEALTH CARE AND MEDICAL 250482 250482 PROFESSIONAL GROWTH 92260 36219 56041 DUES, LICENSES, & SUBSC 82156 18108 64048 197439 128998 68441 41545964 37178331 4367633 0 3195 3184 1633549 2404100 5683387 3569221 522681 533697 134976449 69245680 68777537 65730769 36099631 37231202 264783 264783 19802308 19393656 250590 222474 243023 221201 133280684 129574287 3839002 4465447 27895501 26509375 42935000 40535000 100180 83483 3358958 5190649 78128641 76783954 X 46261651 44189586 3315361 3149744 5575031 5451003 55152043 52790333 133280684 129574287 X 452382 -2814092 X X 0 1 1 X 0 X 1607278 1331532 557528 729566 694295 4920199 33693385 36717807 38949532 40148118 39939018 189447860 226623 277147 286346 253832 1043948 35300663 38275962 39784207 41164030 40887145 195412007 0 0 0 195412007 1605129 847419 830206 1019743 1304291 5606788 1605129 847419 830206 1019743 1304291 5606788 36905792 39123381 40614413 42183773 42191436 201018795 0.97210 0.97170 0.02790 0.02830 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2025 2025 0 EXPLANATION OF LOBBYING ACTIVITIES: 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 $2,025. 0 1 2198169 2198169 109220076 52456014 56764062 11796872 9172231 2624641 11761332 7617435 4143897 65730769 INTEREST IN NET ASSETS OF THE BRETHREN HOME FOUNDATION 19393656 C 19393656 OTHER LIABILITIES 44675 INTEREST RATE SWAP AGREEMENT 3883792 ENTRANCE FEES PAYABLE 1262182 5190649 41998346 41545964 452382 -845602 -1968490 -2814092 -2361710 39442266 -845602 -1968490 -2814092 42256358 -258012 -258012 41998346 41803976 258012 258012 41545964 0 41545964 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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. THE PROVISION ALSO PROVIDES GUIDANCE ON DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, AND DISCLOSURES. 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, 2011, 2010, AND 2009 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT -1,559,838. CHANGE IN INTEREST OF NET ASSETS OF AFFILIATES -408,652. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,968,490. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT -1,559,838. CHANGE IN INTEREST OF NET ASSETS OF AFFILIATES -408,652. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -258,012. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 258,012. X X X 0 0 0 0 0 0 0 0 0 VERNON KING 138053 0 0 0 22000 0 6488 0 4989 0 171530 0 0 0 ADAMS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 232988777 006116AL1 2007-11-20 50275000 REFI EXISTING TAX-EXEMPT BONDS & CONSTRCTN OF RESDNTL APRTMNTS/WELLNESS CNTR 0 0 0 9740000 50275000 787859 318142 919321 18537902 30878814 2009 1 1 1 1 0 0 0 0 1 0 1 1 WELLS FARGO BANK NA 25.000000000000 0 0 0 0 0 PART V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION THE ORGANIZATION EXPECTS TO ADOPT A WRITTEN POLICY FOR ITS TAX-EXEMPT DEBT DURING ITS PRESENT FISCAL YEAR. 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 DIRECTOR OF ACCOUNTING SERVICES, 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -845,602. CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT -1,559,838. CHANGE IN INTEREST OF NET ASSETS OF AFFILIATES -408,652. TOTAL TO FORM 990, PART XI, LINE 5: -2,814,092. AUDIT OVERSIGHT: FORM 990 PAGE 12, PART XII, LINE 2C 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 PO BOX 128 NEW OXFORD PA 17350 232454835 FUNDRAISING ACTIVITIES PA 501(C)(3) 7 N/A 0 THE BRETHREN MANAGEMENT SERVICES CORP PO BOX 128 NEW OXFORD PA 17350 222426313 PROPERTY MANAGEMENT SVC. PA THE BRETHREN HOME FOUNDATION C 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0