2013-11-11T08:07:34-06:00 2013-06-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2012-07-01 311002846 WESTMINSTER VILLAGE WEST LAFAYETTE INC WEST 7654637546 2741 NORTH SALISBURY STREET WEST LAFAYETTE IN 47906 JOLENE MILLER 7654637546 2013-10-30 1 JEFF PARKER P00970069 3149254300 2012 2016-02-24 21:20:13Z JOLENE MILLER 2741 NORTH SALISBURY STREET WEST LAFAYETTE IN 47906 15400665 0 X N/A X 1976 IN PROVIDES RESIDENTIAL FACILITIES DESIGNED TO MEET THE NEEDS OF THE ELDERLY. 9 9 323 62 0 0 113599 111641 13608659 14595094 -379 118975 483096 574955 14204975 15400665 164824 88838 0 0 6555289 7389772 0 0 0 7373857 8589442 14093970 16068052 111005 -667387 54160302 56750158 49076764 51907572 5083538 4842586 PROVIDES RESIDENTIAL FACILITIES DESIGNED TO MEET THE NEEDS OF THE ELDERLY AND PROVIDE FOR THE PHYSICAL, MENTAL AND FINANCIAL WELL BEING OF ITS RESIDENTS. FINANCIAL ASSISTANCE IS PROVIDED TO THOSE RESIDENTS UNABLE TO MEET THEIR LIVING EXPENSES. 0 0 13975573 88838 14595094 WESTMINSTER VILLAGE WEST LAFAYETTE, INC. IS A NOT-FOR-PROFIT, CONTINUING CARE RETIREMENT COMMUNITY LOCATED IN WEST LAFAYETTE, INDIANA. FACILITIES INCLUDE 130 RESIDENTIAL UNITS (INDEPENDENT LIVING CENTER), 57 INDEPENDENT LIVING COTTAGES, A 72 BED COMPREHENSIVE CARE FACILITY (THE HEALTH CENTER), AND A 76 BED ASSISTED LIVING FACILITY. WESTMINSTER'S PRIMARY PURPOSE IS THE PROVISION OF CONTINUING CARE SERVICES TO THE CITIZENS OF WEST LAFAYETTE, INDIANA AND THE SURROUNDING COMMUNITIES. 13975573 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 25 0 323 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X WESTMINSTER VILLAGE WEST LAFAYETTE 7654637546 2741 NORTH SALISBURY WEST LAFAYETTE IN 47906 PETER NEISEL 12.00 X X 0 0 0 MARILYN WHITSEL 5.00 X X 0 0 0 JOLENE MILLER 5.00 X X 0 0 0 THOMAS PEARSON 15.00 X 0 0 0 ROBERT WOERNER 5.00 X 0 0 0 JAMES ALMOND 12.00 X X 0 0 0 STEVE HABBEN 10.00 X 0 0 0 MARTHA CHISCON 5.00 X 0 0 0 ANDREW S GUTWEIN 5.00 X 0 0 0 DAWN WALKER 40.00 X 124716 0 0 124716 0 0 1 0 0 0 KETTELHUT CONSTRUCTION 740 SAGAMORE PARKWAY SOUTH LAFAYETTE IN 47903 CONSTRUCTION 1118717 CRSA LCS MANAGEMENT LLC 400 LOCUST ST SUITE 820 DES MOINES IA 50309 MANAGEMENT SERVICES 947517 GORDON FOOD SERVICE DEPT CH 10490 PALATINE IL 60055 FOOD & SUPPLIES 819767 LAWN & SHRUB PO BOX 155 BUCK CREEK IN 47924 LANDSCAPING 708879 REHABCARE GROUP PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 565753 15 88838 22803 111641 SERVICE FEES 623000 14087334 14087334 LIFE OCC. FEE AMORTIZATION 623000 507760 507760 14595094 118975 118975 OTHER INCOME 623000 244083 244083 BEAUTY SALON INCOME 623000 100321 100321 PHARMACY INCOME 623000 96761 96761 133790 133790 574955 15400665 14595094 0 693930 88838 88838 6063829 5218821 845008 37967 32676 5291 850955 732373 118582 437021 376121 60900 462506 462506 1813 1813 60650 60650 1170474 1007368 163106 250576 250576 675692 675692 69347 69347 796961 728025 68936 66399 66399 767913 721731 46182 2857489 2685754 171735 229115 229115 FOOD 893102 893102 EQUIPMENT AND MAINT 100936 100936 RESIDENT ENTERTAINMENT 77526 77526 MISCELLANEOUS 75750 38358 37392 33193 33193 16068052 13975573 2092479 0 4296044 6241489 4018847 4283414 189903 339331 57120 61665 36025 45591 72616613 27439740 44982174 45176873 580189 601795 54160302 56750158 1317689 1282278 22845246 24891318 23804349 24870000 1109480 863976 49076764 51907572 X 5066262 4812505 17276 30081 5083538 4842586 54160302 56750158 X -667387 150931 275504 X X 0 1 X 1 0 X 81875 103346 92045 113599 111641 502506 12109227 12603449 13982511 10582729 14595094 63873010 12191102 12706795 14074556 10696328 14706735 64375516 0 0 0 64375516 68268 29715 12188 3919 118975 233065 68268 29715 12188 3919 118975 233065 383577 402801 454844 483096 574955 2299273 12642947 13139311 14541588 11183343 15400665 66907854 0.96220 0.96240 0.00350 0.00410 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2939505 2939505 62171403 24568746 37602657 7474805 2870994 4603811 30900 30900 45176873 RESIDENT DEPOSITS 159000 FAIR VALUE OF INTEREST RATE SWAPS 704976 863976 X 15738262 426435 426435 15311827 88838 88838 15400665 15979214 0 15979214 88838 88838 16068052 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE VILLAGE ADOPTED THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE VILLAGE DOES NOT CURRENTLY INCLUDE AN INCOME TAX PROVISION IN THE FINANCIAL STATEMENTS. MANAGEMENT MONITORS THE REPORTING OF UNCERTAIN TAX POSITIONS, WHICH COULD RESULT IN RECORDING OF AN INCOME TAX PROVISION IN THE FUTURE. WESTMINSTER VILLAGE WEST LAFAYETTE, INC. TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE VILLAGE IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX EXEMPT STATUS AND IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAX EXCEPT FOR THOSE THAT ARE ALREADY REPORTED ANNUALLY. THE TAX RETURNS FOR THE YEARS 2010 THROUGH 2012 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSES NETTED WITH REVENUE ON F/S 88,838. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSES NETTED WITH REVENUE ON F/S 88,838. 1 FINANCIAL ASSISTANCE 6 88838 FAIR MARKET VALUE PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE FINANCIAL ASSISTANCE IS PROVIDED ON AN ANNUAL BASIS WITH THE REVIEW AND WRITE OFF OF THE ACCOUNTS RECEIVABLE. A CITY OF WEST LAFAYETTE IN 356001233 NONEAVAIL 2010-08-26 8500000 REPAY PREVIOUS MORTGAGE 0 0 0 B CITY OF WEST LAFAYETTE IN 356001233 NONEAVAIL 2010-08-26 17000000 NEW CONSTRUCTION, RENOVATION OF EXISTING FACILITY, LAND PURCHASE 0 0 0 A 380000 8500000 7919814 200186 2010 0 0 1 1 B 250000 17000000 353522 570709 16075769 2012 0 0 1 1 A 0 1 0 0 0 0 1 B 0 1 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 PAGE 1, PART III, LINE 2 THE INSTITUTION DOES REGULARLY "LEASE" OR MAKES PROPERTY AVAILABLE FOR USE BY THE ELDERLY AS PART OF ITS TAX EXEMPT MISSION. STEVE HABBEN STEVE HABBEN IS A MEMBER OF THE BOARD OF DIRECTORS 1118717 STEVE HABBEN IS A MEMBER OF THE BOARD OF DIRECTORS AND HE IS ALSO AN EXECUTIVE AT KETTELHUT CONSTRUCTION, INC., WHICH PERFORMED CONSTRUCTION SERVICES FOR THE FACILITY DURING THE YEAR. 0 FORM 990, PART VI, SECTION A, LINE 3 THREE KEY MANAGEMENT EMPLOYEES, THE EXECUTIVE DIRECTOR, CONTROLLER, AND THE HEALTH FACILITY ADMINISTRATOR ARE EMPLOYEES OF CRSA/LCS, THE MANAGEMENT COMPANY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING. THE FORM 990 IS APPROVED BY THE FINANCE AND MANAGEMENT COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD OF DIRECTORS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS. IF A POSSIBLE CONFLICT OF INTEREST DOES ARISE, THE ISSUE IS VOTED ON BY ALL BOARD MEMBERS THAT DO NOT HAVE AN INTEREST IN THE OUTCOME. FORM 990, PART VI, SECTION B, LINE 15 REVIEW OF COMPENSATION FOR A SIMILAR POSITION IN THE GEOGRAPHIC AREA. FORM 990, PART VI, SECTION C, LINE 19 ALTHOUGH NOT REQUIRED, THE ORGANIZATION WILL PROVIDE PHOTOCOPIES OF ITS FINANCIAL STATEMENTS TO ALL WHO REQUEST THEM. A COPY OF THE FINANCIAL STATEMENTS IS ALSO LOCATED IN THE WESTMINSTER VILLAGE LIBRARY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: UNREALIZED LOSS ON SWAP 275,504. FORM 990, PAGE 12, PART XII, LINE 2C THE ORGANIZATION HAS A FINANCE AND MANAGEMENT COMMITTEE THAT IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT. THIS PRACTICE IS CONSISTENT WITH THE PRIOR YEARS. WESTMINSTER VILLAGE FOUNDATION OF WEST LAFAYETTE INDIANA INC 2741 N SALISBURY STREET WEST LAFAYETTE IN 47906 351537414 SUBSIDIZE EXEMPT ACTIVITIES IN 501(C)(3) LINE 11A, I 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0