2013-08-15T09:32:45-05:00 2012-09-30 420714325 MCGLADREY LLP 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2011-10-01 371138846 DESERT HEALTH CARE FACILITIES INC DESE 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 CHARLES MCARTHUR 3093431550 2013-08-07 1 BEN MCMAHAN P00702421 3093428026 2011 2016-02-24 21:20:13Z CHARLES MCARTHUR 285 SOUTH FARNHAM STREET GALESBURG IL 61401 22800535 0 X N/A X 1984 NV DHCF, INC. PROVIDES & OPERATES NURSING & ASSISTED LIVING FACILITIES FOR THE ELDERLY. 4 3 587 17 0 0 1890 1077 22711095 22786860 3078 12559 0 0 22716063 22800496 1250 15401 0 0 9291572 10143718 0 0 0 13563515 13350916 22856337 23510035 -140274 -709539 6678567 5961506 4994660 4987138 1683907 974368 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 22304925 15401 22786860 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 507 BEDS. 22304925 1 0 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 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 1 0 1 22 0 1 587 1 0 0 0 0 0 0 0 0 0 0 X 4 3 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X X RON WILSON RFMS INC 3093431550 285 SOUTH FARNHAM GALESBURG IL 61401 X CHARLES MCARTHUR 2.00 X X 4500 0 0 CHARLES PERRY 2.00 X 3000 0 0 IRWIN JANN 2.00 X 4500 0 0 GERALD DUBOIS 2.00 X X 4500 0 0 RON WILSON RFMS INC 40.00 X 0 0 0 16500 0 0 0 0 0 0 SYNERTX REHABILITATION 7540 N 19TH AVENUE STE 200 PHOENIX AZ 85021 THERAPY 707025 RFMS INC 285 SOUTH FARNHAM GALESBURG IL 61401 ADMINISTRATIVE SERVICES 548345 ALLIANCE REHABILITATION PO BOX 202 ELKO NV 89803 THERAPY 508279 MESA VIEW PHYSICAL THERAPY PO BOX 757 MESQUITE NV 89024 THERAPY 252069 4 1077 1077 MEDICARE & MEDICAID 623000 15365612 15365612 RESIDENT PRIVATE PAY 623000 7352888 7352888 RESIDENT THERAPY 623000 55172 55172 OTHER INCOME 623000 13188 13188 22786860 1371 1371 11227 39 11188 11188 11188 22800496 22786860 0 12559 15401 15401 14250 14250 8674886 8434471 240415 40732 39603 1129 596142 579621 16521 817708 795046 22662 696560 405816 290744 110031 110031 68510 68510 4270 4270 1906643 1906643 131869 118682 13187 157833 123176 34657 67480 53984 13496 5041021 4891469 149552 53480 42271 11209 15002 12106 2896 6744 6744 292802 278162 14640 184859 176704 8155 SUPPLIES & SMALL EQUIP. 2311936 2311917 19 MEDICAID ASSESSMENT TAX 1895987 1895987 EQUIPMENT RENT & MAINT. 128036 127392 644 SUBSCRIPTIONS & FEES 109577 82874 26703 168276 13600 154676 23510035 22304925 1205110 0 740662 175940 1273791 410234 2748250 3486698 362338 398908 3617079 2278187 1396029 1338892 10000 10000 147497 140834 6678567 5961506 1661317 1692273 3183576 3119631 149767 175234 4994660 4987138 X 1683907 974368 1683907 974368 6678567 5961506 -709539 0 X X 1 0 1 X 0 X 1903 646 1210 1890 1077 6726 18053417 19687017 20577136 22711095 22786860 103815525 18055320 19687663 20578346 22712985 22787937 103822251 0 0 0 103822251 16378 5914 7462 2526 1371 33651 16378 5914 7462 2526 1371 33651 18071698 19693577 20585808 22715511 22789308 103855902 0.99970 0.99950 0.00030 0.00050 X 4270 4270 22304925 22309195 1000000 250000 0 0 998361 1000000 1000000 1000000 3998361 5997542 4020 4181 4270 4270 16741 249590 250000 250000 250000 999590 1499385 478991 140004 338987 2831336 1942616 888720 306752 195567 111185 1338892 RESIDENT SECURITY DEPOSITS 118400 DUE TO RESIDENTS 56834 175234 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVEUNE CODE. THEREFORE, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. 1 X PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANT FUNDS ARE ONLY GIVEN TO ORGANIZATIONS WHO CONFIRM THE USE OF SUCH MONIES IN THE UNITED STATES. LTC SUPPORT SERVICES (LTC) TWO DIRECTORS COMMON TO DHCF & LTC ARE CHARLES PERRY & IRWIN JANN. 143840 MANAGEMENT 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 $2,250 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2012. IRWIN JANN, WHO IS A DIRECTOR OF DESERT HEALTH CARE FACILITIES, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $2,250 AND ANNUAL COMPENSATION OF $48,000 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2012. FEES PAID TO LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2012 WERE $143,840, AND FEES PAID FOR CALENDAR YEAR 2011 WERE $71,520. 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION RECEIVES MANAGEMENT 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 2011 IS $174,956. 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. 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 9730821 2817474 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 8482935 1701528 N/A MESQUITE HEALTH CARE LLC 285 S FARNHAM STREET GALESBURG IL 61401 275440122 OPERATES A NURSING HOME FOR THE ELDERLY. NV 4575552 1271003 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 1 0 RFMS INC MEDICAL BENEFIT PLAN TRUST Q 281561 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.