2013-11-12T13:22:12-06:00 2012-12-31 310210560 BATTELLE & BATTELLE LLP 2000 WEST DOROTHY LANE DAYTON OH 45439 990 2012-01-01 237085581 GRACE BRETHREN VILLAGE GRAC 9378364011 1010 TAYWOOD ROAD ENGLEWOOD OH 45322 MICHAEL MONTGOMERY 9378364011 2013-11-11 1 KAREN O CRIM P00368385 9372980201 2012 2016-03-07 17:11:31Z MICHAEL MONTGOMERY 1010 TAYWOOD ROAD ENGLEWOOD OH 45322 4062273 0 X WWW.GBVILLAGE.COM X 1969 OH TO PROVIDE A CONTINUUM OF CARE FOR OLDER ADULTS IN A SAFE, NURTURING CHRISTIAN ENVIRONMENT INCLUDING SKILLED AND INTERMEDIATE HEALTHCARE AS WELL AS ASSISTED LIVING AND INDEPENDENT LIVING 9 9 96 99 2644 1644 4841 22379 3921935 4016995 26264 19882 1711 2644 3954751 4061900 0 0 0 0 2492549 2179054 0 0 0 1897079 1626315 4389628 3805369 -434877 256531 6581870 6614396 5210750 4963585 1371120 1650811 TO FOSTER, MAINTAIN, AND OPERATE A CHRISTIAN RETIREMENT COMMUNITY AND TO PROVIDE SERVICES WHICH ENHANCE PHYSICAL, MENTAL, AND SPIRITUAL WELL-BEING ENABLING PERSONS TO LIVE SECURELY WITH DIGNITY, CONTINUING TO LOVE, LEARN, AND ACHIEVE PERSONAL FULFILLMENT. 0 0 3318049 4016995 GRACE BRETHREN VILLAGE (GBV) IS A FAITH-BASED NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY. GBV HAS BEEN SERVING AREA SENIORS WITH HOUSING AND SERVICES FOR INDEPENDENT LIVING, ASSISTED LIVING AND SKILLED NURSING SINCE 1971. OUR GOAL IS MUCH GREATER THAN TO PROVIDE JUST HOUSING AND SERVICES TO OUR RESIDENTS. OUR GOAL IS TO EXEMPLIFY THE VALUES OF THE CHRISTIAN TRADITION WHILE FULFILLING RESIDENTS' PHYSICAL, INTELLECTUAL, SOCIAL, EMOTIONAL AND SPIRITUAL NEEDS. THE CAMPUS CONSISTS OF A 50-BED NURSING HOME, OF WHICH FOUR UNITS ARE ASSISTED-LIVING APARTMENTS, IN ADDITION TO 77 INDEPENDENT-LIVING UNITS. DURING 2006, THE ORGANIZATION BECAME DUALLY CERTIFIED FOR MEDICAID AND MEDICARE FOR 45 NURSING HOME BEDS. 3318049 1 1 0 0 0 0 0 0 1 0 1 1 0 0 1 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 0 0 0 1 9 0 96 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 0 0 X MICHAEL MONTGOMERY 9378364011 1010 TAYWOOD ROAD ENGLEWOOD OH 45322 STEVE HAGEN 1.00 X X 0 0 0 BRUCE MCKENZIE 1.00 X X 0 0 0 RONALD WYSS 1.00 X X 0 0 0 BAMBI PEIRSON-CLINE 1.00 X X 0 0 0 ROBERT FOOTE 1.00 X 0 0 0 CAROLYN GUITTAR 1.00 X 0 0 0 TIM MIHOJEVICH 1.00 X 0 0 0 GREG RYERSON 1.00 X 0 0 0 JOSEPH PATTERSON 1.00 X 0 0 0 MICHAEL MONTGOMERY 40.00 X 89999 0 28 PAMELA JONES 40.00 X 83940 0 9552 173939 0 9580 0 0 0 0 CONCEPT REHAB 7150 GRANITE CIRCLE TOLEDO OH 43617 THERAPY SERVICES 136659 1 22379 22379 RESIDENT SERVICES 623000 4016995 4016995 4016995 19882 19882 3017 373 2644 2644 2644 4061900 4016995 2644 19882 183519 183519 1476369 1363720 112649 217678 214558 3120 301488 249112 52376 1043 1043 32403 32403 6544 6544 11508 9954 1554 232414 205689 26725 211451 211451 580 580 70168 70168 311883 302763 9120 80947 80947 CONTRACT SERVICES 289924 263328 26596 FRANCHISE & INCOME TAX 212875 212875 REPAIRS & MAINTENANCE 99960 99960 MISCELLANEOUS 62607 62607 2008 1120 888 3805369 3318049 487320 0 286435 251583 211061 440062 3534 1896 31979 9706 10226617 4877724 5526671 5348893 504290 544356 17900 17900 6581870 6614396 419273 428027 3370696 3137023 4656 2617 1215079 1195561 201046 200357 5210750 4963585 X 1238503 1513743 32617 37068 100000 100000 1371120 1650811 6581870 6614396 256531 23160 0 X X 0 1 X 1 0 X 8370 6798 50391 4841 22379 92779 3848339 4151137 3734590 3921935 4016995 19672996 3856709 4157935 3784981 3926776 4039374 19765775 0 0 0 19765775 30489 17504 21456 21777 19882 111108 30489 17504 21456 21777 19882 111108 1685 2734 832 711 1644 7606 3888883 4178173 3807269 3949264 4060900 19884489 0.99400 0.99230 0.00560 0.00730 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 39558 39558 9026379 3998641 5027738 749850 554634 195216 410830 324449 86381 5348893 MUTUAL FUNDS 544356 F 544356 COST REPORT SETTLEMENTS PAYABLE 200357 200357 X 4085060 23160 23160 4061900 0 4061900 3805369 0 3805369 0 3805369 PART IV, LINE 2B: THE ORGANIZATION HOLDS DEPOSITS FROM RESIDENTS TO BE USED BY THE RESIDENTS FOR INCIDENTAL EXPENSES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: A PROVISION FOR INCOME TAXES HAS NOT BEEN INCLUDED IN THE FINANCIAL STATEMETNS SINCE THE ORGANIZATION HAS RECEIVED TAX-EXEMPT STATUS FROM THE INTERNAL REVENUE SERVICE UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2009. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE A SEPARATE COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 WILL BE MADE AVAILABLE TO THE BOARD FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF TRUSTEES SIGNS A CONFLICT OF INTEREST STATEMENT ANNUALLY FORM 990, PART VI, SECTION B, LINE 15A REVIEWED BY THE FINANCE COMMITTEE WITH FINAL APPROVAL BY THE BOARD OF TRUSTEES FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST FORM 990, PART XII, LINE 2C: THE PROCESS BY WHICH THE ORGANIZATION SELECTS AN INDEPENDENT ACCOUNTANT TO CONDUCT ITS AUDIT HAS NOT CHANGED SINCE THE PRIOR YEAR