2012-11-15T07:48:25-06:00 2011-12-31 310210560 BATTELLE & BATTELLE LLP 2000 WEST DOROTHY LANE DAYTON OH 45439 990 2011-01-01 237085581 GRACE BRETHREN VILLAGE GRAC 9378364011 1010 TAYWOOD ROAD ENGLEWOOD OH 45322 MICHAEL MONTGOMERY 9378364011 2012-11-14 1 TRACY A POEPPELMAN P00996263 9372980201 2011 2016-02-24 21:20:13Z MICHAEL MONTGOMERY 1010 TAYWOOD ROAD ENGLEWOOD OH 45322 4116864 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 84 75 1711 711 50391 4841 3733990 3921935 21453 26264 1832 1711 3807666 3954751 0 0 0 0 2544032 2492549 0 0 0 1602390 1897079 4146422 4389628 -338756 -434877 7067067 6581870 5516164 5210750 1550903 1371120 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 3501891 3921935 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. 3501891 1 0 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 0 1 5 0 84 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 DAVE BLACK 1.00 X 0 0 0 REV 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 GENE A GEASLEN 35.00 X 74000 0 26224 MICHAEL MONTGOMERY 40.00 X 80047 0 312 PAMELA JONES 40.00 X 89230 0 7581 243277 0 34117 0 0 0 0 CONCEPT REHAB 7150 GRANITE CIRCLE TOLEDO OH 43617 THERAPY SERVICES 146673 1 4841 4841 RESIDENT SERVICES 623000 3921935 3921935 3921935 21777 21777 1980 269 1711 1711 1711 166331 161844 4487 4487 4487 3954751 3921935 1711 26264 277394 277394 1615631 1414211 201420 392873 386145 6728 206651 122348 84303 24100 24100 52157 52157 6090 6090 45976 43792 2184 284309 258941 25368 248423 235175 13248 262 262 82548 82548 327140 311493 15647 84424 84424 MISCELLANEOUS 252396 252396 CONTRACT SERVICES 200060 165480 34580 FRANCHISE & INCOME TAX 199530 199530 REPAIRS & MAINTENANCE 83961 83961 5703 3421 2282 4389628 3501891 887737 0 344245 286435 313649 211061 19171 3534 12836 31979 10115766 4589095 5715335 5526671 643931 504290 17900 17900 7067067 6581870 297077 419273 3825401 3370696 1682 4656 1229432 1215079 162572 201046 5516164 5210750 X 1430694 1238503 20209 32617 100000 100000 1550903 1371120 7067067 6581870 X -434877 255094 X 0 1 1 X 0 X 11398 8370 6798 50391 4841 81798 3690558 3848339 4151137 3734590 3921935 19346559 3701956 3856709 4157935 3784981 3926776 19428357 0 0 0 19428357 52229 30489 17504 21456 21777 143455 52229 30489 17504 21456 21777 143455 1701 1685 2734 832 711 7663 3755886 3888883 4178173 3807269 3949264 19579475 0.99230 0.98570 0.00730 0.01390 X 0 1 39558 39558 9004022 3757930 5246092 665229 515260 149969 406957 315905 91052 5526671 MUTUAL FUNDS 504290 F 504290 CHARITABLE GIFT ANNUITIES 689 COST REPORT SETTLEMENTS PAYABLE 200357 201046 3954751 4389628 -434877 4039 251055 255094 -179783 3958790 4039 4039 3954751 0 3954751 4389628 0 4389628 0 4389628 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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 2008. 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 CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 4,039. PRIOR PERIOD ADJUSTMENTS: 251,055. TOTAL TO FORM 990, PART XI, LINE 5: 255,094.