2011-02-14T08:34:38-06:00 2010-09-30 Blue & Co LLC One American Square 2200 Indianapolis IN 46282 990 2009-10-01 311209757 Westminster Village North Inc WEST 3178236841 11050 Presbyterian Drive Indianapolis IN 46236 William Lee 3178236841 2011-02-14 1 Carrie A Merrill CPA 3176334705 2009 2016-02-24 21:20:13Z William Lee 11050 Presbyterian Drive Indianapolis IN 46236 18754530 0 X www.westminstervillage.com X 1972 IN SATISFY NEEDS OF THE ELDERLY BY PROVIDING HOUSING, HEALTHCARE, & FINANCIAL SECURITY 12 12 427 75 0 0 1588216 1702900 15636936 16814396 403378 134940 132511 102294 17761041 18754530 66058 119946 0 9244295 9551251 0 0 7928098 8105917 17238451 17777114 522590 977416 48145969 49825000 39721042 41103682 8424927 8721318 Westminster Village North, a nonprofit continuing care community is committed to excellence in residential and health care services for senior adults in a secure home environment that enhances their mental, physical and spiritual well-being. 0 0 15453046 119946 16814396 To provide housing, healthcare, and financial security pursuant to rev. Rul. 72-124 satisfying the three special needs of the elderly.Housing:The village provides residential facilities that are specifically designed to meet the needs of the elderly; constructed with fire-resistant material; bathrooms equipped with grab-bars; equipped with ramps and elevators for wheelchair use; carpeted corridors and handrails; maintenance free living; on-site commercial services (bank, store, beauty salon); chapel; emergency call system and intercom. Financial security:Westminster village provides continuing care to the village residents regardless of their ability to pay. Although reimbursement for services rendered is critical to the operation and stability of the facility, not all residents possess the necessary financial resources to maintain their living expenses. Services were also provided to Medicare patients at reimbursement rates below cost. During The current fiscal year $633,317 of charity care was provided with $474,749 related to Medicaid losses and $158,468 related to direct charity care write offs. The village provides charity care to those residents who have exhausted their resources. This equates to Healthcare:The village provides for the physical and mental well-being of their residents; health center on premises; skilled & intermediate nursing care with 24 hour professional staffing; scheduled physician outpatient services; scheduled speech and physical therapy; prescription services; exercise classes and a wide range of social and recreational activities. Social Accountability:In addition, as a not-for-profit other programs and services for the benefit of the community are provided, such as meals on wheels daily deliveries, health promotions and education seminars, internships and site visits for health care students and other volunteer activities. We also encourage our associates to take an active part in the community we serve.Westminster Village North, Inc. opens its doors to both the residents and the community we serve by providing personnel, speakers, and space, if needed to/for the following organizations and events.Allisonville United Christian Presentation and DinnerAlzheimer's Association DonationsBeans & Rice Project for Lawrence Food PantryBenjamin Harrison Master Gardeners LuncheonBrookville Road Church Mimers (on-site)Castleton United Methodist Church (on-site)Cat Companions for Seniors PresentationsChristmas Hobby ShowCivic Theatre Resident AttendanceCivil Air PatrolClifty Falls Park TripCommunity Hospice PresentationsCommunity Life Line Christian Church (on-site)Coupon Cutters for the MilitaryDaisy Girl Scouts #98Dance KaleidoscopeDevourDowntown.orgFood Drive for Outlook Christian ChurchGrand Opening, Mary Newill Therapy CenterGrandfather/Granddaughter BrunchGreat Decisions Series at Butler UniversityHarvest Church, McCordsvilleHoliday BazaarHorizon Church (on-site)Indiana Actors' TheatreIndiana Historical SocietyIndiana State MuseumIndiana State ParksIndiana State UniversityIndianapolis Museum of Art Resident AttendanceIndianapolis Symphony Orchestra Resident AttendanceIndianapolis ZooIrvington Presbyterian Church Home TourIrvington Presbyterian Church PresentationsKiwanis Doll ProjectKiwanis Meetings on siteKiwanis Presentation - Carmel Kiwanis Presentation - CastletonLawrence Chamber of Commerce Business After HoursLawrence Chamber of Commerce Health FairLawrence Chamber of Commerce Women's BreakfastLawrence Fraternal Order of Police MeetingsLawrence Methodist PreschoolLawrence North Jazz BandLawrence Police Merit Commission MeetingsLilly ChoirMaennerchor Musical PerformanceMartha Davis Book SigningMud Creek Players PresentationMud Creek Players Resident AttendanceOrchard Park Presbyterian Church LuncheonPEO PresentationPioneer Network National Conference - Resident SpeakersPioneer Network National Conference - Transportation Political Forum Featuring Sheriff AndersonPraise & Worship Church Luncheon/Meeting (x2)Purdue University Glee ClubRhythm DiscoveryScottish Rite CathedralSecond Presbyterian Church Senior LuncheonSen. Jim Merritt Reports to Constituents on CampusSenior Art Show in Memory of Rosemary Lawton-ThomasSenior Health Fair Presentation, Live 40 MagazineSertoma Meetings on siteServants of Christ Lutheran Church TransportationSpreading Sunshine Presentation to Lawrence Fire Department Ladies' AuxiliarySuper Bowl Scarf Knitting ProjectThe Indiana Harmony Brigade at Crispus Attucks Medical Magnet High SchoolThe PlayersTurkey Run State ParkVirginia B. Fairbanks Art & Nature Park at IMAVoceWeekly Resident Transportation to Community Hospital Campus AppointmentsKiwanis MeetingVesper ServicesBible Studies (7)Care Givers Support GroupHealth Fair (residents, employees, families, visitors)Lawrence Chamber of Commerce Board Meetings (KB)Lawrence Chamber Executive Meetings (KB)Lawrence Chamber Breakfast (KB)Presentation to PEO ClubPresentation to Irving Presbyterian ChurchPresentation to Stephen Ministries, Northminster Presbyterian ChurchVillage Pathways informational newsletter to discharge planners, senior advisors, physicians, etc. Easter Egg HuntThe Westminster Foundation Veal Tust Educational Assistance for EmployeesThe Westminster Foundation Benevolent Assistance for ResidentsThe Westminster Foundation Village BridgeThe Westminster Foundation Annual Report/Philanthropy PresentationCrime Prevention Seminars for ResidentsMemorial Services (Chaplain)Funeral Attendance/Speaking(Chaplain)Hospital Visitation (Chaplain)open HousesThirsty Thursday Social Hour - Themed social hourPlanned Giving Group of Indiana (SBC)Association of Fundraising Professionals (SBC) Catholic MassMeet the Mayor & CandidatesMeet the Republican CandidatesSlide tour of IMAOctober FestNIFS Presentation: Take HeartHighlights of the IMANIFS Healthy Heart IncentiveIntroducing the EiteljorgIndiana Historical Society Eiteljorg Museum TourNIFS Body Fat TestingPaws & Think PresentationIndiana Historical SocietyTravelogue - DenmarkMassages from Active ChiropracticDemocrat DayRepublican DayGardening Questions & AnswersNIFS Presentation: Sun SafetyNIFS Obstacle CourseNICS ABCs of Wellness ChallengeTravelogue w/ Earl MuellerFaith Presbyterian ChurchIrvington Presbyterian ChurchNorthminster Presbyterian ChurchChrist ChurchAll Souls Unitarian ChurchMinistry LuncheonWestminster ToursParkinson's Exercise Group open to publicGeist Sertoma MeetingElection Polling Site - Primary and General ElectionsAdopt a Grandparent ProgramBargain BasementTrick or TreatingHalloween - "Haunted Trail of Terror"Easter egg hunt open to communityChurch groups coming to the communityFall/Safety screenings for ResidenIVY Tech Certified Nursing Assistant Training SiteCommunity North Hospital I/P Hospice Site 15453046 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 26 0 427 1 0 0 0 0 0 0 0 0 0 12 12 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 IN X William Robert Lee CFO 3178236841 11050 PRESBYTERIAN DR INDIANAPOLIS IN 46236 Brian Madden 1.00 X 0 0 0 Anthony Nicholas 1.00 X 0 0 0 Frank Neese 1.00 X 0 0 0 Kay Sutherlin 1.00 X 0 0 0 Brad HITZFIELD 1.00 X 0 0 0 Jack Jackson 1.00 X 0 0 0 VirGINIA MAHER 1.00 X 0 0 0 Jon Miller 1.00 X 0 0 0 Bettye Parks 1.00 X 0 0 0 Linda Pendleton 1.00 X 0 0 0 Bill Riggs 1.00 X 0 0 0 Mary Steinke 1.00 X 0 0 0 Elizabeth Coffey 1.00 X 0 0 0 Shelly Rauch 40.00 X 143160 0 22374 William Robert Lee 40.00 X 93531 0 6228 Stephanie James 40.00 X 92865 0 10681 329556 0 39283 1 0 1 0 Rehab Strategies Inc 2091 Ridgemer Way Greenwood IN 46143 Contract Therapy 1573862 Senior Care Pharmacy Inc 6530 Corporate Drive Building A Indianapolis IN 46278 Pharmacy Provider 724408 US Food Service Inc 12301 Cumberland Road Fishers IN 46038 Food Supplier 541742 Indianapolis Power & Light One Monument Circle Indianapolis IN 46206 Utilities 403742 McKesson Medical - Surgical One Post Street San Francisco CA 94104 Information Technology 201891 8 1528463 125000 49437 1702900 Patient Service Revenu 623000 16814396 16814396 16814396 134940 134940 20209 20209 20209 20209 Miscellaneous 900099 82085 82085 82085 18754530 16814396 0 237234 25000 25000 94946 94946 329556 247167 82389 7301949 6936852 365097 25958 24660 1298 1238107 1176202 61905 655681 622897 32784 34264 34264 37578 37578 1968522 1745598 222924 204622 204622 105025 99774 5251 22175 21066 1109 851560 808982 42578 18500 14800 3700 1549 1162 387 1026102 1026102 1767245 1608193 159052 231044 231044 Medical Supplies and Fo 1743552 1743552 Bad Debt Expense 51151 51151 Other Expense 43028 0 43028 17777114 15453046 2324068 0 1365509 1659972 4318555 5573807 1027997 787326 127340 116157 193013 219020 54017284 16280655 32974835 37736629 8138720 3732089 48145969 49825000 1311728 1942337 13396611 13939893 23215000 22775000 1797703 2446452 39721042 41103682 X 8223539 8533079 201388 188239 8424927 8721318 48145969 49825000 X 0 1 1 X 0 X 961530 1198407 1367321 1306139 1702900 6536297 11246463 12772541 13700347 15636936 16814396 70170683 134778 115851 102294 352923 12207993 13970948 15202446 17058926 18619590 77059903 0 0 0 77059903 305942 583852 510121 420038 134940 1954893 305942 583852 510121 420038 134940 1954893 12513935 14554800 15712567 17478964 18754530 79014796 0.97530 0.97320 0.02470 0.02680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 201388 164730 119946 57933 188239 71854 255621 66508 4360 55219 201388 1.00000 0 0 167474 167474 49545803 12851584 36694219 4049356 3202217 847139 254651 226854 27797 37736629 CAsh in bank - patient accounts 16926 Deferred Financing Costs 611189 Escrow & Debt Service Funds - held by trustee 2914171 Other Receivables 94803 Estimated Third-Party Settlements 95000 3732089 Apartment Deposits 21600 Cash In Bank - patient accounts 16926 Derivative Liability 2277111 Other Liabilities 130815 2446452 18754530 17777114 977416 -681025 -681025 296391 18073505 -681025 -681025 18754530 0 18754530 17777114 0 17777114 0 17777114 Part V, Line 4: Description of Intended Use of Endowment Funds: Temporarily restricted net assets are available for certain operational uses including charity care. 1 The Westminster Foundation 5740 Kilmer Lane Indianapolis IN 46205 351603830 501(c)3 25000 Charity care offset 1 0 Veal Tuition Progam 16 94946 Provides scholarships for employees furthering their education. Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The assistance is provided for tuition reimbursement which is monitored by the Director of Human Resources. THe Director of HR reviews the grades and tuition expenses incurred by an employee and verfies the individual received a C or higher letter grade and has been working for the organization for one year. X X 0 0 0 0 0 0 0 0 0 Shelly Rauch 143160 0 0 0 0 0 1854 0 20520 0 165534 0 0 0 Form 990, Part VI, Section A, line 6 The organization is organized as a nonprofit corporation with a board of directors. Form 990, Part VI, Section B, line 11 The Form 990 was discussed at the Finance Committee Meeting held in January 2011. It is the intent for the CFO to prepare a summary of the 990 for the Board Members. The Board will then review the Summary at the February 2011 meeting and copies will be available for review. Form 990, Part VI, Section B, line 12c Each Year the Board members complete a "Conflict of Interest" Form. Form 990, Part VI, Section B, line 15 The Compensation Committee of the Board as well as the Fianance Committee review the Executive Director's compensation each year. Form 990, Part VI, Section C, line 19 The organization does not make the governing documents, conflict of interest policy, or financial statements available to the public. Form 990, Part XI, Line 2c Audit Oversight The Board of Directors assumes responsibility for oversight of the audit of the financial statements and no processes have changed from prior year. The Westminister Foundation 11050 Presbyterian Drive Indianapolis IN 46236 351603830 Assist Westminister Village North IN 501(c)(3) Line 7 N/A 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0