2011-05-09T13:51:33-05:00 2010-12-31 LARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2010-01-01 371017284 CLARK-LINDSEY VILLAGE INC CLAR 2173442144 101 WEST WINDSOR ROAD URBANA IL 61802 THOMAS B BERNS 2173442144 2011-05-06 1 3149254300 2010 2016-03-07 17:11:31Z THOMAS B BERNS 101 WEST WINDSOR ROAD URBANA IL 61802 15422249 0 X WWW.CLARK-LINDSEY.COM X 1970 IL TO PROVIDE HOUSING AND HEALTHCARE FACILITIES/SERVICES FOR ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN. 11 11 283 50 0 0 73782 21069 11815435 12860979 66236 888575 231793 195321 12187246 13965944 0 0 0 0 6667232 6643783 0 0 0 5959435 6219010 12626667 12862793 -439421 1103151 25426555 26054770 13671274 13547900 11755281 12506870 TO PROVIDE HOUSING AND HEALTHCARE FACILITIES/SERVICES FOR ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN. 0 0 11541858 12860979 CLARK-LINDSEY VILLAGE'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE HOUSING, SERVICES, AND HEALTHCARE TO THE ELDERLY PERSONS ON A NON-PROFIT BASIS, WITHOUT REGARD TO RACE, RELIGION, SEX, CREED OR NATIONAL ORIGIN. IN 2010, CLARK- LINDSEY VILLAGE PROVIDED HOUSING AND SERVICES TO 409 ELDERLY PEOPLE, RESULTING IN 81,062 DAYS OF CARE. IN ADDITION, CLARK-LINDSEY PROVIDED 169,000 MEALS, 148,500 HOURS OF NURSING CARE, 25,156 SESSIONS OF THERAPY, AND MORE THAN 400 SENIOR PROGRAMS DESIGNED TO PROMOTE CONTINUED LEARNING AND SUCCESSFUL AGING. 11541858 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 53 0 1 283 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X DEBRA REARDANZ CEO 2173442144 101 WEST WINDSOR ROAD URBANA IL 61802 THOMAS B BERNS 1.00 X X 0 0 655 GLEN C PAINE 1.00 X X 973 0 0 CATHERINE A MURPHY 1.00 X X 0 0 0 CHRISTOFER MOYER 1.00 X 0 0 596 E PHILLIPS KNOX 1.00 X X 0 0 0 CAMILLE S HARMON 1.00 X 0 0 0 MICHAEL B PROVENZANO 1.00 X 0 0 0 MICHAEL W LYON 1.00 X 0 0 115 ROLAND WHITE 1.00 X 972 0 0 DAVID W HOOD 1.00 X 709 0 0 ELIZABETH H TYLER 1.00 X 0 0 0 DEBRA S REARDANZ 40.00 X 179934 0 29578 TIMOTHY P MAST 40.00 X 70837 0 4151 JASON RICE 40.00 X 84727 0 18414 253425 0 35095 1 0 1 0 REHABCARE GROUP INC 7733 FORSYTH BOULEVARD SUITE 2300 ST LOUIS MO 63105 THERAPY SERVICES 486667 BARBER AND DEATLY INC 611 N GOODWIN URBANA IL 61801 CONSTRUCTION SERVICES 248838 MTK TECHNOLOGIES INC 701 DEVONSHIRE DRIVE CHAMPAIGN IL 61820 TECHNOLOGY CONSULTING AND HARDWARE 126947 3 21069 21069 RESIDENT SERVICES 623000 11635004 11635004 AMORTIZATION OF DEFERR 623000 1071828 1071828 MISCELLANEOUS PROGRAM 900099 154147 154147 12860979 206025 206025 2138855 1448071 8234 690784 -8234 682550 682550 MEAL REVENUE 900099 117460 117460 HAIR SALON SERVICES 900099 71228 71228 MISCELLANEOUS REVENUE 900099 6633 6633 195321 13965944 12860979 0 1083896 284500 284500 5311506 4834140 477366 148614 128009 20605 477578 443028 34550 421585 371485 50100 44400 44400 42412 42412 52464 52464 11950 11950 64451 64451 13337 13337 170926 147655 23271 544536 538640 5896 30237 3591 26646 12144 4595 7549 226474 226474 1558683 1541806 16877 232863 230342 2521 THERAPY, NURSING SUPPLI 937068 937068 DIETARY 757001 757001 MAINTENANCE AND GROUNDS 465274 460236 5038 REAL ESTATE TAXES 386215 382033 4182 CHARITY CARE EXPENSE 186348 186348 482227 336070 146157 12862793 11541858 1320935 0 500 500 1135247 1812851 545527 1125347 30658 27272 59150 133829 30289037 15458411 15800064 14830626 7855409 8124345 25426555 26054770 1251313 1312292 6955413 7620867 4351987 4215347 909500 318500 203061 80894 13671274 13547900 X 11392906 12130719 343289 357065 19086 19086 11755281 12506870 25426555 26054770 X 1103151 -351562 X X 0 1 1 X 0 X 544272 253515 354943 95282 21069 1269081 10286143 12034438 11626029 11951946 12860979 58759535 195321 195321 10830415 12287953 11980972 12047228 13077369 60223937 0 0 0 60223937 317321 322411 236724 129044 206025 1211525 317321 322411 236724 129044 206025 1211525 11147736 12610364 12217696 12176272 13283394 61435462 0.98030 0.97900 0.01970 0.02100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1912590 10100 143851 77947 13068 1975526 1651044 10000 281355 15567 14242 1912590 0.90950 0.00960 0.08090 0 0 225000 225000 23521195 10852134 12669061 6542842 4606277 1936565 14830626 FUNDS HELD FOR OTHERS 21233 DEFERRED COMPENSATION 59661 80894 13965944 12862793 1103151 -351562 -351562 751589 13570152 -351562 -351562 13921714 52464 -8234 44230 13965944 12818563 0 12818563 52464 -8234 44230 12862793 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ARMSEY BEAUTIFICATION FUND IS A TERM ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT FOR CLARK-LINDSEY RESIDENT GROUNDS AND GARDENS. THE THOMPSON LIBRARY FUND IS A TERM ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF THE CLARK-LINDSEY RESIDENT LIBRARY. THE WEBBER EDUCATIONAL FUND IS A PERMANENT ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF CONTINUING EDUCATION FOR HEALTH CENTER STAFF. THE STEWART LIBRARY FUND IS A PERMANENT ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT OF THE CLARK-LINDSEY RESIDENT LIBRARY. THE KAULFERS FUND IS A BOARD DESIGNATED, QUASI ENDOWMENT USED TO PROVIDE FINANCIAL SUPPORT FOR QUALITY OF LIFE IMPROVEMENTS INDCLUDING PROGRAMS AND FACILITIES ESPECIALLY DEVELOPED FOR SENIOR CITIZENS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE VILLAGE QUALIFIES AS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE VILLAGE IS NOT SUBJECT TO FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE CODE. THE VILLAGE IS CLASSIFIED AS A PUBLICLY SUPPORTED CHARITABLE ORGANIZATION UNDER THE CODE AND CONTRIBUTIONS TO THE VILLAGE QUALIFY AS A CHARITABLE TAX DEDUCTION FOR THE CONTRIBUTOR. THE VILLAGE'S 2009, 2008 AND 2007 TAX YEARS ARE OPEN FOR EXAMINATION BY THE IRS. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS -8,234. PART XIII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS -8,234. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 DEBRA S REARDANZ 171434 0 0 0 8500 0 11394 0 18184 0 209512 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDED REIMBURSEMENT FOR COMPANION TRAVEL TO ITS BOARD MEMBERS. THE SPECIFIC INDIVIDUALS AND AMOUNTS ARE INCLUDED ON FEDERAL FORM 990, PART VII, SECTION A. PART I, LINE 4A CLIFFORD INGERSOLL, FORMER CEO, RECEIVED HIS 457 PLAN DISTRIBUTION OF $131,211 DURING 2010, OF WHICH $39,038 WAS TAXABLE. CITY OF URBANA CHAMPAIGN COUNTY ILLINOIS 376000524 NONEAVAIL 2004-05-20 5000000 IMPROVEMENTS TO HEALTHCARE FACILITY 0 0 0 784653 5000000 100000 4900000 2005 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 E PHILLIPS KNOX BOARD SECRETARY 52464 INVESTMENT MANAGEMENT FEES PAID TO BUSEY WEALTH MANAGEMENT. MR. KNOX IS A DIRECTOR AT THE PARENT COMPANY, FIRST BUSEY CORPORATION. 0 E PHILLIPS KNOX BOARD SECRETARY 350195 LOAN PAYMENTS MADE TO BUSEY BANK. MR. KNOX IS A DIRECTOR AT THE PARENT COMPANY, FIRST BUSEY CORPORATION. 0 DEBRA REARDANZ PRESIDENT/CEO 14921 DUES PAID TO LIFE SERVICES NETWORK (LSN), ON WHICH, MS. REARDANZ IS A BOARD MEMBER. 0 CURTIS FARELL PRESIDENT'S BROTHER 11682 WAGES PAID FOR PART-TIME EMPLOYMENT 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE BOARD DIRECTS THAT AT LEAST ONE BOARD MEMBER, WHO SERVES ON THE FINANCE COMMITTEE, CONDUCT THE ANNUAL REVIEW OF THE FORM 990 AND PRESENT IT TO THE FULL BOARD PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD DIRECTS THAT OFFICERS, DIRECTOR, AND KEY EMPLOYEES ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR PREPARING QUARTERLY REPORTS TO THE BOARD FINANCE COMMITTEE THAT DISCLOSES ACTUAL, POTENTIAL OR PERCEIVED CONFLICTS OF INTEREST. IN THE EVENT THAT A CONFLICT EXISTS, THE PERSON IS REQUIRED TO RECUSE HIMSELF OR HERSELF FROM PARTICIPATING IN THE DECISION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD DIRECTS THAT THE PERSONNEL & POLICY COMMITTEE (P&PC) CONDUCT THE PRESIDENT'S ANNUAL PERFORMANCE REVIEW AND DEVELOP SALARY AND COMPENSATION RECOMMENDATIONS FOR FULL BOARD APPROVAL. A COMPARATIVE ANALYSIS OF THE PRESIDENT'S ANNUAL COMPENSATION IS REVIEWED BY THE P&PC USING SOURCES SUCH AS INDEPENDENT SALARY SURVEYS, REVIEW OF FORM 990S AND OTHER INFORMATION AS IT IS AVAILABLE. TO ENSURE THE INDEPENDENCE AND OBJECTIVITY OF THE COMPARATIVE REVIEW, THE DATA AND ANALYSIS IS PREPARED BY SOMEONE OTHER THAN THE PRESIDENT. IN REGARDS TO OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PRESIDENT PERFORMS A SIMILAR PROCESS USING INDEPENDENT SALARY SURVEY DATA TO DETERMINE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 CLARK-LINDSEY VILLAGE, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -351,562. FORM 990, PART XII, LINE 2C THE PROCESS FOR REVIEW AND OVERSIGHT OF THE AUDIT PROCESS IS CONSISTENT WITH PRIOR YEARS.