2011-08-11T10:49:19-05:00 2010-09-30 RSM MCGLADREY INC 117 E MAIN ST STE 210 GALESBURG IL 61401 990 2009-10-01 371079626 COMMUNITY LIVING OPTIONS INC COMM 3093431550 285 SOUTH FARNHAM STREET GALESBURG IL 61401 JOHN CROCK 3093431550 2011-08-10 1 BEN MCMAHAN 3093428026 2009 2016-02-24 21:20:13Z JOHN CROCK 285 SOUTH FARNHAM STREET GALESBURG IL 61401 40462140 0 X N/A X 1979 IL TO PROVIDE & OPERATE LONG-TERM CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED AND THE ELDERLY. 5 5 670 0 0 0 14819 20337 32118777 31862221 469394 549278 0 32602990 32431836 286915 1519620 0 11125772 11082057 0 0 18625882 18550794 30038569 31152471 2564421 1279365 144354498 139346827 77432399 70470955 66922099 68875872 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 28994792 1519620 31862221 ALL PROGRAM SERVICES RELATE TO PROVIDING AND OPERATING LONG-TERM CARE FACILITIES AND OTHER RELATED SERVICES TO THE DEVELOPMENTALLY DISABLED AND THE ELDERLY. 28994792 1 0 0 1 0 0 0 0 0 1 0 1 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 1 1 0 1 86 0 1 670 1 0 0 0 0 0 0 0 0 0 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 IL X X RON WILSON RFMS INC 3093431550 285 SOUTH FARNHAM GALESBURG IL 61401 JOHN Crock 2.00 X X 4000 0 0 JOHN Thompson 2.00 X X 4000 0 0 HOWARD LEHMANN 2.00 X 4000 0 0 Robert Marshall 2.00 X 4000 0 0 Michael Wartman 2.00 X 4000 0 0 RON WILSON RFMS INC 10.00 X 0 0 121196 LAURA KELLY LTC SUPPORT 13.30 X 0 0 120000 20000 0 241196 0 0 0 0 RFMS INC 285 SOUTH FARNHAM ST GALESBURG IL 61401 ADMINISTRATIVE SERVICES 1177440 LTC SUPPORT SERVICES LLC 285 SOUTH FARNHAM ST GALESBURG IL 61401 SUPPORT SERVICES 783360 MCGLADREY & PULLEN LLP 5155 PAYSPHERE CIRCLE CHICAGO IL 60674 ACCOUNTING 401310 3 20337 20337 MEDICARE & MEDICAID 623000 19184954 19184954 facility lease income 623000 8402711 8402711 Private Pay resident s 623000 4083794 4083794 aid training 623000 190522 190522 activity fund income 623000 240 240 31862221 891797 891797 7685258 2527 8030304 -345046 2527 -342519 -342519 32431836 31862221 0 549278 1519620 1519620 25693 25693 9180273 8908067 272206 75260 73028 2232 1064269 1032712 31557 736562 714722 21840 1961160 1293924 667236 339257 339257 473320 473320 8289 8289 354907 354907 84676 76208 8468 276189 217278 58911 23870 19096 4774 1823372 1770518 52854 280631 276687 3944 151673 136506 15167 4413642 4402514 11128 4236587 4172822 63765 120761 102647 18114 SUPPLIES & SMALL EQUIP. 2362603 2362603 MEDICAID ASSESSMENT TAX 1274670 1274670 EQUIPMENT RENT & MAINT. 198561 198259 302 SUBSCRIPTIONS & FEES 91609 27875 63734 RESIDENT VACATIONS 28618 28618 46399 31511 14888 31152471 28994792 2157679 0 2716751 1593143 3437622 2916349 9416054 5916909 438454 447451 120730060 26851596 105273021 93878464 8161156 7590581 12947647 25023857 1963793 1980073 144354498 139346827 2948684 2802628 175373 162451 73843309 67475876 465033 30000 77432399 70470955 X 66922099 68875872 66922099 68875872 144354498 139346827 X 0 1 1 X 0 X 31905 19220 10704 14819 20337 96985 29424520 31462768 31863930 32118777 31862221 156732216 29456425 31481988 31874634 32133596 31882558 156829201 0 0 0 156829201 1418208 1252302 1016833 479139 891797 5058279 1418208 1252302 1016833 479139 891797 5058279 30874633 32734290 32891467 32612735 32774355 161887480 0.96880 0.96310 0.03120 0.03690 X 8289 8289 28994792 29003081 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 5881 9634 9177 8289 32981 250000 250000 250000 250000 1000000 1500000 4373431 4373431 105724011 20632248 85091763 1495680 573795 921885 6487129 3758923 2728206 2649809 1886630 763179 93878464 ASSETS WHOSE USE IS LIMITED - COLLATERAL ACCOUNT 2659160 F MEMBER INTEREST - LTC SUPPORT SERVICES, LLC 10000 C STANDBY LOAN AGREEMENT RECEIVABLE FROM UNRELATED 501(C)(3) ORGANIZATIONS 6323576 C advance receivable from unlimited development, inc., A SUBSIDIARY 881654 C rent receivable from unlimited development, inc., A SUBSIDIARY 25233 C ESCROW DEPOSITS 577098 F REPLACEMENT AND REPAIR RESERVES 1913803 F ADVANCE RECEIVABLE FROM KEOKUK VILLAGE CIRCLE, LTD., NFP, A SUBSIDIARY 9833333 C note receivable from unrelated 501(c)(3) organization 2800000 C 25023857 SECURITY DEPOSITS 30000 30000 Part X: Description of Uncertain Tax Positions Under FIN 48: THE ORGANIZATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE FINANCIAL ACCOUNTING STANDARDS BOARD ISSUED NEW GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE ORGANIZATION ADOPTED THIS NEW GUIDANCE FOR THE YEAR ENDED SEPTEMBER 30, 2010. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR YEARS BEFORE 2005. 1 UNLIMITED DEVELOPMENT INC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 364094409 501(C)(3) 1500774 GENERAL SUPPORT FLORIDA LIVING OPTIONS INC 851 WEST LUMSDEN ROAD BRANDON FL 33511 364467489 501(C)(3) 18846 FORGIVEN INTERST ON DEBT 2 0 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) A SINGLE DIRECTOR COMMON TO BOTH CLO & LTC IS JOHN CROCK. 783360 MANAGEMENT SERVICES IN THE AMOUNT OF $783,360 ARE PROVIDED BY LTC SUPPORT SERVICES, LLC., AS DESCRIBED ABOVE IN SCHEDULE O RELATIVE TO PART VI, SECTION A, LINE 3. JOHN CROCK, WHO IS A DIRECTOR OF COMMUNITY LIVING OPTIONS, INC., AND LTC SUPPORT SERVICES, LLC, RECEIVED DIRECTOR'S FEES OF $1,000 FROM LTC SUPPORT SERVICES, LLC, FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2010. 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. COMMUNITY LIVING OPTIONS, INC., OWNS 12.5% OF LTC SUPPORT SERVICES, LLC, AND UNLIMITED DEVELOPMENT, INC., (A SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC.) OWNS 12.5% OF LTC SUPPORT SERVICES, LLC. THE REMAINING 75% 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 AND THROUGH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. 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 COMMUNITY LIVING OPTIONS, 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., AND THE COMPENSATION REPORTED IN COLUMN F REPRESENTS 100% OF THE WAGES AS REPORTED ON HIS RFMS, INC. FORM W-2, BOX 5 FOR CALENDAR YEAR 2009. THE COMPENSATION AMOUNT HAS NOT BEEN PRORATED BASED ON TIME SPENT PER ORGANIZATION. LAURA KELLY IS EMPLOYED BY LTC SUPPORT SERVICES, LLC, AN UNRELATED ORGANIZATION WHICH PROVIDES MANAGEMENT SERVICES TO COMMUNITY LIVING OPTIONS, INC., AS DETAILED IN THE SCHEDULE O EXPLANATION ABOVE RELATIVE TO FORM 990, PART VI, SECTION A, LINE 3. LAURA KELLY MANAGES THE DEVELOPMENTALLY DISABLED OPERATIONS OF COMMUNITY LIVING OPTIONS, INC. THE COMPENSATION REPORTED IN COLUMN F REPRESENTS 100% OF THE WAGES REPORTED ON HER LTC SUPPORT SERVICES, LLC, FORM W-2, BOX 5. fORM 990, PART VII, SECTION A, COLUMN b: APPROXIMATELY ONE HALF OF THE AVERAGE HOURS PER WEEK ESTIMATED FOR EACH DIRECTOR AND OFFICER IS DEVOTED TO RELATED ORGANIZATIONS LISTED ON SCHEDULE R. fORM 990, PART XI, LINE 2c: THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. SCHEDULE R, PART V, LINE 1A: ALL AMOUNTS RECEIVED FROM UNLIMITED DEVELOPMENT, INC. AND KEOKUK VILLAGE CIRCLE, LTD., NFP, ARE RELATED TO THE ORGANIZATION'S EXEMPT PURPOSE. UNLIMITED DEVELOPMENT, INC., A 501(C)(3) SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC., FILES A SEPERATE FORM 990 AND REPORTED THESE ITEMS AS PROGRAM-RELATED EXPENSES ACCORDINGLY. KEOKUK VILLAGE CIRCLE, LTD., NFP, A 501(C)(2) SUBSIDIARY OF COMMUNITY LIVING OPTIONS, INC., FILES A SEPERATE FORM 990 AND REPORTED THESE ITEMS AS PROGRAM-RELATED EXPENSES ACCORDINGLY. NEITHER UNLIMITED DEVELOPMENT, INC. OR KEOKUK VILLAGE CIRCLE, LTD., NFP, REPORT ANY UNRELATED BUSINESS TAXABLE INCOME ON THEIR RESPECTIVE FORM 990, AND NEITHER ENTITY IS REQUIRED TO FILE FORM 990-T. SCHEDULE R, PART V, LINE 2, COLUMN C: THE AMOUNTS REPORTED ARE DETERMINED BY THE CASH TRANSACTIONS BETWEEN THE PARTIES AND ARE BASED ON THE FAIR MARKET VALUE OF EACH RESPECTIVE ITEM. SCHEDULE R, PART II: UNLIMITED DEVELOPMENT, INC. AND KEOKUK VILLAGE CIRCLE, LTD., NFP, ARE SUBSIDIARIES OF COMMUNITY LIVING OPTIONS, INC. FORM 990, PART XI, LINE 2B: THE FINANCIAL STATEMENTS OF COMMUNITY LIVING OPTIONS, INC., WERE AUDITED AS PART OF THE CONSOLIDATED FINANCIAL REPORT ISSUED FOR COMMUNITY LIVING OPTIONS, INC. AND SUBSIDIARIES. MARION WILLIAMSON COUNTY PARKWAY LLC 3116 WILLIAMSON COUNTY PARKWAY MARION IL 62959 352259772 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 846873 10654430 N/A LEROY SOUTH BUCK LLC 509 SOUTH BUCK ROAD LEROY IL 61752 611485632 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 419101 4596306 N/A 2245 SEMINARY STREET LLC 2245 NORTH SEMINARY GALESBURG IL 61401 364568737 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 466004 5069388 N/A CENTRALIA EAST MCCORD LLC 1910 EAST MCCORD STREET CENTRALIA IL 62801 201313879 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 840206 8980897 N/A GALESBURG NORTH SEMINARY LLC 2345 NORTH SEMINARY STREET GALESBURG IL 61401 201334252 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 818441 9306229 N/A PEKIN EL CAMINO LLC 1520 EL CAMINO DRIVE PEKIN IL 61554 300330354 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 668341 7747060 N/A JERSEYVILLE NORTH STATE LLC 1251 NORTH STATE STREET JERSEYVILLE IL 62052 383715772 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 875788 10285614 N/A SHELBYVILLE ROUTE 128 LLC ROUTE 128 NORTH PO Box 49 SHELBYVILLE IL 62565 201334393 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 558094 6059341 N/A PITTSFIELD LOWRY LLC 610 LOWRY STREET PITTSFIELD IL 62363 201334359 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 570188 6670446 N/A ABINGDON WEST MARTIN LLC 801 WEST MARTIN STREET ABINGDON IL 61410 364560809 OWNS FACILITY OPERATED BY UNLIMITED DEVELOPMENT, INC. IL 180000 1582423 N/A HAWTHORNE INN OF PRINCETON LLC 140 NORTH SIXTH STREET PRINCETON IL 61356 753019235 OWNS FACILITY LEASED TO UNRELATED 501(C)(3) ORGANIZATION IL 122833 0 N/A MARYVILLE VADALABENE LLC 2133 VADALABENE DRIVE MARYVILLE IL 62062 201334411 NOT IN USE DURING FISCAL YEAR ENDING 9/30/2010 IL 0 0 N/A UNLIMITED DEVELOPMENT INC 285 SOUTH FARNHAM STREET GALESBURG IL 61401 364094409 OPERATES ELDERLY SKILLED NURSING,ASSISTED/INDEPNDENT LIVING FACILITIES IL 501(c)(3) Line 9 N/A KEOKUK VILLAGE CIRCLE LTD NFP 285 SOUTH FARNHAM STREET GALESBURG IL 61401 262341634 ACQUIRING & HOLDING TITLE TO PROPERTY; REMITTING ALL INCOME TO 501(C)(3) IL 501(c)(2) N/A 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 UNLIMITED DEVELOPMENT INC A 8022927 UNLIMITED DEVELOPMENT INC B 1500774 UNLIMITED DEVELOPMENT INC D 881654 KEOKUK VILLAGE CIRCLE LTD NFP - (A 501(C)(2) ORGANIZATION) D 9833333