2026-04-13T09:17:09-05:00 2025-05-31 410746749 CLIFTONLARSONALLEN LLP 475 REGENCY PARK SUITE 175 OFALLON IL 62269 990 2024-06-01 431825029 THE GOOD SAMARITAN INDEPENDENT LIVING INC GOOD 3149689313 1150 HANLEY INDUSTRIAL CT ST LOUIS MO 63144 CHAD SNEED CFO 3149689313 2026-04-07 1 1 ERIKA MARTINEZ P02297196 6182331200 2026-04-07 2024 2025-03-06 01:10:19Z X CAPE ALBEON CHAD SNEED 1150 HANLEY INDUSTRIAL CT ST LOUIS MO 63144 17444037 0 X HTTPS://WWW.EVERTRUELIVING.ORG/ X 1998 MO TO PROVIDE ASSISTED AND INDEPENDENT LIVING TO THE ELDERLY. 9 9 146 15 0 0 1886665 14873 11232203 11887195 932497 960377 49539 53499 14100904 12915944 96100 100800 0 0 4061437 4571235 0 0 0 6389607 6791926 10547144 11463961 3553760 1451983 47494099 50150166 24250516 25984481 23243583 24165685 X TO PROVIDE A RETIREMENT COMMUNITY THAT INCLUDES FACILITIES FOR INDEPENDENT LIVING AND ASSISTED LIVING THAT OFFERS A VARIETY OF PROGRAMS AND SERVICES TO RESIDENTS TO AID THEIR SPIRITUAL, EMOTIONAL, AND PHYSICAL HEALTH. 0 0 5221608 100800 7302375 THE GOOD SAMARITAN INDEPENDENT LIVING, INC. (DBA "CAPE ALBEON") WAS INCORPORATED ON AUGUST 24, 1998 TO OWN AND OPERATE A RETIREMENT COMMUNITY IN WEST ST. LOUIS COUNTY, MISSOURI. CAPE ALBEON PROVIDES SERVICES TO ITS RESIDENTS IN ASSISTED AND INDEPENDENT LIVING SETTINGS CONSISTING OF APARTMENTS, COTTAGES, AND OTHER RELATED FACILITIES. IT ALSO HAS A STATE-LICENSED ASSISTED LIVING FACILITY CATERING TO PERSONS WHO NEED THEIR ACTIVITIES OF DAILY LIVING TO BE MONITORED AND ASSISTED BY CARE-GIVING PROFESSIONALS. 3373209 0 4665369 OUR ASSISTED LIVING COMMUNITY -- KNOWN AS THE VILLAGE -- IS LICENSED AS AN ASSISTED LIVING FACILITY IN THE FENTON & KIRKWOOD AREA. PERSONAL CARE SERVICES ARE PROVIDED TO MAKE LIFE EASIER FOR RESIDENTS AND THEIR FAMILIES. CHOOSE FROM PRIVATE STUDIO, ONE-BEDROOM OR TWO-BEDROOM APARTMENTS SPECIALLY DESIGNED FOR COMFORT AND STYLE. OUR CARING STAFF PROVIDES AS MUCH ASSISTANCE AS NEEDED WHILE CONTINUALLY RESPECTING OUR RESIDENTS' DIGNITY.OUR RESIDENT CARE TEAM PROVIDES RESIDENTS WITH A VARIETY OF PERSONAL CARE SERVICES, INCLUDING MEDICATION MANAGEMENT AND ASSISTANCE WITH BATHING AND DRESSING. THE STAFF ALSO ARRANGES ON-SITE PHYSICAL THERAPY SESSIONS, BLOOD TESTING, AND DOCTOR APPOINTMENTS, AND THEY PROVIDE FRIENDLY REMINDERS ABOUT MEAL TIMES AND EVENTS TO RESIDENTS WHO NEED THEM. 0 0 -80549 THE ORGANIZATION PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO RESIDENTS AND OTHER CLIENTS MEETING CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE PROJECT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE REPORTED AS A DEDUCTION TO NET RESIDENT SERVICE REVENUE. 8594817 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 61 0 146 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X SHERRI ROGERS 3149689313 1150 HANLEY INDUSTRIAL CT ST LOUIS MO 63144 DR ROBERT HILL CHAIR 1.00 1.00 X X 0 0 0 REVEREND RICHARD ELLERBRAKE VICE CHAIR 1.00 1.00 X X 0 0 0 STEFFANIE RAUSCHER BOARD MEMBER 1.00 1.00 X 0 0 0 REVEREND KEVIN GREGORY BOARD MEMBER 1.00 1.00 X 0 0 0 DIANE MEATHEANY BOARD MEMBER 1.00 1.00 X 0 0 0 HARRY WILSON BOARD MEMBER 1.00 1.00 X 0 0 0 REVEREND RICHARD BRANDON BOARD MEMBER 1.00 1.00 X 0 0 0 NESA JOSEPH BOARD MEMBER 1.00 1.00 X 0 0 0 PAUL BLACK TREASURER/SECRETARY 1.00 1.00 X X 0 0 0 JOSEPH GIRARDI CFO 1.00 39.00 X 0 272413 53394 SUSAN LEONARD CIO 1.00 39.00 X 0 154237 14743 BILL HOLMAN CEO 1.00 39.00 X 0 414954 55078 JANET LEIGH CDO 1.00 39.00 X 0 133222 2229 MAUREEN DUNN CPSO 1.00 39.00 X 0 198259 26334 CHRISTINE RUTHERFORD CDO 1.00 39.00 X 0 104869 9388 CAROL DISANZA EXECUTIVE DIRECTOR 40.00 0.00 X 134575 0 9941 134575 1277954 171107 1 0 1 0 POLSINELLI PC 887 MASONRIDGE RD CREVE COUER MO 63141 LEGAL SERVICES 647947 ST ANDREW'S RESOURCES FOR SENIOR SYSTEM 1001 CRAIG ROAD ST LOUIS MO 63146 MANAGEMENT SERVICES 605143 2 14873 14873 RESIDENT SERVICE REVENUE 623000 7221826 7221826 ASSISTED LIVING 623000 4665369 4665369 11887195 851116 851116 1200 0 1200 1200 1200 4637354 4528093 109261 109261 109261 SALON SERVICES 623000 13506 13506 TRANSPORTATION 623000 11979 11979 GUEST APARTMENT 623000 8820 8820 17994 17994 52299 12915944 11887195 0 1013876 100800 100800 3798977 3222997 575980 36016 28092 7924 443514 345941 97573 292728 228328 64400 605143 605143 4305 4305 35385 35385 57331 57331 449224 350395 98829 280394 280394 437786 350622 87164 277397 223488 53909 1283509 762463 521046 26280 20498 5782 3003 2342 661 776502 764329 12173 1318308 1028280 290028 273407 213257 60150 FOOD EXPENSE 798396 798396 UNRECOVERED COST BASIS 91107 91107 RECRUITING/EMPLOYMENT S 49849 38882 10967 BAD DEBT 24600 24600 11463961 8594817 2869144 0 3599315 5045521 1110993 457487 1869713 0 805393 67146 849318 1270936 41891 51279 50820 45350 34742376 21961704 12525607 12780672 26616182 27759628 24867 10178 0 2661969 47494099 50150166 1071327 3331332 666066 557977 15006430 14707207 7506693 7387965 24250516 25984481 X 23243583 24165685 23243583 24165685 47494099 50150166 1451983 1342201 -1872082 0 X 0 0 0 X 273310 22561 15013 1886665 14873 2212422 8936557 9221644 9696202 11232203 11887195 50973801 1 52837 40901 36554 49251 179544 9209868 9297042 9752116 13155422 11951319 53365767 0 0 0 53365767 338712 451549 720033 846166 852316 3208776 338712 451549 720033 846166 852316 3208776 69050 16623 12692 12585 3048 113998 9617630 9765214 10484841 14014173 12806683 56688541 0.94140 0.94210 0.05660 0.05390 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: SALON SERVICES - 2020 AMOUNT: $ 21,397. MEALS - 2020 AMOUNT: $ 19,141. GUEST APARTMENT - 2020 AMOUNT: $ 696. TELECOMMUNICATION SERVICES - 2020 AMOUNT: $ 10,331. MAINTENANCE - 2020 AMOUNT: $ 806. OTHER INCOME - 2020 AMOUNT: $ 12,491. 2021 AMOUNT: $ 7,215. 2022 AMOUNT: $ 12,692. 2023 AMOUNT: $ 12,585. 2024 AMOUNT: $ 3,048. ACTIVITY - 2020 AMOUNT: $ 49. APPLICATION/FORFEITURE FEES - 2020 AMOUNT: $ 4,139. 2021 AMOUNT: $ 9,408. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3800000 3800000 25982060 18984213 6997847 662452 404053 258399 4260550 2573438 1687112 37314 37314 12780672 DUE FROM AFFILIATES 2661969 2661969 DEPOSITS 981465 REFUNDABLE ENTRANCE FEES 6406500 7387965 1 ST ANDREW'S CHARITABLE FOUNDATION 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 260568165 501(C)(3) 100800 0 TO ASSIST ORGANIZATION IN FURTHERING ITS MISSION. 1 PART I, LINE 2: BOARD OF DIRECTORS ANNUALLY REVIEWS, SELECTS AND AWARDS FINANCIAL ASSISTANCE BASED ON NEED. 0 0 0 0 0 0 0 0 0 BILL HOLMAN CEO 0 414954 0 0 0 0 0 21668 0 33410 0 470032 0 0 JOSEPH GIRARDI CFO 0 272413 0 0 0 0 0 30500 0 22894 0 325807 0 0 MAUREEN DUNN CPSO 0 198259 0 0 0 0 0 14162 0 12172 0 224593 0 0 SUSAN LEONARD CIO 0 154237 0 0 0 0 0 5402 0 9341 0 168980 0 0 PART I, LINE 3 THE TOP MANAGEMENT OFFICIALS ARE COMPENSATED BY A RELATED ORGANIZATION AND THE ORGANIZATION USES THE FOLLOWING METHODS IN ORDER TO ESTABLISH COMPENSATION FOR THESE INDIVIDUALS: COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. A THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE COUNTY OF ST LOUIS MISSOURI 431170145 791524BY6 2015-11-20 74385822 TO PROVIDE FUNDS TO FINANCE, REFINANCE AND REIMBURSE COSTS OF FACILITIES 0 0 0 A 2165364 15827914 2108289 315855 14392324 2017 0 1 1 1 A 0 1 1 1 0 0.00430 0.00000 0.00430 0 0 1 A 0 0 0 1 1 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE COUNTY OF ST. LOUI DATE THE REBATE COMPUTATION WAS PERFORMED: 07/14/2021 SCHEDULE K, PG 1- DIFFERENCE BETWEEN ISSUE PRICE & TOTAL PROCEEDS OF ISSUE ON NOVEMBER 20, 2015, SERIES 2015 SENIOR LIVING FACILITIES REVENUE BONDS WERE ISSUED TO ST. ANDREW'S RESOURCES FOR SENIORS AND THE GOOD SAMARITAN INDEPENDENT LIVING INC., COLLECTIVELY THE "OBLIGATED GROUP". AMOUNTS REPORTED IN SCHEDULE K ARE GOOD SAMARITAN INDEPENDENT LIVING INC.'S PORTION ALONG WITH THE ORGANIZATION'S PORTION OF INVESTMENT EARNINGS. ST. ANDREW'S RESOURCES FOR SENIORS' PORTION OF THE SERIES 2015 BONDS ISSUANCE IS SEPARATELY REPORTED WITHIN THEIR SCHEDULE K. FORM 990, PART VI, SECTION A, LINE 3 THE GOOD SAMARITAN INDEPENDENT LIVING, INC. HAS A MANAGEMENT CONTRACT WITH ST. ANDREW'S RESOURCES FOR SENIORS SYSTEM (STARSS). THE EXECUTIVE DIRECTOR OF THE GOOD SAMARITAN INDEPEDENT LIVING IS AN EMPLOYEE OF STARSS. FORM 990, PART VI, SECTION A, LINE 6 BASED ON THE ORGANIZATION'S SECOND AMENDED AND RE-STATED BYLAWS, ST. ANDREW'S RESOURCES FOR SENIORS SYSTEM ("STARSS") IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A ON JUNE 1, 2014, ST. ANDREW'S RESOURCES FOR SENIORS SYSTEM ("STARSS") BECAME THE SOLE MEMBER OF CAPE ALBEON, AND AS A RESULT OF CAPE ALBEON'S BYLAW CHANGES, STARSS HAS THE ABILITY TO RATIFY ANY CHANGES TO THE MEMBERS OF GOOD SAM AND CAPE ALBEON'S BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER MUST APPROVE CERTAIN TRANSACTIONS SET FORTH IN THE SECOND AMENDED AND RESTATED OPERATING AGREEMENT. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS REVIEWED AND APPROVED BY THE CFO. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS IS REQUIRED TO SIGN THE CONFLICT OF INTEREST STATEMENT ANNUALLY AND DISCLOSE ANY CONFLICTS THEY MAY HAVE. IF ANY CONFLICTS ARISE DURING THE YEAR THEY MUST RECUSE THEMSELVES FROM ANY VOTE IN WHICH THEY HAVE A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT COMPENSATE ANY TOP MANAGEMENT OFFICIALS. A RELATED ORGANIZATION COMPENSATES THE CEO, EXECUTIVE DIRECTOR AND OTHER KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 GOOD SAMARITAN INDEPENDENT LIVING, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. GOOD SAMARITAN INC 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 430666750 SUPPORTING ORGANIZATION MO 501(C)(3) LINE 12B, II N/A 0 ST ANDREW'S CHARITABLE FOUNDATION 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 260568165 FUNDRAISING MO 501(C)(3) LINE 7 ST ANDREW'S RESOURCES FOR SENIORS SYSTEM 0 ST ANDREW'S FRANCIS PLACE 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63025 430493215 RETIREMENT HOME MO 501(C)(3) LINE 10 ST ANDREW'S RESOURCES FOR SENIORS SYSTEM 0 ST ANDREW'S RESOURCES FOR SENIORS 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 430784786 RETIREMENT HOME MO 501(C)(3) LINE 10 ST ANDREW'S RESOURCES FOR SENIORS SYSTEM 0 ST ANDREW'S RESOURCES FOR SENIORS SYSTEM 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 260568133 ELDERCARE MO 501(C)(3) LINE 10 N/A 0 ST ANDREW'S ASSISTED LIVING OF BRIDGETON 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 431744746 ASSISTED LIVING MO 501(C)(3) LINE 10 ST ANDREW'S RESOURCES FOR SENIORS SYSTEM 0 ST ANDREW'S AT HOME SERVICES LLC 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 260314772 AT HOME HEALTHCARE SERVICES MO 501(C)(3) LINE 10 ST ANDREW'S RESOURCES FOR SENIORS SYSTEM 0 ST ANDREW'S AT NEW FLORENCE 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 237324298 RETIREMENT HOME MO 501(C)(3) LINE 10 ST ANDREW'S RESOURCES FOR SENIORS SYSTEM 0 SASC LLC 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 870806356 HOME HEALTH CARE MO N/A 0 0 ST ANDREW'S MANAGEMENT SERVICES 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 431250225 NURSING HOME MANAGEMENT MO N/A C 0 ST ANDREW'S REAL ESTATE TRUST 1001 CRAIG ROAD SUITE 200 ST LOUIS MO 63146 616580349 REAL ESTATE TRUST MO N/A T 0 0 1 0 1 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0