2014-05-13T07:46:48-05:00 2013-12-31 621404815 MATHENEY STEES & ASSOCIATES PC 6136 SHALLOWFORD ROAD SUITE 101 CHATTANOOGA TN 374217214 990 2013-01-01 621827400 ELDERTRUST OF FLORIDA INC C/O JAMES A SKINNER AS RECEIVER ELDE 6158902020 500 UNION STREET NO 2700 NASHVILLE TN 37219 JAMES A SKINNER RECEIVER 6158902020 2014-05-12 1 WILLIAM C MATHENEY P00439757 4238947400 2014-05-12 2013 2015-11-30 17:44:51Z JAMES A SKINNER 500 UNION STREET NO 2700 NASHVILLE TN 37219 88352511 0 X N/A X 2000 TN PROVIDING LONG-TERM HEALTHCARE X 0 0 1255 0 0 0 1093 2672 63950042 42314452 -7215 7781 644188 46027606 64588108 88352511 0 0 0 0 40633185 25979868 0 0 0 24992382 16918613 65625567 42898481 -1037459 45454030 27918059 25093487 48278602 0 -20360543 25093487 X PROVIDING LONG-TERM HEALTHCARE 0 1 33074814 88349839 PROVIDING LONG-TERM HEALTHCARE. 33074814 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 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 196 0 1 1255 1 0 0 0 0 0 0 0 0 0 0 X 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 X JAMES A SKINNER 6158506007 500 UNION STREET NASHVILLE TN 37219 X JAMES A SKINNER RECEIVER 0.00 X 0 0 0 0 0 0 0 0 0 0 WALLER LANSDEN DORTCH & DAVIS LLP 511 UNION STREET SUITE 2700 NASHVILLE TN 37219 LEGAL SERVICES 107758 1 2672 2672 LONG-TERM HEALTHCARE 623990 42314452 42314452 42314452 7781 7781 430191 0 430191 430191 430191 FORGIVENESS OF DEBT 900099 45523808 45523808 MISCELLANEOUS REVENUE 900099 73607 73607 45597415 88352511 88349839 0 0 21946168 20191580 1754588 692599 600788 91811 1484235 1369548 114687 1856866 1740623 116243 2119386 2119386 71828 71828 59333 59333 2511756 2341523 170233 410116 410116 82595 81436 1159 123121 72029 51092 1081942 1081942 1311032 1311032 1829948 460099 1369849 SUPPLIES 3700187 3641678 58509 MISCELLANEOUS EXPENSE 1307284 1050985 256299 PURCHASED SERVICES 625715 487036 138679 PROPERTY TAXES 463970 463970 1220400 1037489 182911 42898481 33074814 9823667 0 1200 0 1216005 25093487 4562330 0 138260 0 62646 0 0 0 20875768 0 1061850 0 27918059 25093487 34128294 0 13992159 158149 0 48278602 0 X -20360543 25093487 -20360543 25093487 27918059 25093487 45454030 0 X 0 0 0 X 1093 2672 3765 60525081 61793857 65256383 63950042 42314452 293839815 60525081 61793857 65256383 63951135 42317124 293843580 0 0 0 293843580 150 7781 7931 150 7781 7931 22574713 22574713 60525081 61793857 65256383 63951285 64899618 316426224 0.92860 0.99980 0.00000 0.00020 X 0 X PART X, LINE 2: THE COMPANY IS A TAX-EXEMPT ENTITY AS DESCRIBED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE FOR FEDERAL AND STATE INCOME TAX PURPOSES. THE FAILURE OF THE COMPANY TO MAINTAIN ITS TAX-EXEMPT STATUS WOULD HAVE AN ADVERSE EFFECT ON THE COMPANY'S FINANCIAL POSITION, RESULTS OF OPERATIONS, AND CASH FLOWS. ALL FACILITY ASSETS AND LIABILITIES WERE TRANSFERRED TO NHI IN EXCHANGE FOR THE FORGIVENESS OF DEBT OWED TO NHI. 2013-06-27 25479731 NATIONAL HEALTH INVESTORS INC 100 E VINE STREET MURFREESBORO TN 37130 CORPORATION 0 0 0 0 FORM 990, PART III, LINE 3 THE ORGANIZATION CEASED PROVIDING LONG-TERM HEALTHCARE TO PATIENTS IN APRIL 2013. ACCORDING TO THE SETTLEMENT AGREEMENT,NHC ASSUMED ALL OPERATING ASSETS AND LIABILITIES OF THE ORGANIZATION AND NHI WOULD TAKE OVER ALL PROPERTY PLANT EQUIPMENT AND INVENTORY OWNED BY ELDERTRUST. FORM 990, PART VI, SECTION A, LINE 3 NHC PERFORMED MANAGEMENT DUTIES UNDER A SPECIFIC WRITTEN MANAGEMENT AGREEMENT WHICH IS CUSTOMARILY PERFORMED BY EMPLOYEES OF THE NURSING HOMES. THE CONTRACT WITH NHC WAS TERMINATED ON THE DATE THE NURSING FACILITIES CEASED OPERATIONS. FORM 990, PART VI, SECTION A, LINE 8A THE ORGANIZATION DID NOT DOCUMENT ANY MEETINGS OR WRITTEN ACTIONS ON BEHALF OF THE BOARD OF DIRECTORS BECAUSE THE BOARD OF DIRECTORS DID NOT EXIST IN 2013. THE CHANCERY COURT FOR THE STATE OF TENNESSEE, 20TH JUDICIAL DISTRICT, TURNED THE COMPANY OVER TO RECEIVERSHIP DURING 2011. THE BOARD OF DIRECTORS RESIGNED AND ALL BOARD RESPOSIBILITIES WERE TURNED OVER TO THE COURT APPOINTED RECEIVER. FORM 990, PART VI, SECTION A, LINE 8B THERE WAS NO FORMAL COMMITTEE THAT WAS AUTHORIZED TO ACT ON BEHALF OF THE GOVERNING BOARD FOR 2013. THE RECEIVER WAS AUTHORIZED TO ACT AS A BOARD OF ONE. FORM 990, PART VI, SECTION B, LINE 11 THE CHANCERY COURT FOR THE STATE OF TENNESSEE, 20TH JUDICIAL DISTRICT, TURNED THE ORGANIZATION OVER TO RECEIVERSHIP DURING 2011. FOR 2013, THE RECEIVER REVIEWS AND APPROVES THE TAX RETURN BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS CALCULATED BY AN INDEPENDENT PERSON AND REVIEWED ANNUALLY BY ANOTHER. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CFM BUCKLEY SOUTH LLC DBA HOLYOKE HEALTH CARE CENTER 282 CABOT STREET HOLYOKE MA 01040 043554853 LONG-TERM NURSING HOME CARE MA N/A CFM BUCKLEY NORTH LLC DBA BUCKLEY-GREENFIELD HEALTH CENTER 95 LAUREL STREET GREENFIELD MA 01301 043554854 LONG-TERM NURSING HOME CARE MA N/A JOHN ADAMS NURSING HOME LLC 211 FRANKLIN STREET QUINCY MA 02169 043554849 LONG-TERM NURSING HOME CARE MA N/A LONGMEADOW OF TAUNTON LLC 68 DEAN STREET TAUNTON MA 02781 043554851 LONG-TERM NURSING HOME CARE MA N/A CFN MANCHESTER NORTH LLC DBA EPSOM HEALTH CARE CENTER 901 SUNCOOK VALLEY HIGHWAY EPSOM NH 03234 020524819 LONG-TERM NURSING HOME CARE NH N/A CFN MANCHESTER CENTER LLC DBA MAPLE LEAF HEALTH CARE CENTER 198 PEARL STREET MANCHESTER NH 03104 020524818 LONG-TERM NURSING HOME CARE NH N/A CFN MANCHESTER EAST LLC DBA VILLA CREST NURSING & RETIREMENT 1276 HANOVER STREET MANCHESTER NH 03104 020524817 LONG-TERM NURSING HOME CARE NH N/A