2023-08-10T14:45:27-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 420 SOUTH ORANGE AVENUE SUITE 900 ORLANDO FL 32801 990 2022-01-01 590760207 FLORIDA PRESBYTERIAN HOMES INC FLOR 8636885521 16 LAKE HUNTER DRIVE LAKELAND FL 33803 DAVID LARSON CHIEF FINANCIAL OFFICER 8636885521 2023-08-09 1 DAVID LARSON 999009999 0 AMY CHAPMAN P00843460 4078021200 2023-08-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ELENA NICHOLAS 16 LAKE HUNTER DRIVE LAKELAND FL 33803 22848488 0 X WWW.FPHI.ORG X 1955 FL TO SERVE OLDER ADULTS FROM ALL FAITHS WITH HOLISTIC, COMPASSIONATE CARE (CONTINUED ON SCHEDULE O)AND SUPPORT IN MAINTAINING INDEPENDENCE AND ACHIEVING GREATER WELLNESS. 15 15 262 15 0 0 2298027 485040 14182830 13760847 1312811 745988 3960 67303 17797628 15059178 0 0 0 0 6630961 7014515 0 0 0 8380665 8603638 15011626 15618153 2786002 -558975 60980180 55952183 32609699 30458152 28370481 25494031 FLORIDA PRESBYTERIAN HOMES IS A NONPROFIT, LIFE PLAN COMMUNITY WHOSE MINISTRY IS TO SERVE OLDER ADULTS FROM ALL FAITHS WITH HOLISTIC, COMPASSIONATE CARE AND SUPPORT IN MAINTAINING INDEPENDENCE AND ACHIEVING GREATER WELLNESS. 0 0 11775792 13760847 FPHI PROVIDES HOUSING, HEALTHCARE, AND RELATED SERVICES TO SENIOR ADULTS. THE COMMUNITY IS SPONSORED BY THE SYNOD OF SOUTH ATLANTIC OF THE PRESBYTERIAN CHURCH. THE COMMUNITY CONSISTS OF 115 INDEPENDENT LIVING HOMES, 62 APARTMENTS, 42 ASSISTED LIVING APARTMENTS, AND A 68-BED SKILLED NURSING FACILITY. THE ORGANIZATION OPERATES UNDER THE "CONTINUING CARE" CONCEPT IN WHICH RESIDENTS ENTER INTO AN OCCUPANCY AGREEMENT WHICH REQUIRES PAYMENT OF A ONE-TIME ENTRANCE FEE AND A MONTHLY SERVICE FEE. GENERALLY, THESE PAYMENTS ENTITLE THE RESIDENTS TO THE USE AND PRIVILEGES OF THE COMMUNITY FOR LIFE, INCLUDING NURSING SERVICES IN THE ORGANIZATION'S SKILLED NURSING FACILITY. THE OCCUPANCY AGREEMENT DOES NOT ENTITLE THE RESIDENTS TO AN INTEREST IN THE REAL ESTATE OF ANY PROPERTY OWNED BY THE ORGANIZATION. 11775792 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 10 0 1 262 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X DAVID LARSON CHIEF FINANCIAL OFFICER 8636885521 16 LAKE HUNTER DRIVE LAKELAND FL 33803 JOE XANTHOPOULOS CHIEF EXECUTIVE OFFICER/ED 40.00 X 171481 0 32174 DAVID LARSON CHIEF FINANCIAL OFFICER 40.00 X 156203 0 21980 CHEVONNE FOSTER ADMINISTRATOR 40.00 X 120164 0 20999 MICHAEL W TAMNEY CHAIRMAN 2.00 X X 0 0 0 KATIE PIPERATA VICE CHAIRMAN 2.00 X X 0 0 0 WILLIAM CLOYD TREASURER 2.00 X X 0 0 0 APRIL NOVOTNY SECRETARY 2.00 X X 0 0 0 JAMES DAN LACY TRUSTEE 1.00 X 0 0 0 MARTHA POPE TRUSTEE 1.00 X 0 0 0 JIM VERPLANCK TRUSTEE 1.00 X 0 0 0 SCOTT LANGSTON TRUSTEE 1.00 X 0 0 0 RONALD SHUCK TRUSTEE 1.00 X 0 0 0 MAUREEN BROWNE TRUSTEE 1.00 X 0 0 0 TOM BOWLES TRUSTEE 1.00 X 0 0 0 DICK HUGGINS TRUSTEE 1.00 X 0 0 0 PAUL SUICH TRUSTEE 1.00 X 0 0 0 DON SELVAGE TRUSTEE 1.00 X 0 0 0 COREY MILLER TRUSTEE 1.00 X 0 0 0 447848 0 75153 3 0 1 0 TMC QUALITY CARE REHAB 8477 S SUNCOAST BLVD HOMOSASSA FL 34446 THERAPY SERVICES 491685 GALE HEALTHCARE SOLUTIONS LLC C/O REALTIME SRVC PO BOX 4729 WINTER PARK FL 32793 STAFFING SERVICES 347247 ELLERBE CONSTRUCTION INC 4855 FOXRUN CIRCLE LAKELAND FL 33813 CONSTRUCTION SERVICES 339508 PRO MED HEALTHCARE SERVICES PO BOX 9310 WINTER HAVEN FL 33883 STAFFING SERVICES 237679 SUPERIOR MEDICAL STAFFING LLC C/O REALTIME SRVC PO BOX 4729 WINTER PARK FL 32793 STAFFING SERVICES 203696 25 485040 485040 HEALTH CENTER REVENUES 623000 5098902 5098902 INDEPENDENT LIVING SERVICES 623000 3901569 3901569 EARNED ENTRANCE FEES 623000 2741752 2741752 ASSISTED LIVING SERVICES 623000 2013064 2013064 ANCILLARY SERVICES 623000 5560 5560 13760847 347128 347128 8188170 7555993 233317 632177 -233317 398860 398860 MISCELLANEOUS INCOME 900099 67303 67303 67303 15059178 13760847 0 813291 X 381838 381838 5317474 3898456 1419018 69337 47040 22297 825813 600354 225459 420053 290967 129086 10710 10710 73270 73270 58009 58009 1667583 1400275 267308 39112 39112 104981 27932 77049 387736 247879 139857 1664716 1613629 51087 34213 13328 20885 29596 5293 24303 698830 698830 2009686 1542385 467301 616096 282623 333473 FOOD COSTS 614064 612892 1172 PROGRAM SUPPLIES 348844 348844 DUES AND SUBSCRIPTIONS 89405 13719 75686 PANDEMIC EXPENSES 85062 85062 71725 46284 25441 15618153 11775792 3842361 0 1489442 4176 934531 294807 585169 799113 127250 0 90946 92358 114354 754517 64626812 31717083 33989555 32909729 2315522 2223502 21333411 18873981 60980180 55952183 945792 1361543 15224678 14228792 15153082 14752013 38109 28054 1248038 87750 32609699 30458152 X 13332851 12913779 15037630 12580252 28370481 25494031 60980180 55952183 X -558975 -4114686 1797211 X 0 1 X 1 0 X 214479 76450 1276282 2298027 485040 4350278 15346017 15055553 14065041 14182830 13760847 72410288 15560496 15132003 15341323 16480857 14245887 76760566 0 0 0 76760566 447923 257899 408366 285597 347128 1746913 447923 257899 408366 285597 347128 1746913 140586 13360 48233 3960 67303 273442 16149005 15403262 15797922 16770414 14660318 78780921 0.97440 0.97540 0.02220 0.02160 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2018 AMOUNT: $ 140,586. 2019 AMOUNT: $ 13,360. 2020 AMOUNT: $ 48,233. 2021 AMOUNT: $ 3,960. 2022 AMOUNT: $ 67,303. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5975852 -932988 5042864 5402974 572878 5975852 4816329 586645 5402974 4080279 736050 4816329 5646211 -1565932 4080279 1.00000 1 0 2163208 2163208 50270764 22269343 28001421 1410832 1062207 348625 10251245 8117653 2133592 530763 267880 262883 32909729 DEPOSITS 176168 ASSETS LIMITED AS TO USE 18029045 INTEREST RATE SWAP ASSET 668768 18873981 RESIDENT DEPOSITS 87750 87750 X 13187983 -4114686 2068183 -2046503 15234486 58009 -233317 -175308 15059178 15793461 233317 233317 15560144 58009 58009 15618153 PART V, LINE 4: THE ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE A PERMANENT INVESTMENT TO PRODUCE INCOME TO BE USED AS A SOURCE OF FUNDING FOR BENEVOLENT ASSISTANCE FOR RESIDENTS IN ACCORDANCE WITH DONOR RESTRICTIONS. PART X, LINE 2: THE ORGANIZATION FOLLOWS THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. AS OF DECEMBER 30, 2021 AND 2020, MANAGEMENT IS NOT AWARE OF ANY UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGES IN VALUE OF SPLIT-INTEREST AGREEMENTS -50,545. NET ASSETS RELEASED FROM RESTRICTIONS 270,972. CHANGES IN VALUE OF INTEREST RATE SWAP LIABILITY 1,847,756. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS -233,317. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF ASSETS 233,317. X X X 0 0 0 0 0 0 0 0 0 JOE XANTHOPOULOS CHIEF EXECUTIVE OFFICER/ED 171481 0 0 0 0 0 7213 0 24961 0 203655 0 0 0 DAVID LARSON CHIEF FINANCIAL OFFICER 156203 0 0 0 0 0 6405 0 15575 0 178183 0 0 0 A POLK COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 591292108 2010-11-19 7500000 2010 BONDS - SEE PART VI 1 0 0 B POLK COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 591292108 2015-12-09 11000000 2015 BONDS - SEE PART VI 1 0 0 A 1500000 7500000 392850 150000 6957150 2012 0 0 1 1 B 11000000 439000 216098 8865250 1479652 2016 1 0 1 1 A 0 0 0 0 0.00190 0.00190 0 0 1 B 0 0 0 0 0.00190 0.00190 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 1 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: POLK COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/19/2020 ISSUER NAME: POLK COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/09/2020 SCH K, PART I, LINE A, COL F PURPOSE OF SERIES 2010 BONDS: IN NOVEMBER 2010, THE ORGANIZATION BORROWED $6,000,000 OF SERIES 2010A AND $1,500,000 OF SERIES 2010B HEALTH CARE FACILITIES REVENUE BONDS THROUGH THE POLK COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY (COLLECTIVELY, THE "SERIES 2010 BONDS"). THE PROCEEDS OF THE SERIES 2010 BONDS WERE USED TO (A) FINANCE THE CONSTRUCTION COSTS FOR A THREE-STORY, 28 UNIT ASSISTED LIVING APARTMENT BUILDING, AND UP TO 20 INDEPENDENT LIVING APARTMENTS AND EXECUTIVE OFFICE SPACE, (B) ESTABLISH A DEBT SERVICE RESERVE, AND (C) PAY THE COSTS OF ISSUANCE OF THE SERIES 2010 BONDS. THE SERIES 2010B BONDS CONSISTED OF A CONSTRUCTION LINE-OF-CREDIT AGREEMENT, WHICH MATURED ON DECEMBER 15, 2020. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE CORPORATION AND THE CHAIRPERSONS OF THE BOARD'S COMMITTEES PLUS THE TWO REPRESENTATIVES ELECTED BY THE RESIDENTS POPULATION. THE EXECUTIVE DIRECTOR SHALL BE AN EX-OFFICIO MEMBER WITHOUT VOTE. THE CHAIR OF THE BOARD SHALL SERVE AS CHAIR OF THE EXECUTIVE COMMITTEE. THE SECRETARY OF THE BOARD SHALL SERVE AS SECRETARY OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE POWER DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD OF DIRECTORS TO TRANSACT ANY AND ALL BUSINESS WHICH THE BOARD MAY DIRECT IT TO TRANSACT, OR WHICH MAY BE LEFT TO THE COMMITTEE BY THE BOARD, OR WHICH MAY BE NECESSARY FOR THE PROPER OPERATIONS OF THE HOMES DURING SAID INTERIM. FORM 990, PART VI, SECTION A, LINE 7A TWO MEMBERS OF THE GOVERNING BODY SHALL COME FROM THE RESIDENTS ASSOCIATION, ELECTED BY THE RESIDENTS POPULATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM, REVIEWED BY MANAGEMENT BEFORE BEING FILED WITH THE IRS, AND IS PRESENTED TO THE BOARD OF DIRECTORS OF FLORIDA PRESBYTERIAN HOMES, INC. AT ONE OF THEIR QUARTERLY BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES CERTIFY THAT THEY HAVE AND WILL DECLARE ANY CONFLICT OF INTEREST, BE IT REAL, POTENTIAL OR APPARENT, WHICH IS NOT IMMEDIATELY OBVIOUS WITH REGARD TO ANY MATTER WITHIN HIS/HER AREA OF RESPONSIBILITY. BOARD MEMBERS AND KEY EMPLOYEES SHALL AFFIRM THEIR COMPLIANCE ANNUALLY. FOR BOARD MEMBERS, DISCLOSURE STATEMENTS ARE PROVIDED TO THE EXECUTIVE DIRECTOR. FOR EMPLOYEES (I.E., MANAGERS AND SUPERVISORS, ETC.), DISCLOSURE STATEMENTS ARE PROVIDED TO THE EXECUTIVE DIRECTOR. IN THE CASE OF THE EXECUTIVE DIRECTOR, DISCLOSURE STATEMENTS ARE PROVIDED TO THE CHAIR OF THE BOARD. THE CHAIR OF THE BOARD, TOGETHER WITH THE EXECUTIVE DIRECTOR, SHALL ENSURE THAT THE IMPLEMENTATION OF THIS POLICY WILL BE FAIR, JUST AND EQUITABLE IN ALL SITUATIONS. THE OFFICERS OF THE CORPORATION ARE RESPONSIBLE FOR THE IMMEDIATE INTERPRETATION OF A BOARD MEMBER'S OR THE EXECUTIVE DIRECTOR'S CONFLICT OF INTEREST, THE EXECUTIVE DIRECTOR IS RESPONSIBLE FOR THE IMMEDIATE INTERPRETATION OF A KEY EMPLOYEE'S CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED USING COMPARABILITY DATA. THE CHIEF EXECUTIVE OFFICER/EXECUTIVE DIRECTOR'S PERFORMANCE IS REVIEWED AND COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THIS PROCESS IS DOCUMENTED DURING PERFORMANCE REVIEWS. ALL STAFF SALARIES AND BENEFITS ARE REVIEWED, AT A MINIMUM, ON AN ANNUAL BASIS BY HUMAN RESOURCES AND THE CHIEF EXECUTIVE OFFICER/EXECUTIVE DIRECTOR. THE LAST REVIEW OF ALL SALARIES WAS CONDUCTED IN 2021. IN 2022, FLORIDA PRESBYTERIAN HOMES OBTAINED COMPARABILITY DATA FROM OTHER LOCAL CCRCS, ETC. AND ALSO THE "CONTINUING CARE RETIREMENT COMMUNITY SALARY AND BENEFITS REPORT 2021-2022", PUBLISHED BY THE HOSPITAL & HEALTHCARE COMPENSATION SERVICE. IT WAS DETERMINED THAT ALL EXECUTIVE AND MANAGEMENT LEVEL SALARIES WERE FAIR AND REASONABLE. THIS PROCESS WAS DOCUMENTED DURING PERFORMANCE REVIEWS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST, AT THE FACILITY. FORM 990, PART IX, LINE 11G CONSULTANT FEES: PROGRAM SERVICE EXPENSES 58,990. MANAGEMENT AND GENERAL EXPENSES 228,605. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 287,595. THERAPY FEES: PROGRAM SERVICE EXPENSES 440,911. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 440,911. LAB AND RADIOLOGY FEES: PROGRAM SERVICE EXPENSES 22,270. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,270. TEMPORARY LABOR: PROGRAM SERVICE EXPENSES 869,279. MANAGEMENT AND GENERAL EXPENSES 8,010. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 877,289. OTHER CONTRACTS: PROGRAM SERVICE EXPENSES 2,568. MANAGEMENT AND GENERAL EXPENSES 20,912. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,480. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 6,257. MANAGEMENT AND GENERAL EXPENSES 9,781. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,038. FORM 990, PART XI, LINE 9: CHANGES IN VALUE OF SPLIT-INTEREST AGREEMENTS -50,545. CHANGES IN VALUE OF INTEREST RATE SWAP LIABILITY 1,847,756.