2024-03-07T05:46:00-06:00 2023-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2022-07-01 270280268 GARDEN SPOT VILLAGE OF AKRON D/B/A MAPLE FARMS NURSING CENTER GARD 7173556000 433 SOUTH KINZER AVENUE NEW HOLLAND PA 17557 NATHANIEL WEBER CFO 7173556000 2024-03-05 1 NATHANIEL WEBER XXX-XX-XXXX 0 KERRI N BOGDA CPA P00760402 7177404863 2024-03-05 X 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MAPLE FARMS NURSING CENTER STEPHEN D LINDSEY 433 SOUTH KINZER AVENUE NEW HOLLAND PA 17557 7195267 0 X WWW.GARDENSPOTVILLAGE.ORG X 2009 PA OPERATE A SKILLED NURSING FACILITY TO ENRICH THE LIVES OF OLDER ADULTS. 10 10 149 15 0 0 1075047 998383 5600676 6182482 0 0 5834 3443 6681557 7184308 0 0 0 0 4204928 4754963 0 0 0 2402790 2517365 6607718 7272328 73839 -88020 7057442 6642740 9083222 8756540 -2025780 -2113800 TO ENRICH THE LIVES OF OLDER ADULTS AS AN EXPRESSION OF CHRIST'S LOVE. GARDEN SPOT VILLAGE OF AKRON IS A CCRC WHICH PROVIDES SERVICES TO SKILLED NURSING RESIDENTS. 0 0 6569728 0 6182482 PROVIDED SKILLED NURSING CARE IN A 46 BED, MEDICARE/MEDICAID CERTIFIED FACILITY FOR AN AVERAGE OF 43 RESIDENTS. GARDEN SPOT VILLAGE OF AKRON PROVIDED OVER $1,416,000 OF UNREIMBURSED CARE. 6569728 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 0 1 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 1 0 0 0 1 X 23 0 149 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 PA X NATHANIEL WEBER CFO 7173556049 433 SOUTH KINZER AVENUE NEW HOLLAND PA 17557 JEFF GOSS CHAIR 1.00 4.00 X X 0 0 0 JOYCE HOOVER VICE CHAIR 1.00 4.00 X X 0 0 0 KAREN MUSSER SECRETARY 1.00 4.00 X X 0 0 0 TIMOTHY BENDER TREASURER 1.00 4.00 X X 0 0 0 ALPHAUS STOLTZFUS DIRECTOR 1.00 4.00 X 0 0 0 DONALD ALDRICH DIRECTOR 1.00 4.00 X 0 0 0 EJ RITTERSPACH DIRECTOR 1.00 4.00 X 0 0 0 DAVID VEGA DIRECTOR 1.00 4.00 X 0 0 0 PHIL HESS DIRECTOR 1.00 4.00 X 0 0 0 CARL EDWARDS DIRECTOR 1.00 4.00 X 0 0 0 STEPHEN LINDSEY CEO 5.00 50.00 X 0 275421 44753 NATHANIEL WEBER CFO 5.00 50.00 X 0 135742 33786 STEVE MULLER COO 5.00 50.00 X 0 166329 32255 SHANNON SEST NURSING HOME ADMIN TO 2/22/23 40.00 0.00 X 113546 0 609 D SCOTT MILLER CMO 5.00 45.00 X 0 138654 14750 LOIS DOSTALK TRANSFORMATIONAL ARCHITECT 5.00 45.00 X 0 119460 9122 BRYAN GROFF DIRECTOR OF HR 5.00 45.00 X 0 109504 29346 LORA GOMBAC DIR. OF HEALTHCARE SERVICES 5.00 50.00 X 0 142104 29584 DALE BEILER FORMER TREASURER TO 6/11/22 5.00 50.00 X 0 100741 21308 113546 1187955 215513 4 1 1 0 COVENANT ALLIANCE REHAB EAST 28100 TORCH PARKWAY SUITE 600 WARRENVILLE IL 60555 PHYS, OCCUP, SPEECH THERAPY 274805 1 898492 98031 1860 998383 NET RESIDENT REVENUE 623000 6182482 6182482 6182482 13800 10959 2841 2841 2841 MISCELLANEOUS 900099 602 602 602 7184308 6182482 0 3443 3768125 3522275 245850 81478 76538 4940 631869 590308 41561 273491 254904 18587 85320 85320 14649 14649 6000 6000 662 662 429718 422423 7295 2486 2486 150849 127042 23807 123516 30883 92633 219048 219048 37087 24397 12690 132228 132228 300922 300922 56416 56416 MEDICAL SUPPLIES 254190 254190 FOOD 154376 153998 378 REPAIRS & MAINTENANCE 139471 137809 1662 PA NURSING HOME ASSESSM 112393 112393 298034 210370 87664 7272328 6569728 702600 0 306721 247076 958364 750174 8476 8179 104317 78475 8760309 3220251 5655638 5540058 23926 18686 0 92 7057442 6642740 361155 315543 35163 0 2805000 2645000 23926 18686 5857978 5777311 9083222 8756540 X -2026100 -2115236 320 1436 -2025780 -2113800 7057442 6642740 -88020 0 X 0 1 X 1 0 X 1034023 1123763 1280725 1075047 998383 5511941 5490936 5289152 5410471 5600676 6182482 27973717 6524959 6412915 6691196 6675723 7180865 33485658 0 0 0 33485658 13800 16424 13800 16424 13800 74248 13800 16424 13800 16424 13800 74248 6787 41 254 602 7684 6538759 6436126 6705037 6692401 7195267 33567590 0.99760 0.99740 0.00220 0.00230 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS - 2019 AMOUNT: $ 6,787. 2020 AMOUNT: $ 41. 2021 AMOUNT: $ 254. 2022 AMOUNT: $ 602. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 662 662 0 PART II-B, LINE 1: GSV OF AKRON PAID $662 IN DUES TO LEADING AGE PA AND LEADING AGE NATIONAL DUES. 0 1 X 988161 988161 6510710 2232197 4278513 1103405 889968 213437 158033 98086 59947 5540058 DUE TO AFFILIATES 5777311 5777311 7195267 10959 10959 7184308 0 7184308 7283287 10959 10959 7272328 0 7272328 PART IV, LINE 2B: RESIDENT ESCROW FUNDS - THESE FUNDS ARE FOR MEDICAID RESIDENTS THAT GARDEN SPOT VILLAGE OF AKRON IS THE REPRESENTATIVE PAYEE FOR. THESE FUNDS ARE HELD IN A SEPARATE INTEREST BEARING CHECKING ACCOUNT. THEY ARE RECORDED ON THE BALANCE SHEET AS BOTH AN ASSET AND A LIABILITY. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 10,959. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 10,959. 0 0 0 0 0 0 0 0 0 STEPHEN LINDSEY CEO 0 275421 0 0 0 0 0 27000 0 17753 0 320174 0 0 STEVE MULLER COO 0 166329 0 0 0 0 0 8722 0 23533 0 198584 0 0 LORA GOMBAC DIR. OF HEALTHCARE SERVICES 0 142104 0 0 0 0 0 9200 0 20384 0 171688 0 0 NATHANIEL WEBER CFO 0 135742 0 0 0 0 0 10339 0 23447 0 169528 0 0 D SCOTT MILLER CMO 0 138654 0 0 0 0 0 7075 0 7675 0 153404 0 0 DALE BEILER FORMER TREASURER TO 6/11/22 0 100741 0 0 0 0 0 13000 0 8308 0 122049 0 0 PART I, LINE 3 THE CEO IS AN EMPLOYEE OF GARDEN SPOT VILLAGE ("GSV"). GSV USES THE FOLLOWING TO ESTABLISH HIS COMPENSATION: COMPENSATION COMMITTEE, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD AND COMPENSATION COMMITTEE. A LANCASTER MUNCIPAL AUTHORITY 237334160 2011-05-13 3720000 RENOVATE MF NURSING CENTER INTO HOUSEHOLDS 0 0 0 A 1075000 3720000 3720000 2013 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 A 1 FORM 990, PART V, LINE 2A: SALARIES AND BENEFITS REPORTED ON PART IX ARE ALLOCATED EXPENSES FOR TIME THAT INDIVIDUALS WORK ON GARDEN SPOT VILLAGE OF AKRON. ALL EMPLOYEES ARE EMPLOYEES OF GARDEN SPOT VILLAGE ("GSV"), RELATED ORGANIZATION. GSV FILES ALL REQUIRED EMPLOYMENT TAX RETURNS UNDER ITS EIN 23-2640814. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS GARDEN SPOT COMMUNITIES ("GSC"). FORM 990, PART VI, SECTION A, LINE 7A THE CEO OF GSC OR HIS/HER DESIGNEE SHALL SERVE AS A VOTING MEMBER OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B WITHOUT THE APPROVAL OF THE MEMBER, GSC, THE BOARD MAY NOT: (A) INITIATE, CEASE, OR SIGNIFICANTLY MODIFY ANY FUND-RAISING OR SOLICITATION ACTIVITIES; (B) CHANGE THE AREA SERVED BY THE CORPORATION; (C) BORROW MORE THAN $10,000 UNDER TERMS WHICH PROVIDE FOR A REPAYMENT PERIOD IN EXCESS OF THREE MONTHS; (D) ENTER INTO ANY LEASES WHICH WOULD OBLIGATE THE CORPORATION TO MAKE RENTAL PAYMENTS IN EXCESS OF $10,000 PER YEAR; (E) PURCHASE INSURANCE POLICIES OTHER THAN POLICIES WHICH COMPLY WITH ANY REQUIREMENT SET FORTH IN ANY AGREEMENT ENTERED INTO BY THE CORPORATION; (F) UNDERTAKE ANY CAPITAL EXPENDITURES IN EXCESS OF $5,000 AND ANY CAPITAL EXPENDITURES INVOLVING RELATED PROJECTS WHICH, IN THE AGGREGATE, EXCEED $25,000; (G) ADOPT ANY ORIGINAL OR REVISED CAPITAL OR OPERATING BUDGETS WHICH WOULD RESULT IN ANY EXPENDITURE IN EXCESS OF $10,000 OVER ANTICIPATED REVENUE; (H) AMEND THE CORPORATION'S ARTICLES OF INCORPORATION OR THE BYLAWS; (I) INITIATE, CEASE, OR SIGNIFICANTLY MODIFY ANY OF THE CORPORATION'S LINES OF SERVICE, PRODUCTS OR PROGRAMS; (J) SELL, RELINQUISH, OR OTHERWISE AUTHORIZE A CHANGE IN CONTROL OF MORE THAN 10% OF THE ASSETS OF THE CORPORATION; (K) SELECT, REMOVE OR REPLACE INDEPENDENT ACCOUNTANTS AND AUDITORS FOR THE CORPORATION; (L) AUTHORIZE FUNDAMENTAL CHANGES TO THE CORPORATION, INCLUDING THE ADOPTION OF A PLAN OF DISSOLUTION OF THE CORPORATION; THE ADOPTION OF A PLAN OF MERGER, CONSOLIDATION, DIVISION, CONVERSION OR AFFILIATION WITH ANOTHER ENTITY; AND CHANGE TO THE CURRENT CORPORATION'S CORPORATE ORGANIZATIONAL STRUCTURE; (M) AUTHORIZE AND DESIGNATE OFFICERS OF THE CORPORATION TO EXECUTE A DEED OF ASSIGNMENT FOR THE BENEFIT OF CREDITORS; FILE A VOLUNTARY PETITION IN BANKRUPTCY; FILE AN ANSWER CONSENTING TO THE APPOINTMENT OF A RECEIVER; OR FILE AN ANSWER TO AN INVOLUNTARY PETITION IN BANKRUPTCY; (N) ORGANIZE OR ACQUIRE ANY SUBSIDIARY OR AFFILIATE; (O) CHANGE THE CORPORATION'S FISCAL YEAR; (P) ELECTION OF THE OFFICERS FOR THE CORPORATION; OR (Q) THE DETERMINATION TO INDEMNIFY A REPRESENTATIVE AS PROVIDED IN SECTION 10.2 OF THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED IN DETAIL BY THE TREASURER/CFO. A COPY OF THE 990 IS THEN PROVIDED TO EACH BOARD MEMBER VIA E-MAIL FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY. BOARD MEMBERS ARE REQUIRED TO COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT EACH YEAR WHICH ARE MAINTAINED BY MANAGEMENT. THE CEO & CHAIRMAN OF THE BOARD ENSURE THAT EVERYONE HAS COMPLETED A STATEMENT AND REVIEW EACH FORM FOR ANY POTENTIAL CONFLICTS. ANY CONFLICTS ARE DEALT WITH ON AN AS-NEEDED BASIS. CONFLICTS WOULD BE DOCUMENTED AND THE BOARD MEMBER WOULD REFRAIN FROM ANY VOTE FOR WHICH THERE IS A CONFLICT OF INTEREST. COMPLIANCE WITH THE POLICY IS MONITORED BY THE BOARD CHAIR AND CEO. NO CONFLICTS WERE NOTED FOR THE CURRENT YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AND FINANCIAL STATEMENTS ALSO THROUGH AN ANNUAL DISCLOSURE STATEMENT FILING WITH STATE. GARDEN SPOT VILLAGE 433 SOUTH KINZER AVENUE NEW HOLLAND PA 17557 232640814 NURSING HOME FACILITY PA 501(C)(3) LINE 10 GARDEN SPOT COMMUNITIES 0 GARDEN SPOT COMMUNITIES 433 SOUTH KINZER AVENUE NEW HOLLAND PA 17557 811141253 MANAGEMENT SERVICES PA 501(C)(3) LINE 12C, III-FI N/A 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1