2022-08-10T14:02:10-05:00 2021-09-30 593070669 MSL PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2020-10-01 592867652 WATERMAN COMMUNITIES INC WATE 3523830051 250 BROOKFIELD AVENUE MOUNT DORA FL 32757 HEARDLEY MURDOCK VICE PRESIDENT/CFO 3523830051 2022-08-10 1 HEARDLEY MURDOCK 999009999 HARRY E HARP CPA P00176471 4077405400 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z WATERMAN VILLAGE OF MT DORA ANDREW DUJON 250 BROOKFIELD AVENUE MOUNT DORA FL 32757 31730253 0 X WWW.WATERMANVILLAGE.COM X 1987 FL TO PROVIDE HOUSING, HEALTHCARE AND OTHER SERVICES TO THE ELDERLY. 7 6 494 14 0 0 1211379 2891630 29487230 27523022 15986 936967 0 0 30714595 31351619 0 0 0 0 17686389 17120036 0 0 0 13869977 15258920 31556366 32378956 -841771 -1027337 47781091 148398473 59109873 161424725 -11328782 -13026252 X AS A COMMUNITY CENTERED ORGANIZATION, WATERMAN COMMUNITIES, INC. MAKES IT POSSIBLE FOR RESIDENTS TO AGE SUCCESSFULLY, LIVING THEIR BEST LIFE WITH MAXIMUM WELLNESS AND INDEPENDENCE THROUGH A BROAD RANGE OF SERVICES DELIVERED WITH CARE, INTEGRITY AND PROFESSIONALISM. 0 0 25806894 27523022 WATERMAN COMMUNITIES, INC. PROVIDES SENIOR LIVING, INDEPENDENT LIVING, ASSISTED LIVING, AND NURSING CARE TO ITS RESIDENTS. THE FILING ORGANIZATION OPERATES 56 INDEPENDENT LIVING MANOR UNITS, 203 INDEPENDENT LIVING VILLAS, 77 ASSISTED LIVING UNITS, AND A 120-BED SKILLED NURSING FACILITY, INCLUDING AN 18-BED DEMENTIA UNIT. ACROSS ALL PROGRAMS, THERE WERE 160,201 RESIDENT DAYS IN THE CURRENT YEAR.SEE SCHEDULE O FOR ADDITIONAL INFORMATION.THE EDGEWATER HEALTH CARE AND REHABILITATION CENTER, A SKILLED NURSING FACILITY, SERVES APPROXIMATELY 120 RESIDENTS IN ITS REHABILITATION THERAPY SUB-ACUTE AND SECURED DEMENTIA UNITS, AND LONG-TERM CARE NURSING FACILITY BEDS. THE INDEPENDENT LIVING UNITS SERVE APPROXIMATELY 259 ELDERLY RESIDENTS BY PROVIDING ONE MEAL PER DAY, TRANSPORTATION TO MEDICAL APPOINTMENTS, SHOPPING, ACTIVITIES, WEEKLY HOUSEKEEPING, MAINTENANCE, BASIC CABLE TELEVISION AND SOME UTILITIES. THE BRIDGEWATER ASSISTED LIVING FACILITY SERVES APPROXIMATELY 77 ELDERLY RESIDENTS WITH ASSISTANCE IN CERTAIN ACTIVITIES OF DAILY LIVING, INCLUDING A 24-HOUR NURSING STAFF; THREE MEALS DAILY; HOUSEKEEPING AND MAINTENANCE; TRANSPORTATION TO MEDICAL APPOINTMENTS AND SHOPPING ACTIVITIES; BASIC CABLE TELEVISION AND ALL UTILITIES. WATERMAN VILLAGE HOME CARE PROVIDES COMPANION/SITTERS, CNA SERVICES, NURSING SERVICES, AND REHABILITATIVE THERAPY TO INDEPENDENT LIVING AND BRIDGEWATER RESIDENTS AS WELL AS OFF-CAMPUS PEOPLE. 25806894 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 23 0 1 494 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 X HEARDLEY MURDOCK 3523830051 250 BROOKFIELD AVENUE MOUNT DORA FL 32757 ANDREW DUJON PRESIDENT/CEO 40.00 X 409837 0 13626 HEARDLEY MURDOCK VICE PRESIDENT/CFO 40.00 X 201326 0 13626 DAVID NWOGU EXECUTIVE DIRECTOR 40.00 X 175121 0 13626 RODGER REEVES VICE PRESIDENT 40.00 X 135172 0 0 SANDRA VAN SYCKEL RISK MANAGER 40.00 X 129538 0 0 THERESE KIRLEW HOME CARE ADMINISTRATOR 40.00 X 133907 0 0 TITO ARDINES HR MANAGING DIRECTOR 40.00 X 123429 0 9639 KEVIN W MCEWEN CHAIRMAN 2.00 X X 0 0 0 JOHN J COFFEY VICE CHAIRMAN 2.00 X X 0 0 0 KIM Y STEWART TREASURER 2.00 X X 0 0 0 THOMAS POPIESKI SECRETARY 2.00 X X 0 0 0 RICHARD A LEIGH DIRECTOR 2.00 X 0 0 0 GUSTAV SCHEUNEMAN DIRECTOR 2.00 X 0 0 0 GARY SKILTON DIRECTOR 2.00 X 0 0 0 1308330 0 50517 9 0 1 0 TITAN FLORIDA LLC PO BOX 932622 ATLANTA GA 31193 CONSTRUCTION SERVICES 1602215 RICK TANNER BUILDERS INC 21502 PARADISE WAY EUSTIS FL 32736 CONSTRUCTION SERVICES 1176803 SODEXO INC & AFFILIATES PO BOX 905374 CHARLOTTE NC 28290 DINING SERVICES 982447 EIGHT TWENTY 8 DESIGN LLC 10422 MENCHACA ROAD AUSTIN TX 78748 CONSULTING SERVICES 836655 BANNING LUMBER & MILLWORK 12595 BELCHER ROAD SOUTH LARGO FL 33773 CONSTRUCTION SERVICES 832736 24 2891300 330 2891630 RESIDENT SERVICE REVENUE 623000 13677956 13677956 PATIENT SERVICE REVENUE 623990 10449046 10449046 HOME HEALTH REVENUE 623000 1934482 1934482 EARNED ENTRANCE FEES 623000 829996 829996 OTHER RESIDENT REVENUE 623000 631542 631542 27523022 985225 985225 330376 378634 -48258 -48258 -48258 31351619 27523022 0 936967 808585 808585 13456361 11494776 1961585 1846529 1477582 368947 1008561 831474 177087 48000 48000 1606187 1132946 473241 684643 684643 501703 22100 479603 2361213 2147466 213747 952692 723831 228861 3387799 2710953 676846 1082059 865682 216377 FOOD AND DIETARY USAGE 2423200 2384512 38688 EXTINGUISHMENT OF DEBT 813203 813203 MEDICAL SUPPLIES 535137 535137 OTHER EXPENSES 437009 261227 175782 426075 406005 20070 32378956 25806894 6572062 0 8850271 10028693 5485543 62158946 1735709 1314164 74637 93398 996354 582667 128908602 55397908 29916741 73510694 436015 441133 285821 268778 47781091 148398473 3407374 7492293 3606985 3352249 16415166 125603152 10092807 3700459 779771 21887082 24197260 59109873 161424725 X -11328782 -13026252 -11328782 -13026252 47781091 148398473 X -1027337 -650646 -19487 X X 0 1 X 1 0 X 189634 238503 177674 1211379 2891630 4708820 29634852 31646671 30365711 29487230 27523022 148657486 29824486 31885174 30543385 30698609 30414652 153366306 0 0 0 153366306 38527 196664 92172 985225 1312588 38527 196664 92172 985225 1312588 709048 633482 516368 1858898 30533534 32557183 31256417 30790781 31399877 156537792 0.97970 0.98090 0.00840 0.00240 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 11610 436 11174 0 3711303 3711303 54203669 42082822 12120847 18635194 13315086 5320108 52358436 52358436 73510694 OTHER LIABILITIES 916902 REFUNDABLE ENTRANCE FEES LIABILITY 10201835 LAKESIDE RESERVATION DEPOSITS 4774443 RESERVATION DEPOSIT LIABILITIES 8304080 24197260 X 29868283 -650646 -832690 -1483336 31351619 0 31351619 31565753 0 31565753 813203 813203 32378956 PART IV, LINE 1B: THE COMMUNITY PROVIDES A CASH MANAGEMENT SERVICE TO ITS RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF EACH RESIDENT, TO BE DISBURSED ONLY AS REQUESTED AND, ACCORDINGLY, THESE FUNDS ARE EXCLUDED FROM THESE COMBINED FINANCIAL STATEMENTS. THE COMMUNITY HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. AT SEPTEMBER 30, 2021 AND 2020, THESE FUND BALANCES WERE APPROXIMATELY $11,200 AND $11,600, RESPECTIVELY. PART X, LINE 2: THE COMMUNITY IS ORGANIZED AS A NOT-FOR-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF FLORIDA AND HAS BEEN GRANTED RECOGNITION OF ITS TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, NO INCOME TAX LIABILITY OR PROVISION FOR INCOME TAXES IS REFLECTED IN THESE COMBINED FINANCIAL STATEMENTS. THE COMMUNITY'S TAX RETURNS FOR THE LAST THREE YEARS ARE SUBJECT TO INCOME TAX EXAMINATION BY U.S. FEDERAL OR STATE OF FLORIDA TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF WATERMAN VILLAGE FOUNDATION -17,043. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -2,444. LOSS ON EXTINGUISHMENT OF DEBT -813,203. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON EXTINGUISHMENT OF DEBT 813,203. X X 0 1 0 0 0 1 0 0 0 ANDREW DUJON PRESIDENT/CEO 298000 0 61583 0 50254 0 0 0 13626 0 423463 0 0 0 HEARDLEY MURDOCK VICE PRESIDENT/CFO 154577 0 20083 0 26666 0 0 0 13626 0 214952 0 0 0 DAVID NWOGU EXECUTIVE DIRECTOR 142271 0 17212 0 15638 0 0 0 13626 0 188747 0 0 0 PART I, LINE 4B ALL MANAGING DIRECTORS ARE ELIGIBLE TO PARTICIPATE IN THE NON-QUALIFED DEFERRED COMPENSATION PLAN ESTABLISHED BY THE ORGANIZATION. ALL COMPENSATED INDIVIDUALS LISTED ON PART VII PARTICIPATE IN THE PLAN, AND NONE OF THESE INDIVIDUALS WITHDREW MONIES FROM THE PLAN DURING THE REPORTING YEAR. NO WITHDRAWALS CAN BE MADE FROM THE PLAN EXCEPT UNDER THE FOLLOWING CIRCUMSTANCES, (1) RETIREMENT - AGE 65, (2) TERMINATION OF EMPLOYMENT, (3) DEATH, (4) UNFORESEEABLE EMERGENCY, (5) DE MINIMIS EXCEPTION, OR (6) AGE 70 1/2 REQUIRED MINIMUM DISTRIBUTION. AFTER FIVE YEARS OF SERVICE, THE EARNED OWNERSHIP INTEREST (VESTING) OF THE EMPLOYER CONTRIBUTIONS BECOMES 100%. PART I, LINE 6 CEO AND CFO BONUSES ARE BASED ON OPERATIONAL PROFIT, NOT INCLUDING EXTRAORDINARY ITEMS. A MOUNT DORA HEALTH FACILITIES AUTHORITY 596000380 2016-02-26 23000000 SEE SUPPLEMENTAL INFORMATION 0 0 0 B LAKE COUNTY FLORIDA 596000695 50826FAD5 2020-10-08 126340000 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 6586000 23000000 1150000 7374621 449982 14025397 2016 1 0 1 1 B 123507807 7153488 22639925 2470156 91244238 2020 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 0 A 1 B 1 SCHEDULE K, PART I, LINE A(F) IN FEBRUARY 2016, THE COMMUNITY ISSUED THE MOUNT DORA HEALTH FACILITIES AUTHORITY SERIES 2016 TAX-EXEMPT BONDS CONSISTING OF $23,000,000 OF TAX-EXEMPT SERIES 2016A BONDS. THE PROCEEDS OF THE SERIES 2016 BONDS WERE USED TO: (1) REFUND THE SERIES 2002 AND 2004 BONDS, AS WELL AS A PROMISSORY NOTE BALANCE OF APPROXIMATELY $836,000, (2) FUND A DEBT SERVICE RESERVE FUND FOR THE SERIES 2016 BONDS, (3) FUND CAPITAL EXPENDITURES, AND (4) PAY THE COSTS ASSOCIATED WITH THE ISSUANCE OF THE SERIES 2016 BONDS. SCHEDULE K, PART I, LINE B(F) ON OCTOBER 8, 2020, THE COMMUNITY COMPLETED THE SERIES 2020 LAKE COUNTY, FLORIDA, RETIREMENT FACILITY REVENUE BONDS (THE "SERIES 2020 BONDS") FINANCING OF APPROXIMATELY $126,340,000 IN CONNECTION WITH THE DEVELOPMENT OF THE LAKESIDE EXPANSION CAMPUS. THE PROCEEDS OF THE SERIES 2020 BONDS ARE TO BE USED TO (1) FINANCE THE COST OF CONSTRUCTING, DEVELOPING, MARKETING, ACQUIRING AND EQUIPPING THE LAKESIDE EXPANSION PROJECT, (2) REPAYMENT OF THE SERIES 2018 REVENUE BOND ANTICIPATION NOTES AND THE SERIES 2016 BONDS, (3) FUND INTEREST ON THE PORTION OF THE SERIES 2020 BONDS ALLOCATED TO THE LAKESIDE EXPANSION PROJECT (4) FUND A DEBT SERVICE RESERVE FUND FOR EACH SERIES OF THE SERIES 2020 BONDS (5) PAY THE COSTS ASSOCIATED WITH THE ISSUANCE OF THE SERIES 2020 BONDS, AND (6) REPAY CERTAIN PREVIOUSLY OUTSTANDING PROMISSORY NOTE BALANCES. THE SERIES 2020 BONDS ARE COLLATERALIZED BY SUBSTANTIALLY ALL ASSETS (INCLUDING A MORTGAGE ON THE REAL PROPERTY OF THE COMMUNITY), REVENUES, INCOME, AND RECEIPTS OF THE COMMUNITY. HILLCREST INSURANCE AGENCY ENTITY OWNED MORE THAN 35% BY BOARD MEMBER, KEVIN MCEWEN 84133 INSURANCE 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CHIEF FINANCIAL OFFICER CONDUCTS A COMPREHENSIVE REVIEW OF THE FORM 990 BEFORE IT IS FILED. A COPY OF THE RETURN, AS ULTIMATELY FILED, IS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE ANNUAL DISCLOSURE PROCESS AND PROHIBITS OFFICERS AND DIRECTORS FROM VOTING ON MATTERS WHERE ACTUAL CONFLICTS OF INTEREST EXIST. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS DETERMINES THE COMPENSATION AND BENEFITS OF THE CHIEF EXECUTIVE OFFICER. THE CEO DETERMINES THE COMPENSATION AND BENEFITS OF OTHER OFFICERS AND KEY EMPLOYEES. THE BOARD AND CEO ARE INDEPENDENT WITH RESPECT TO THE COMPENSATION ARRANGEMENTS BEING CONSIDERED. THE BOARD UTILIZES COMPARABILITY SURVEYS PROVIDED BY THE ORGANIZATION'S CPA FIRM. THE REVIEW AND APPROVAL PROCESS IS DOCUMENTED IN BOARD MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -2,444. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF WATERMAN VILLAGE FOUNDATION -17,043. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. LAKESIDE AT WATERMAN VILLAGE LLC 250 BROOKFIELD AVENUE MOUNT DORA FL 32757 592867652 DEVELOPMENT OF NEW CAMPUS FOR WATERMAN COMMUNITIES, INC. FL 979867 114825749 WATERMAN COMMUNITIES INC WATERMAN COMMUNITIES FOUNDATION INC 250 BROOKFIELD AVENUE MOUNT DORA FL 32757 030386001 RAISES FUNDS FOR THE BENEFIT OF WATERMAN COMMUNITIES, INC. FL 501(C)(3) LINE 12A, I N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1