2022-10-31T15:02:10-05:00 2021-12-31 134008324 PRICEWATERHOUSECOOPERS LLP 76 S LAURA STREET SUITE 2100 JACKSONVILLE FL 32202 990 2021-01-01 262386152 BONITA SPRINGS RETIREMENT VILLAGE INC BONI 3523728400 SANTAFE HEALTHCARE INC PO BOX 749 GAINESVILLE FL 326270749 PHILIP G BOWLING ASSISTANT TREASURER 3523728400 2022-10-31 1 PHILIP BOWLING 999009999 NADER FARHAT P01004599 9043540671 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z THE TERRACES AT BONITA SPRINGS LAWRENCE G SCHREIBER SANTAFE HEALTHCARE INC PO BOX 749 GAINESVILLE FL 326270749 19006932 0 X WWW.THETERRACESATBONITASPRINGS.COM X 2008 FL TO PROVIDE HIGH QUALITY CONTINUING CARE RETIREMENT SERVICES TO SENIOR CITIZENS. 10 9 286 0 0 0 611593 607979 18648560 18189621 734161 140790 0 0 19994314 18938390 0 0 0 0 7288532 8241009 0 0 0 18945611 19841860 26234143 28082869 -6239829 -9144479 107065105 109847615 198152744 178421050 -91087639 -68573435 TO PROVIDE HIGH QUALITY CONTINUING CARE RETIREMENT SERVICES AND FACILITIES TO BENEFIT THE LARGEST POSSIBLE SEGMENT OF THE SENIOR POPULATION LIVING IN BONITA SPRINGS, FLORIDA AND THE SURROUNDING AREAS. 0 0 11377127 9097707 BONITA SPRINGS RETIREMENT VILLAGE, INC. PROVIDED CLEANING, LAUNDRY, MAINTENANCE, MEALS, SECURITY AND UTILITIES TO SENIORS IN RESIDENTIAL UNITS. THE AVERAGE NUMBER OF INDIVIDUALS SERVED PER DAY IN 2021 WERE APPROXIMATELY 164. 5702856 3879150 BONITA SPRINGS RETIREMENT VILLAGE, INC. PROVIDED CLEANING, LAUNDRY, MAINTENANCE, MEALS, SECURITY AND UTILITIES TO ASSISTED LIVING AND MEMORY SUPPORT SENIORS IN RESIDENTIAL UNITS. THE TOTAL RESIDENT DAYS SERVED IN 2021 WERE 17,636. 6876479 5212764 BONITA SPRINGS RETIREMENT VILLAGE, INC. PROVIDED SKILLED NURSING AND RELATED HEALTH CARE SERVICES, INCLUDING THERAPY FOR INDIVIDUALS WHO ARE UNABLE TO CARE FOR THEMSELVES. THE TOTAL PATIENT DAYS SERVED IN 2021 WERE 10,862. 23956462 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 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 1 0 1 124 0 1 286 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X PHILIP G BOWLING ASST TREASURER 3523728400 4300 NW 89TH BLVD GAINESVILLE FL 326065688 X LAWRENCE G SCHREIBER CHIEF EXECUTIVE OFFICER/DIRECTOR 1.50 58.50 X X 0 2065713 368929 STEVEN M ZIEGLER ASSISTANT SECRETARY 0.50 59.50 X 0 1382460 41751 RANDALL L STUART ASSISTANT TREASURER 0.50 59.50 X 0 951678 141554 TROY R HART PRESIDENT 15.00 45.00 X 0 590403 75966 DAVID GRAY HEALTH CARE ADMINISTRATOR 40.00 0.00 X 137344 0 20067 LISA COX NURSING DIRECTOR 40.00 0.00 X 114061 0 8235 RACHEL L HENDERSON DIRECTOR OF COMMISSION REL AND SALES 40.00 0.00 X 103824 0 8493 PHYLLIS M LAM-FLACK DIRECTOR OF OPERATIONS 40.00 0.00 X 102738 0 7644 GLENDA E HOOD CHAIR/DIRECTOR 0.10 2.90 X X 0 71800 0 JACKSON N SASSER PHD VICE CHAIR/DIRECTOR 0.10 1.40 X X 0 59050 0 BENJAMIN I DOERR JR DIRECTOR 0.10 1.40 X 0 59050 0 ROBERT L EPLING TREASURER/DIRECTOR 0.10 1.40 X X 0 56650 0 KATHERINE L FERNANDEZ DIRECTOR 0.10 1.40 X 0 56650 0 JAMES D LEE DIRECTOR 0.10 1.40 X 0 56650 0 PAMELA J MOONEY PHD DIRECTOR 0.10 1.40 X 0 56650 0 JOSEPH W DAVIS DIRECTOR 0.10 1.40 X 0 54250 0 GEORGE E FLETCHER DIRECTOR 0.10 1.40 X 0 54250 0 ALBERT E DOTSON PHD SECRETARY/DIRECTOR (THRU 5/29/21) 0.10 1.40 X X 0 27125 0 457967 5542379 672639 4 0 1 0 SANTAFE SENIOR LIVING INC PO BOX 749 GAINESVILLE FL 326270749 MANAGEMENT 1234457 REHABCARE GROUP EAST LLC PO BOX 503534 SAINT LOUIS MO 63150 OCCUPATIONAL/PHYSICAL THERAPY 589938 CAREMASTERS HEALTHCARE SERVICES LLC PO BOX 2599 SARASOTA FL 34230 HEALTHCARE SERVICES 435147 SANTAFE MANAGEMENT SERVICES LLC PO BOX 749 GAINESVILLE FL 326270749 MANAGEMENT 358186 ALLIED UNIVERSAL 161 WASHINGTON STREET SUITE 6 CONSHOHOCKEN PA 19428 SECURITY SERVICES 208026 8 63072 544907 607979 MONTHLY SERVICE FEES 531110 13384065 13384065 RESIDENT SERVICES 900099 4805556 4805556 18189621 220697 220697 -26365 -26365 15000 68542 -53542 -53542 -53542 18938390 18189621 0 140790 7146013 6641886 504127 25967 23693 2274 577517 538990 38527 491512 452186 39326 1600459 1600459 149649 149649 40394 40394 21143 21143 1060126 590755 469371 713125 713125 504702 302295 202407 103731 103731 1750765 1637076 113689 8091 4489 3602 33869 21115 12754 7201782 6841693 360089 3289838 2960854 328984 925941 833347 92594 FOOD & FOOD SERVICES 826338 826338 THERAPY SERVICES 664722 664722 MEDICAL SUPPLIES 342597 342597 EQUIP RENTAL AND MAINT 250676 238939 11737 353912 322362 31550 28082869 23956462 4126407 0 500 500 961435 2324085 544680 888430 78999 78791 126632 165211 114588348 29431588 87515195 85156760 1134805 5236304 16702859 15997534 107065105 109847615 918445 1425589 68098 72059 79951546 79034558 117214655 97888844 198152744 178421050 X -91557091 -69128785 469452 555350 -91087639 -68573435 107065105 109847615 X -9144479 -387417 32046100 X X 0 1 X 1 0 X 71582 56278 36037 611593 607979 1383469 17975784 17826459 19060754 18648560 18189621 91701178 18047366 17882737 19096791 19260153 18797600 93084647 0 0 0 93084647 565726 378270 506467 756718 194332 2401513 565726 378270 506467 756718 194332 2401513 2499 2499 18615591 18261007 19603258 20016871 18991932 95488659 0.97480 0.97020 0.02510 0.02980 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS OTHER INCOME - 2017 AMOUNT: $ 2,499. 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 0. 2020 AMOUNT: $ 0. 2021 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7509563 7509563 100114008 24080857 76033151 6559603 5350731 1208872 405174 405174 85156760 CASH & INVESTMENTS HELD BY TRUSTEE 10631728 ESCROW ACCOUNTS REQUIRED BY FLORIDA 2009862 RESIDENT RESERVATION DEPOSITS 1307761 DEFERRED CONTRACT ACQUISTION COSTS 1201191 BENEFICIAL INTEREST IN NET ASSETS OF SANTAFE SENIOR LIVING FOUNDATION, INC. 555350 DEFERRED FINANCING COSTS - NET 224833 RIGHT OF USE ASSETS 34809 ASSISTED LIVING DEPOSITS 32000 15997534 REFUNDABLE ENTRANCE FEES 66772620 DEFERRED INCOME - ENTRANCE FEES 19642932 FUTURE SERVICE OBLIGATION 9349000 DUE TO AFFILIATES 1200343 BOND INTEREST PAYABLE 817484 RESERVATION DEPOSITS 72212 LEASE LIABILITY 34253 97888844 X 18875318 0 18875318 63072 63072 18938390 28082869 0 28082869 0 28082869 PART X, LINE 2: EXPLANATION FOR UNCERTAIN TAX POSITIONS UNDER ASC 740: BONITA SPRINGS RETIERMENT VILLAGE, INC. IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. BONITA SPRINGS RETIREMENT VILLAGE, INC. IS SUBJECT TO INCOME TAXES ON UNRELATED BUSINESS INCOME. BONITA SPRINGS RETIREMENT VILLAGE, INC. INCURRED NO INCOME TAX EXPENSE IN 2021 AND 2020 AND HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021 OR 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION FROM RELATED ORGANIZATIONS RECOGNIZED FOR TAX 63,072. 0 1 0 0 0 0 0 0 0 LAWRENCE G SCHREIBER CHIEF EXECUTIVE OFFICER/DIRECTOR 0 1031801 0 983856 0 50056 0 341826 0 27103 0 2434642 0 0 STEVEN M ZIEGLER ASSISTANT SECRETARY 0 409764 0 210927 0 761769 0 11641 0 30110 0 1424211 0 443834 RANDALL L STUART ASSISTANT TREASURER 0 514448 0 262007 0 175223 0 116730 0 24824 0 1093232 0 88421 TROY R HART PRESIDENT 0 388935 0 114984 0 86484 0 51657 0 24309 0 666369 0 35776 DAVID GRAY HEALTH CARE ADMINISTRATOR 136554 0 0 0 790 0 0 0 20067 0 157411 0 0 0 PART I, LINE 3 LAWRENCE G SCHREIBER IS THE CHIEF EXECUTIVE OFFICER (CEO) OF BONITA SPRINGS RETIREMENT VILLAGE, INC. MR. SCHREIBER IS COMPENSATED BY SANTAFE HEALTHCARE, INC., A RELATED SUPPORTING ORGANIZATION. SANTAFE HEALTHCARE, INC. UTILIZES THE FOLLOWING PROCESS TO ESTABLISH THE CEO'S COMPENSATION AND BENEFITS: ANNUALLY, THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS CONSULTING FIRM (FIRM) TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE CEO'S TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISON TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. THE FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ESTABLISHES THE FINAL COMPENSATION AND BENEFIT PACKAGE FOR THE CEO TAKING INTO CONSIDERATION THE MARKET COMPETITIVENESS REVIEW AND FINAL RECOMMENDATION OF THE FIRM. THE FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE CEO'S FINAL COMPENSATION AND BENEFITS PACKAGE. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. PART I, LINE 4B (RELATES TO PART I, LINE 4A): LISTED PERSONS ARE EMPLOYEES OF BONITA SPRINGS RETIREMENT VILLAGE, INC. OR RELATED ORGANIZATIONS. BONITA SPRINGS RETIREMENT VILLAGE, INC. EMPLOYEES ARE NOT COVERED BY A FORMAL SEVERANCE POLICY; SEVERANCE IS HANDLED ON A CASE BY CASE BASIS. EMPLOYEES OF RELATED ORGANIZATIONS ARE COVERED BY A SEVERANCE POLICY WHICH INCLUDES MONTHLY PAYMENTS UP TO A MAXIMUM OF 12 - 36 MONTHS UNDER QUALIFYING CIRCUMSTANCES AND DEPENDING ON POSITION. NO ONE LISTED RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS DURING 2021. PART I, LINE 4B: LISTED PERSONS PARTICIPATING IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE YEAR: LAWRENCE G SCHREIBER, RANDALL L STUART, STEVEN M ZIEGLER AND TROY R HART ARE EMPLOYEES OF SANTAFE HEALTHCARE, INC., A RELATED SUPPORTING ORGANIZATION. THEY PARTICIPATE IN TWO NONQUALIFIED DEFERRED COMPENSATION RETIREMENT PLANS SPONSORED BY SANTAFE HEALTHCARE, INC. FOR A CERTAIN GROUP OF EXECUTIVES. ONE PLAN RESTORES RETIREMENT BENEFITS EQUIVALENT TO QUALIFIED 401(K)BENEFITS ON INCOME EARNED IN EXCESS OF THE INTERNAL REVENUE SERVICE CODE SECTION 401(A)(17) RECOGNIZABLE PAY LIMITS (A DEFINED CONTRIBUTION RESTORATION PLAN). VESTING FOR THIS PLAN IS ACHIEVED AT AGE 55 AND 10 YEARS OF SERVICE OR AT AGE 65 AND 5 YEARS OF SERVICE. THE SECOND SUPPLEMENTAL DEFINED CONTRIBUTION PLAN PROVIDES ADDITIONAL RETIREMENT INCOME BASED ON A PERCENTAGE OF BASE SALARY AND VESTS AT THREE AND FIVE YEARS OF SERVICE. MR. ZIEGLER VESTED AND RECEIVED $741,092 FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS IN 2021. MR. STUART VESTED AND RECEIVED $165,974 FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS IN 2021. MR. HART VESTED AND RECEIVED $65,677 FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS IN 2021. SCHEDULE J, PART II: CERTAIN SENIOR EXECUTIVES ARE ACCOUNTABLE FOR AND PERFORM SERVICES FOR SANTAFE HEALTHCARE, INC. AND EACH OF ITS AFFILIATES. SANTAFE HEALTHCARE, INC. AND AFFILIATES REPRESENT A DIVERSIFIED FAMILY OF NOT-FOR-PROFIT ORGANIZATIONS WITH APPROXIMATELY $2 BILLION IN GROSS RECEIPTS AND MORE THAN 1,500 EMPLOYEES. THESE SENIOR EXECUTIVES ARE PAID DIRECTLY BY SANTAFE HEALTHCARE, INC., AND THEIR COMPENSATION AND BENEFITS ARE APPORTIONED AND CHARGED TO THE RESPECTIVE AFFILIATES BASED ON THE ESTIMATED AMOUNT OF TIME SPENT ON EACH AFFILIATE'S ACTIVITIES. EXECUTIVE COMPENSATION AND BENEFITS FOR THOSE SENIOR EXECUTIVES PAID BY RELATED ORGANIZATIONS WERE NOT APPORTIONED AND CHARGED TO BONITA SPRINGS RETIREMENT VILLAGE, INC. HOWEVER, MANAGEMENT FEES PAID BY BONITA SPRINGS RETIREMENT VILLAGE, INC. TO RELATED ORGANIZATIONS COVERED AN ALLOCABLE PORTION OF THE EXECUTIVE SALARIES AND BENEFITS PAID BY THE RELATED ORGANIZATIONS. A ALACHUA COUNTY HEALTH FACILITIES AUTHORITY 592442398 010685JN6 2011-11-03 142316817 CONSTRUCT FACILITY 0 0 0 A 62385000 146377007 8500407 28658682 2846336 295802 101805584 4270196 2013 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: ALACHUA COUNTY HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/03/2021 SCHEDULE K, PART II, LINE 3 THE AMOUNT REPORTED AS TOTAL PROCEEDS ON LINE 3 IS GREATER THAN THE ISSUE PRICE REPORTED ON SCHEDULE K, PART I, LINE A, COLUMN E DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART II, LINE 11 PROCEEDS REPORTED ON THIS LINE WERE USED TO RETIRE BOND PRINCIPAL. FORM 990, PART VI, SECTION A, LINE 7A BONITA SPRINGS RETIREMENT VILLAGE, INC.'S ARTICLES OF INCORPORATION AND BYLAWS STATE THAT THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS SHALL CONSTITUTE THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS CONSTITUTES THE ORGANIZATION'S BOARD OF DIRECTORS, WHICH MAKES ALL GOVERNANCE DECISIONS OF THE ORGANIZATION. THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS HAS THE POWER AND AUTHORITY TO ESTABLISH COMMITTEES, TO ELECT AND REMOVE OFFICERS, TO APPROVE AMENDMENTS OF THE ORGANIZATION'S GOVERNING DOCUMENTS, AND TO MODIFY, AMEND, RESCIND, OR REPEAL ANY ACTION TAKEN BY THE ORGANIZATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S PROCESS FOR ENSURING THE ACCURATE PREPARATION, REVIEW AND APPROVAL OF THE 2021 FORM 990 BEGAN WITH PROFESSIONAL DEVELOPMENT OF STAFF (SEVERAL OF WHICH ARE CPAS) WHICH WERE INVOLVED IN THE PREPARATION OF THE 2021 FORM 990. IN ADDITION TO STAFF DEVELOPMENT, WHICH INCLUDED ATTENDING TAX SEMINARS AND CLASSES, MANAGEMENT ALSO CONSULTED WITH INDEPENDENT ACCOUNTING FIRMS AND TAX LEGAL COUNSEL REGARDING THE IRS FORM 990 CODE AND FILING REQUIREMENTS. THE ORGANIZATION ALSO EDUCATED ITS MANAGEMENT TEAM, OFFICERS AND DIRECTORS, WITH THE ASSISTANCE OF PRICEWATERHOUSECOOPERS LLP, REGARDING THE FORM 990 AND THEIR INVOLVEMENT IN REVIEWING THE RETURN. FOLLOWING MANAGEMENT'S PREPARATION OF THE 2021 FORM 990, PRICEWATERHOUSECOOPERS LLP REVIEWED THE 2021 FORM 990. A COPY OF THE 2021 FORM 990 AND ATTACHMENTS WERE PROVIDED TO THE ORGANIZATION'S CURRENT BOARD OF DIRECTORS FOR THEIR REVIEW AND COMMENT. EXECUTIVE MANAGEMENT ADDRESSED ANY QUESTIONS RAISED BY THE BOARD MEMBERS PRIOR TO FILING THE 2021 FORM 990 AND ATTACHMENTS WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C BONITA SPRINGS RETIREMENT VILLAGE, INC. HAS A PROCEDURE FOR MONITORING AND ENFORCING COMPLIANCE WITH ITS CORPORATE CONFLICT OF INTEREST POLICY (POLICY). EACH COVERED PERSON SHALL RECEIVE A COPY OF THE POLICY FOR REVIEW AND SUBMIT AN AFFIRMATION WHICH IS ATTACHED TO THE CODE OF ETHICAL BUSINESS CONDUCT. ADDITIONALLY, EACH COVERED PERSON ENGAGED IN MAKING OR INFLUENCING DECISIONS ON BEHALF OF SANTAFE HEALTHCARE, INC. OR ITS AFFILIATES SHALL COMPLETE A QUESTIONNAIRE CONCERNING CONFLICTS OF INTEREST ANNUALLY. THE PROCEDURE DETAILS THAT THE CORPORATE SECRETARY HAS RESPONSIBILITY FOR DELIVERY OF THE POLICY TO DIRECTORS AND OFFICERS AND RECEIPT OF THEIR AFFIRMATIONS AND QUESTIONNAIRES. THE HUMAN RESOURCES DEPARTMENT SHALL OBTAIN THE AFFIRMATION AND QUESTIONNAIRE FROM EVERY NEW EMPLOYEE AT ORIENTATION. THE HUMAN RESOURCES DEPARTMENT SHALL ALSO OBTAIN THE AFFIRMATION FROM ALL EMPLOYEES AND THE CONFLICT OF INTEREST QUESTIONNAIRE FROM APPLICABLE EMPLOYEES ANNUALLY. MEMBERS OF CORPORATE ADVISORY BOARDS SUBMIT THE AFFIRMATION AND QUESTIONNAIRE TO THE CHIEF COMPLIANCE OFFICER. ANNUAL CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY INTERNAL STAFF TO ENSURE RECORDS ARE COMPLETE. AS PART OF THE CORPORATE CONTRACT REVIEW PROCESS, CONSIDERATION IS GIVEN TO ANY POTENTIAL CONFLICTS OF INTEREST INVOLVING OPERATIONAL OR FINANCIAL TRANSACTIONS. ALL EMPLOYEES ARE EXPECTED TO DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS. INITIAL REVIEW OF EMPLOYEE QUESTIONNAIRES WILL BE PERFORMED BY THE HUMAN RESOURCES DEPARTMENT AND AFFILIATE COMPLIANCE OFFICER, WITH REVIEW OF ANY DISCLOSURES BY THE CHIEF COMPLIANCE OFFICER WHO WILL EVALUATE, MAKE NECESSARY INQUIRIES, AND INVESTIGATE ALTERNATIVES. BOARD MEMBERS SHALL DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS TO THE CHAIRPERSON OF THE SANTAFE HEALTHCARE, INC. BOARD, AND THE CHAIRPERSON OR CHIEF COMPLIANCE OFFICER SHALL EVALUATE CONFLICT DISCLOSURES AND, IF APPROPRIATE, INVESTIGATE ALTERNATIVES AND REPORT TO DISINTERESTED BOARD MEMBERS FOR RESOLUTION. THE MINUTES OF THE BOARD OR ANY COMMITTEE MEETING AT WHICH A POTENTIAL OR ACTUAL CONFLICT OF INTEREST IS DISCLOSED OR DISCUSSED SHALL REFLECT THE NAME OF THE INTERESTED PARTY, THE NATURE OF THE CONFLICT, THE DELIBERATIONS AND THE RESOLUTION OF THE CONFLICT. IF IT IS DETERMINED THAT A COVERED PERSON HAS FAILED TO COMPLY WITH THE POLICY, THE CHIEF COMPLIANCE OFFICER OR THE CHAIRPERSON SHALL TAKE APPROPRIATE ACTION, WHICH MAY INCLUDE REMOVAL FROM OFFICE OR TERMINATION OF EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 LAWRENCE G SCHREIBER IS THE CHIEF EXECUTIVE OFFICER (CEO) OF BONITA SPRINGS RETIREMENT VILLAGE, INC. MR. SCHREIBER IS COMPENSATED BY SANTAFE HEALTHCARE, INC., A RELATED SUPPORTING ORGANIZATION. SANTAFE HEALTHCARE, INC. UTILIZES THE FOLLOWING PROCESS TO ESTABLISH THE CEO'S COMPENSATION AND BENEFITS: THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS CONSULTING FIRM (FIRM) TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE CEO'S TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISON TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. THE FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS ESTABLISHES THE FINAL COMPENSATION AND BENEFIT PACKAGE FOR THE CEO TAKING INTO CONSIDERATION THE MARKET COMPETITIVENESS REVIEW AND FINAL RECOMMENDATION OF THE FIRM. THE FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE FINAL COMPENSATION AND BENEFITS PACKAGE. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15B: PROCESS FOR DETERMINING COMPENSATION FOR ALL NON-DIRECTOR OFFICERS AND DIRECTORS OF BONITA SPRINGS RETIREMENT VILLAGE, INC. IS AS FOLLOWS: THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS ANNUALLY RETAINS AN INDEPENDENT THIRD PARTY COMPENSATION AND BENEFITS FIRM (FIRM) TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF ALL NON-DIRECTOR OFFICERS' TOTAL DIRECT COMPENSATION (BASE SALARY, ANNUAL INCENTIVES, AND LONG TERM INCENTIVES) AND BENEFITS. THE COMPETITIVE ANALYSIS INCLUDES COMPARISONS TO SIMILAR POSITIONS IN COMPANIES OF SIMILAR SIZE WITHIN THE SAME OR SIMILAR INDUSTRY. AFTER COMPLETION OF ITS REVIEW, THE FIRM MAKES RECOMMENDATIONS, IF ANY, DIRECTLY TO THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS. THE FIRM PROVIDES AN OPINION LETTER REGARDING THE REASONABLENESS OF CASH COMPENSATION AND EXECUTIVE BENEFITS. THE ACTIONS OF THE BOARD ARE DOCUMENTED IN THE MINUTES OF THE BOARD MEETINGS. THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS REGULARLY RETAINS AN INDEPENDENT THIRD PARTY CONSULTANT TO CONDUCT A MARKET COMPETITIVENESS REVIEW OF THE BOARD OF DIRECTORS' (INCLUDING OFFICER POSITIONS) COMPENSATION. THE COMPETITIVENESS ANALYSIS INCLUDES COMPARISONS TO BOTH NOT-FOR-PROFIT AND PUBLIC COMPANY (EXCLUDING EQUITY COMPONENT) DATA FOR COMPANIES WITHIN THE SAME OR SIMILAR INDUSTRY. ANY COMPENSATION CHANGES ARE APPROVED BY THE SANTAFE HEALTHCARE, INC. BOARD OF DIRECTORS BASED ON THE MARKET COMPETITIVENESS STUDY. FORM 990, PART VI, SECTION C, LINE 19 BONITA SPRINGS RETIREMENT VILLAGE, INC.'S PROCEDURE FOR MAKING VARIOUS DOCUMENTS AVAILABLE TO THE PUBLIC IS AS FOLLOWS: THE ARTICLES OF INCORPORATION CAN BE ACCESSED DIRECTLY THROUGH THE FLORIDA DEPARTMENT OF STATE, DIVISION OF CORPORATIONS WEBSITE AT WWW.SUNBIZ.ORG. THE CONFLICT OF INTEREST POLICY CAN BE OBTAINED DIRECTLY FROM THE ORGANIZATION UPON WRITTEN REQUEST. BONITA SPRINGS RETIREMENT VILLAGE, INC. DID NOT OTHERWISE MAKE ITS GOVERNING DOCUMENTS, INCLUDING BYLAWS, AVAILABLE TO THE PUBLIC. DURING THE TAX YEAR, BONITA SPRINGS RETIREMENT VILLAGE, INC. MADE ITS FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED BY SECTION 641.091(2), FLORIDA STATUTES. FORM 990, PART VII, SECTION A, LINE 1A: CERTAIN SENIOR EXECUTIVES ARE ACCOUNTABLE FOR AND PERFORM SERVICES FOR SANTAFE HEALTHCARE, INC. AND EACH OF ITS AFFILIATES. SANTAFE HEALTHCARE, INC. AND AFFILIATES REPRESENT A DIVERSIFIED FAMILY OF NOT-FOR-PROFIT ORGANIZATIONS WITH APPROXIMATELY $2 BILLION IN GROSS RECEIPTS AND MORE THAN 1,500 EMPLOYEES. THESE SENIOR EXECUTIVES ARE PAID DIRECTLY BY SANTAFE HEALTHCARE, INC. AND THEIR COMPENSATION AND BENEFITS ARE APPORTIONED AND CHARGED TO THE RESPECTIVE AFFILIATES BASED ON THE ESTIMATED AMOUNT OF TIME SPENT ON EACH AFFILIATE'S ACTIVITIES. EXECUTIVE COMPENSATION AND BENEFITS FOR THOSE SENIOR EXECUTIVES PAID BY A RELATED ORGANIZATION WERE NOT APPORTIONED AND CHARGED TO BONITA SPRINGS RETIREMENT VILLAGE, INC. HOWEVER, MANAGEMENT FEES PAID BY BONITA SPRINGS RETIREMENT VILLAGE, INC. TO RELATED ORGANIZATIONS COVERED AN ALLOCABLE PORTION OF THE EXECUTIVE SALARIES AND BENEFITS PAID BY THE RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF SANTAFE SENIOR LIVING FOUNDATION, INC. 85,898. CONTRIBUTION FROM SANTAFE SENIOR LIVING FOUNDATION, INC. -63,072. CHANGE IN FUTURE SERVICE OBLIGATION 8,897,000. EQUITY TRANSFER FROM AFFILIATES 23,126,274. FORM 990, PART XII, LINE 2C AUDIT OVERSIGHT PROCESS: THE COMPANY'S AUDIT COMMITTEE HAS NOT CHANGED ITS PROCESS FOR SELECTION OF THE INDEPENDENT ACCOUNTANT OR ITS PROCESS FOR MANAGING THE AUDIT. SANTAFE HEALTHCARE INC PO BOX 749 GAINESVILLE FL 326270749 592317607 MANAGEMENT AND FINANCIAL SUPPORT FOR NOT-FOR-PROFIT AFFILIATES FL 501(C)(3) 12B TYPE II N/A 0 NORTH FLORIDA RETIREMENT VILLAGE INC PO BOX 749 GAINESVILLE FL 326270749 591912330 RETIREMENT COMMUNITY FL 501(C)(3) 10 SANTAFE HEALTHCARE INC 0 NORTH CENTRAL FLORIDA HOSPICE INC PO BOX 749 GAINESVILLE FL 326270749 592490893 HOSPICE CARE FL 501(C)(3) 10 SANTAFE HEALTHCARE INC 0 SANTAFE SENIOR LIVING INC PO BOX 749 GAINESVILLE FL 326270749 203700526 MANAGEMENT AND FINANCIAL SUPPORT FOR NOT-FOR-PROFIT AFFILIATES FL 501(C)(3) 12B TYPE II SANTAFE HEALTHCARE INC 0 BVG ACQUISITION INC PO BOX 749 GAINESVILLE FL 326270749 203701186 RETIREMENT COMMUNITY FL 501(C)(3) 10 SANTAFE HEALTHCARE INC 0 EAST RIDGE RETIREMENT VILLAGE INC PO BOX 749 GAINESVILLE FL 326270749 590903331 RETIREMENT COMMUNITY FL 501(C)(3) 10 SANTAFE HEALTHCARE INC 0 SANTAFE SENIOR LIVING FOUNDATION INC PO BOX 749 GAINESVILLE FL 326270749 264464727 CHARITABLE AND EDUCATIONAL PURPOSES FL 501(C)(3) 7 SANTAFE HEALTHCARE INC 0 AVMED INC PO BOX 749 GAINESVILLE FL 326270749 592742907 HEALTH CARE FL 501(C)(4) N/A SANTAFE HEALTHCARE INC 0 HFK CARE CORPORATION PO BOX 749 GAINESVILLE FL 326270749 592386289 HOSPICE CARE & HOME HEALTH CARE FL 501(C)(3) 7 SANTAFE HEALTHCARE INC 0 HAVEN FOUNDATION INC 4200 NW 90TH BLVD GAINESVILLE FL 326069945 850863879 CHARITABLE AND EDUCATIONAL PURPOSES FL 501(C)(3) 12A TYPE I NORTH CENTRAL FLORIDA HOSPICE INC 0 SF HOLDING CORP INC PO BOX 749 GAINESVILLE FL 326270749 592903901 HOLDING COMPANY FL N/A C 0 AVMED ADMINISTRATORS INC PO BOX 749 GAINESVILLE FL 326270749 842931956 THIRD PARTY ADMINISTRATIVE SERVICES FL N/A C 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 1 0 0 1 AVMED INC P 640356 ACTUAL INVOICES