2021-11-15T14:30:15-06:00 2020-12-31 381357951 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2020-01-01 271953892 COLORADO SENIOR RESIDENCES INC COLO 9708798855 2855 OWL HOOT TRAIL STEAMBOAT SPRINGS CO 80487 CHARLES PARSONS PRESIDENT 9708798855 2021-11-10 1 CHARLES PARSONS 999009999 RYAN C HARRIS P00614618 3037409400 2021-11-10 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CASEY'S POND SENIOR LIVING BRAD BOATRIGHT 2855 OWL HOOT TRAIL STEAMBOAT SPRINGS CO 80487 11134287 0 X WWW.CASEYSPOND.ORG X 2010 CO TO PROVIDE HOUSING, HEALTHCARE, & OTHER SERVICES TO SENIOR CITIZENS THROUGH A RETIREMENT COMMUNITY. 12 12 189 30 0 0 0 631973 11665302 10476934 85190 16248 95038 9132 11845530 11134287 5750 4000 0 0 5422170 5634964 0 0 0 9484676 9949360 14912596 15588324 -3067066 -4454037 40882003 40070549 61109505 64752088 -20227502 -24681539 TO BE VIEWED AS A LEADER IN THE SENIOR LIVING CONTINUUM OF SERVICES WITH WARM AND INVITING RESIDENCES, DEDICATED AND VISIONARY LEADERSHIP, PROFESSIONAL MANAGEMENT AND AN ENGAGED STAFF WHO ARE COMMITTED TO AN ENVIRONMENT OF GROWTH AND INDEPENDENCE. 0 0 13183073 4000 10476934 CASEY'S POND WAS FORMED TO DEVELOP, OWN, AND OPERATE A SENIOR LIVING AND LONG-TERM CARE COMMUNITY IN STEAMBOAT SPRINGS, COLORADO. CASEY'S POND CONSISTS OF APPROXIMATELY 66 SKILLED NURSING BEDS; 53 ASSISTED LIVING UNITS; 15 MEMORY CARE UNITS; 22 INDEPENDENT LIVING UNITS; AND RELATED COMMON AREAS, AMENITIES, AND OTHER IMPROVEMENTS ALL HOUSED WITHIN ONE BUILDING. 13183073 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 X 55 0 1 189 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X DEBBIE WILLIAMS 9708798855 2855 OWL HOOT TRAIL STEAMBOAT SPRINGS CO 80487 X LOUI ANTONUCCI VICE PRESIDENT 1.00 X X 0 0 0 KAREN BOMBERG DIRECTOR 1.00 X 0 0 0 CONNIE BRINKMAN DIRECTOR 1.00 X 0 0 0 RENEE GILBERSON DIRECTOR 1.00 X 0 0 0 KARL GILLS TREASURER 1.00 X X 0 0 0 BJ HEUBERGER SECRETARY 1.00 X X 0 0 0 MARY JENKINS DIRECTOR 1.00 X 0 0 0 MICHAEL LOMAS DIRECTOR 1.00 X 0 0 0 MARILYN MCCAULLEY DIRECTOR 1.00 X 0 0 0 TRISH O'CONNELL DIRECTOR 1.00 X 0 0 0 CHARLES PARSONS PRESIDENT 1.00 X X 0 0 0 BRAD BOATRIGHT EXECUTIVE DIRECTOR 40.00 X 0 0 0 0 0 0 0 0 0 0 MORRISON COMMUNITY LIVING PO BOX 102289 ATLANTA GA 303682289 DINING SERVICES 1995524 CAPPELLA LIVING SOLUTIONS 9570 S KINGSTON CT STE 300 ENGLEWOOD CO 80112 MANAGEMENT SERVICES 922853 PRIME TIME HEALTHCARE LLC PO BOX 3544 OMAHA NE 681030544 TEMPORARY STAFFING 641883 PREMERE REHAB LLC 25117 SW PARKWAY STE D WILSONVILLE OR 97070 REHAB THERAPY CONTRACTOR 267171 RTG MEDICAL 1005 E 23RD STREET FREMONT NE 68025 TEMPORARY STAFFING 232588 6 631973 631973 RESIDENT/PATIENT SERV. 623000 10476934 10476934 10476934 16248 16248 TRANSPORT, MEALS & MIS 999999 7132 7132 MOVE-IN FEE & LEASE 532000 2000 2000 9132 11134287 10486066 0 16248 X 4000 4000 4649950 3966400 683550 36134 30822 5312 605357 506267 99090 343523 305119 38404 409098 409098 15696 15696 44075 44075 2987652 2446132 541520 71386 38 71348 114287 29698 84589 352479 347794 4685 8532 2608 5924 8474 1893 6581 3332524 3284103 48421 987358 973012 14346 119754 119754 FOOD & BEVERAGE 588728 588728 EXTRAORDINARY COVID COS 302189 284488 17701 SUPPLIES 291274 291093 181 TRUSTEE FEES 96649 96649 219205 120878 98327 15588324 13183073 2405251 0 51968 282356 940099 898812 325931 420234 18778 18778 64041 32905 42550361 8479404 34999757 34070957 4481429 4346507 40882003 40070549 904573 932021 151562 176283 42980200 43043110 3500000 3500000 13573170 17100674 61109505 64752088 X -20227502 -24681539 -20227502 -24681539 40882003 40070549 -4454037 0 X 0 1 X 1 0 X 1762 1983 2000 631973 637718 10122387 11057718 11892343 11760340 10486066 55318854 10124149 11059701 11894343 11760340 11118039 55956572 0 0 0 55956572 30027 8826 51284 85190 16248 191575 30027 8826 51284 85190 16248 191575 10154176 11068527 11945627 11845530 11134287 56148147 0.99660 0.99580 0.00340 0.00420 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3777121 3777121 36542538 5973513 30569025 1917107 2397718 -480611 313595 108173 205422 34070957 DEPOSITS 50470 ASSETS LIMITED AS TO USE 4296037 4346507 DEPOSITS HELD IN ESCROW 40074 SECURITY DEPOSITS 23500 OTHER LONG TERM LIABILITIES 693358 BOND INTEREST PAYABLE 14831542 REFUNDABLE LIFE CARE ENTRY FEES 506300 PAYCHECK PROTECTION PROGRAM LOAN 1005900 17100674 11134287 0 11134287 0 11134287 15588324 0 15588324 0 15588324 A COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648AYC3 2012-05-03 45110000 CONSTRUCTION OF FACILITY 0 0 0 A 43710632 3586747 892257 39231628 2013 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 PART IV, LINE 2C THE REBATE COMPUTATION WAS PERFORMED IN 2017. FORM 990, PART V, LINE 2B: CASEY'S POND USES A PEO, WHICH FILES FORMS W-2 ON BEHALF OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED CONTROL OF THE EXECUTIVE DIRECTOR POSITION TO CAPPELLA LIVING SOLUTIONS. BRAD BOATRIGHT IS THE EXECUTIVE DIRECTOR OF THE ORGANIZATION AND IS AN EMPLOYEE OF CAPPELLA LIVING SOLUTIONS. BRAD BOATRIGHT WAS PAID THROUGH CAPPELLA LIVING SOLUTIONS. BRAD'S WAGES WERE $180,017 AND HIS NONTAXABLE BENEFITS WERE $15,579. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE EXECUTIVE COMMITTEE AND THEN PROVIDED TO THE BOARD MEMBERS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C EACH RESPONSIBLE PERSON HAS A CONTINUING OBLIGATION TO (I) SCRUTINIZE HIS OR HER INTERESTS, RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES, BOTH DIRECT AND INDIRECT, TO IDENTIFY ANY APPARENT OR ACTUAL CONFLICTS OF INTEREST, AND (II) DISCLOSE THE CONFLICT OF INTEREST AS SOON AS IT IS KNOWN. DISCLOSURE IS REQUIRED ANNUALLY, AND WHENEVER A RESPONSIBLE PERSON BECOMES AWARE OF AN ACTUAL OR APPARENT CONFLICT OF INTEREST THAT HAS NOT PREVIOUSLY BEEN DISCLOSED. IN CASES WHERE A RESPONSIBLE PERSON FEELS A CONFLICT ARISES THAT IS NOT PART OF THE ANNUAL DISCLOSURE, HE/SHE SHALL REPORT THE CIRCUMSTANCE TO THE CHAIR OF THE BOARD. IF A CONFLICT OF INTEREST EXISTS, THE RESPONSIBLE PERSON MUST EXCUSE HIMSELF OR HERSELF FROM DISCUSSION, DELIBERATION AND DEBATE ON THE MATTER. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G THERAPY: PROGRAM SERVICE EXPENSES 172,278. MANAGEMENT AND GENERAL EXPENSES 95,959. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 268,237. NURSING: PROGRAM SERVICE EXPENSES 968,444. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 968,444. CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 81,512. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,512. PHARMACY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 5,488. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,488. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 32,310. MANAGEMENT AND GENERAL EXPENSES 358,561. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 390,871. CULINARY SERVICES: PROGRAM SERVICE EXPENSES 1,273,100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,273,100.