2021-11-12T08:45:24-06:00 2021-06-30 593070669 MSL PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2020-07-01 590624420 PENNEY RETIREMENT COMMUNITY INC PENN 9042848200 PO BOX 555 PENNEY FARMS FL 320790555 TERESA SCOTT PRESIDENT 9042848200 2021-11-12 1 TERESA SCOTT 999009999 YASMIN CHEHAYEB P02428781 4077405400 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z TERESA SCOTT PO BOX 555 PENNEY FARMS FL 320790555 27010133 0 X WWW.PENNEYRETIREMENTCOMMUNITY.ORG X 1965 FL TO SERVE SENIORS WHO WISH TO RETIRE IN AN INCLUSIVE CHRISTIAN COMMUNITY. 17 17 299 375 0 0 610884 734079 14349308 15912986 325902 1146361 287235 0 15573329 17793426 0 150027 0 0 7279665 7938269 0 0 13900 8281038 8720948 15560703 16809244 12626 984182 58338823 61971655 40391832 42344243 17946991 19627412 PENNEY RETIREMENT COMMUNITY, INC IS AN INCLUSIVE CHRISTIAN CONTINUING CARE RETIREMENT COMMUNITY SEEKING THE ABUNDANT LIFE THROUGH SOCIAL INTERACTION AND SERVICE. 0 0 15215714 150027 15912986 THE ORGANIZATION PROVIDES HOUSING, HEALTH CARE AND OTHER RELATED SERVICES THROUGH THE OPERATION OF A RETIREMENT COMMUNITY. THE COMMUNITY INCLUDES 301 APARTMENTS, COTTAGES AND HOMES, A 20-BED MEMORY CARE CENTER, 55 INDEPENDENT LIVING UNITS OFFERING ASSISTIVE SERVICES AND A LICENSED SKILLED NURSING CENTER WITH A CAPACITY OF 50 RESIDENTS. THE COMMUNITY ALSO INCLUDES RECREATIONAL AMENITIES, INCLUDING A NINE-HOLE GOLF COURSE, INDOOR SWIMMING POOL, FITNESS CENTER, ART STUDIO, CRAFTS FACILITIES, LIBRARIES AND DINING FACILITIES. 15215714 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 68 0 1 299 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X TERESA SCOTT 9042848200 PO BOX 555 PENNEY FARMS FL 320790555 BERT VAN ROYAL CHAIRMAN 2.00 X X 0 0 0 ALISON E HICKMAN FIRST VICE CHAIR 2.00 X X 0 0 0 JAMES JB RENNIGER SECOND VICE CHAIR 2.00 X X 0 0 0 JAMES KNIGHT TREASURER 2.00 X X 0 0 0 EVELYN DOLLY HILLMAN SECRETARY 2.00 X X 0 0 0 GERALD AGRESTI DIRECTOR 2.00 X 0 0 0 TERESA BARTON DIRECTOR 2.00 X 0 0 0 RON COLEMAN DIRECTOR 2.00 X 0 0 0 WILLIAM COURTNEY DIRECTOR 2.00 X 0 0 0 JIMMY LOVELACE DIRECTOR 2.00 X 0 0 0 W ROY LYONS DIRECTOR 2.00 X 0 0 0 CURRY PAJCIC DIRECTOR 2.00 X 0 0 0 SUSAN PONDER-STANSEL DIRECTOR 2.00 X 0 0 0 HELEN STEPHENS DIRECTOR 2.00 X 0 0 0 CHERIAN THOMAS DIRECTOR 2.00 X 0 0 0 LISA VALENTINE DIRECTOR 2.00 X 0 0 0 STEVE VANDERKAMP DIRECTOR 2.00 X 0 0 0 TERESA D SCOTT PRESIDENT/CEO 40.00 X 192052 0 17002 BETH A MCANALLY CHIEF FINANCIAL OFFICER (BEG. 2/2020) 40.00 X 96121 0 5024 WILLIAM D FISH FORMER CFO (ENDING 1/2020) 40.00 X 71057 0 22516 359230 0 44542 1 1 1 0 STEVENSON CONSTRUCTION CO INC PO BOX 1178 STARKE FL 32091 CONSTRUCTION SERVICES 1503590 FUNCTIONAL PATHWAYS 10133 SHERRILL BLVD SUITE 200 KNOXVILLE TN 379323347 PATIENT THERAPY SERVICES 890250 JAMES DEAN MASONRY INC 3750 CR 315-A GREEN COVE SPRINGS FL 32043 CONSTRUCTION SERVICES 405017 CHANEY'S HOME IMPROVEMENT 116 N ORANGE AVE GREEN COVE SPRINGS FL 32043 CONSTRUCTION SERVICES 291850 HOME MEDIC REMODELING LLC 35 UTHORNE PI PALM COAST FL 32164 CONSTRUCTION SERVICES 156269 8 188942 545137 734079 NET RESIDENT SERVICE REVENUE 623000 15536874 15536874 OTHER RESIDENT SERVICE REVENUE 623000 376112 376112 15912986 278007 278007 10085061 9216707 868354 868354 868354 17793426 15912986 0 1146361 150027 150027 257818 257818 6184546 5504384 678744 1418 233200 196943 36257 775419 752136 19635 3648 487286 423773 63513 2010 2010 1333074 1230807 102267 31498 31498 93792 18303 75489 62926 12109 50817 2292777 2274254 16379 2144 111 88 23 408334 397202 11132 3024591 2937869 86722 654064 623604 30460 SUPPLIES AND EQUIPMENT 559269 531710 22066 5493 BAD DEBT EXPENSE 135672 135672 LIFE SAFETY - FIRST AIR 62241 62241 EMPLOYEE RELATED EXPENS 30434 22849 7516 69 30155 3984 25043 1128 16809244 15215714 1579630 13900 654643 2311963 625926 388063 1529097 810643 137511 139942 348082 37343 79814959 36516315 41662020 43298644 13381544 14291961 0 693096 58338823 61971655 973509 1244299 26467973 28946796 9830403 9579203 3119947 2573945 40391832 42344243 X 14896497 16754733 3050494 2872679 17946991 19627412 58338823 61971655 X 984182 250311 445928 X X 0 1 X 1 0 X 961357 2347104 746643 610884 734079 5400067 12117395 12707454 13841316 14349308 15912986 68928459 13078752 15054558 14587959 14960192 16647065 74328526 0 413876 733209 1115849 712539 1333195 4308668 413876 733209 1115849 712539 1333195 4308668 70019858 211736 308123 419995 269455 278007 1487316 211736 308123 419995 269455 278007 1487316 95740 149821 64662 287235 597458 13386228 15512502 15072616 15516882 16925072 76413300 0.91630 0.91760 0.01950 0.01930 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1699596 214515 1914111 1654054 45542 1699596 1593951 60103 1654054 1476354 117597 1593951 1361189 115165 1476354 1.00000 0 0 1878407 1878407 70357860 32172311 38185549 6688821 4344004 2344817 889871 889871 43298644 CASH AND CASH EQUIVALENTS 2955877 F U.S. GOVERNMENT AND AGENCY OBLIGATIONS 5117390 F DEBT SECURITIES 2312506 F MUTUAL FUNDS - EQUITY SECURITIES 910443 F MUTUAL FUNDS - DEBT SECURITIES 2504323 F BOND FUNDS 491422 F 14291961 DEPOSITS 202900 CHARITABLE ANNUITY OBLIGATION 116554 ACCRUED GIFT BONDS 1555250 INTEREST RATE SWAP AGREEMENT 699241 2573945 X 17944772 250311 445928 696239 17248533 544893 544893 17793426 16288493 0 16288493 520751 520751 16809244 PART V, LINE 4: THE COMMUNITY'S SPENDING POLICY OBJECTIVE IS TO PROTECT THE VALUE AND GROW THE ENDOWMENT FUNDS TO PROVIDE FUTURE CASH FLOWS FOR OPERATONS, GIFT BOND REDEMPTIONS AND OTHER STIPULATED PURPOSES. PART X, LINE 2: THE COMMUNITY HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, INCOME EARNED IN FURTHERANCE OF THE COMMUNITY'S TAX-EXEMPT PURPOSE IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES AND, THEREFORE, THESE FINANCIAL STATEMENTS CONTAIN NO PROVISION OR LIABILITY FOR INCOME TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FMV OF INTEREST RATE SWAP 445,928. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESIDENTS AID FUND OF PRC, LLC - TOTAL REVENUE 234,018. ASSOCIATION OF PRC RESIDENTS, LLC - TOTAL REVENUE 310,875. PART XII, LINE 4B - OTHER ADJUSTMENTS: RESIDENTS AID FUND OF PRC, LLC - TOTAL EXPENSES 194,715. ASSOCIATION OF PRC RESIDENTS, LLC - TOTAL EXPENSES 326,036. 1 PENNEY MEMORIAL CHURCH 4465 POLING BLVD PENNEY FARMS FL 32079 592493127 501(C)(4) 24000 SUPPORT FOR FULL-TIME MINISTER TOWN OF PENNEY FARMS 4100 CLARK AVENUE PENNEY FARMS FL 32079 122511 PICKLEBALL COURT CONSTRUCTION 1 1 X X X 1 0 0 0 0 0 0 0 0 TERESA D SCOTT PRESIDENT/CEO 192052 0 0 0 0 0 9707 0 7295 0 209054 0 0 0 WILLIAM D FISH FORMER CFO (ENDING 1/2020) 71057 0 0 0 0 0 5154 0 17362 0 93573 0 0 0 PART I, LINE 4A DURING 2020, WILLIAM D. FISH, FORMER CFO, RECEIVED $27,912 OF SEVERANCE PAYMENTS. A CLAY COUNTY DEVELOPMENT AUTHORITY 596583087 2017-12-07 13355113 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 1281643 13355113 2762691 267102 10325319 2018 0 0 0 0 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 BRANCH BANKING AND TRUST COMPANY 12.000000000000 0 0 0 0 0 A 0 SCHEDULE K, ROW A, PART I(F) IN DECEMBER 2017, THE CLAY COUNTY DEVELOPMENT AUTHORITY ISSUED ON BEHALF OF THE COMMUNITY, A $13,355,113 HEALTHCARE FACILITIES AND IMPROVEMENT REVENUE BOND, SERIES 2017 ("SERIES 2017 BOND") TO PAY FOR THE CONSTRUCTION OF A NEW 50-BED SKILLED NURSING FACILITY, TO FUND AN ESCROW ACCOUNT TO DEFEASE THE PREVIOUS BONDS, AND TO PAY CERTAIN COSTS OF ISSUING THE SERIES 2017 BOND. FORM 990, PART VI, SECTION B, LINE 11B PER PRC POLICY, THE BOARD CHAIRMAN WILL REVIEW THE ENTIRE FORM 990 WITH ALL BOARD MEMBERS BEFORE IT IS FILED WITH THE IRS. THE CHAIRMAN WILL CONFIRM IN WRITING THAT THE 990 WAS REVIEWED. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO AFFIRM ANNUALLY IN WRITING THAT THEY ARE NOT AWARE OF ANY CONFLICTS OF INTEREST WITHIN THE ORGANIZATION. EMPLOYEES SIGN THAT THEY HAVE READ THE POLICY UPON HIRE. THE POLICY IS REVIEWED PERIODICALLY. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION'S COMPENSATION POLICY REQUIRES THE PRESIDENT'S COMPENSATION BE DETERMINED BY THE DIRECTORS USING COMPARABILITY DATA GATHERED FROM OTHER RETIREMENT COMMUNITIES. ALL DIRECTORS ARE INDEPENDENT WITH REGARD TO THE COMPENSATION AND THE DELIBERATION AND DECISION ARE DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE AT THE CORPORATE OFFICE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FMV OF INTEREST RATE SWAP 445,928. FORM 990, PART XII, LINE 2C OVERSIGHT OF THE AUDIT: THE ORGANIZATION'S AUDIT COMMITTEE IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT AUDIT FIRM AND OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. ASSOCIATION OF PENNEY RETIREMENT COMMUNITY RESIDENTS LLC PO BOX 555 PENNEY FARMS FL 32079 273142533 SUPPORT THE RESIDENTS OF PENNEY RETIREMENT COMMUNITY FL 311252 295616 PENNEY RETIREMENT COMMUNITY RESIDENTS' AID FUND OF PENNEY RETIREMENT COMMUNITY LLC PO BOX 555 PENNEY FARMS FL 32079 273456236 SUPPORT THE RESIDENTS OF PENNEY RETIREMENT COMMUNITY FL 233641 454484 PENNEY RETIREMENT COMMUNITY