2020-06-24T09:50:49-05:00 2019-09-30 061009205 BLUM SHAPIRO & COMPANY PC ONE INTERNATIONAL PLACE 16TH FL BOSTON MA 02110 990 2018-10-01 061073286 POMPERAUG WOODS INC POMP 2032626555 80 HERITAGE ROAD SOUTHBURY CT 06488 KEVIN MOSHIER EXECUTIVE DIRECTOR 2032626555 2020-06-02 1 LAURA J KENNEY P00202198 6177170831 2020-06-02 64.251.63.131 2020-06-02 16:16:27 ED P 9F3B9057DC4C1AB93FF6CCB85D8B21EC61D194BB F655607A01BC9414CB150F5C2D5B642F4B7C09E6 2018 2020-11-06 18:47:13Z KEVIN MOSHIER 80 HERITAGE ROAD SOUTHBURY CT 06488 12433961 0 X WWW.POMPERAUGWOODS.COM X 1988 CT TO PROVIDE CONTINUOUS CARE FOR RETIRED PEOPLE. 9 9 246 48 0 0 11000 40160 12022481 12279932 -10682 23296 35465 37793 12058264 12381181 0 0 0 0 6490978 6603085 0 0 0 5518099 5621800 12009077 12224885 49187 156296 21737577 20894838 34117443 33117564 -12379866 -12222726 TO PROVIDE CONTINUOUS CARE FOR RETIRED PEOPLE. 0 0 9039825 12317725 POMPERAUG WOODS IS A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF 131 LIVING UNITS, 8 ASSISTED LIVING UNITS, AND 37 NURSING BEDS. SERVICES PROVIDED INCLUDED MEDICAL CARE, FOOD, CLEANING AND LAUNDRY. 9039825 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 66 0 1 246 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 1 0 X LANA SMOLITSKY 2032626555 80 HERITAGE ROAD SOUTHBURY CT 06488 WILLIAM B NEIL JR PRESIDENT 1.00 X X 0 0 0 JANET WALKER VICE PRESIDENT 1.00 X X 0 0 0 JAMES R STRUB SECRETARY 1.00 X X 0 0 0 MATTHEW MIHALCIK TREASURER 1.00 X X 0 0 0 JANE C CONNERY DIRECTOR 1.00 X 0 0 0 HELENA JEDLINSKY DIRECTOR 1.00 X 0 0 0 MARK LANCOR DIRECTOR 1.00 X 0 0 0 GAIL E SEYMOUR DIRECTOR 1.00 X 0 0 0 LISA WNUCK DIRECTOR 1.00 X 0 0 0 CASSIE HALEY UNTIL 71519 HC ADMINISTRATOR 40.00 X 0 0 0 KEVIN MOSHIER EXECUTIVE DIRECTOR 40.00 X 0 0 0 LANA SMOLITSKY FINANCE DIRECTOR 40.00 X 112436 0 1014 LYNDA EARLY HR 40.00 X 101721 0 10374 CATHERINE PETERSON NURSING DIRECTOR 40.00 X 104461 0 5747 318618 0 17135 4 0 0 0 LIFE CARE SERVICES 400 LOCUST STREET DES MOINES IA 50309 MANAGEMENT IT CONSULTANT 566176 HERITAGE HEALTH CARE 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY SERVICES 405000 MUELLER HOME IMPROVEMENTS 157 OAK DRIVE WATERTOWN CT 06795 REMODELING SERVICES 143706 THE NATURE'S EDGE LLCS 54 DORMAN ROAD OXFORD CT 06478 LANDSCAPING/SNOW REMOVAL 111827 4 40160 40160 RESIDENT SERVICE REVENUE 623000 7553966 7553966 HEALTH CENTER FEES 623000 3140983 3140983 AMORTIZATION OF ENTRANCE FEES 623000 1584983 1584983 12279932 75969 75969 52673 -52673 -52673 -52673 25598 107 25491 25491 MISC. REVENUE 623000 12302 12302 12302 12381181 12317725 0 23296 405348 405348 5109122 4454746 654376 49940 49940 643378 578054 65324 395297 341052 54245 442205 12924 429281 84511 84511 42889 42889 94583 94583 368943 167495 201448 42964 42964 653057 653057 31205 14692 16513 5034 5034 1338144 1338144 181339 181339 ANCILLARY EXPENSES 690644 214311 476333 FOOD & SUPPLIES 529954 529954 THERAPY 459505 459505 PROMOTIONAL SALES 458018 26878 431140 198805 99456 99349 12224885 9039825 3185060 0 320732 423465 4598235 5246248 1351384 366579 38867 40382 295689 290193 40243074 25715103 15079594 14527971 53076 0 21737577 20894838 3720449 3317885 6504839 5850055 58756 23892155 23890868 34117443 33117564 X -12443920 -12312990 64054 90264 -12379866 -12222726 21737577 20894838 156296 844 0 X X 0 1 X 1 0 X 24475 4020 1975 11000 40160 81630 10661328 11765707 12689076 12058264 12317725 59492100 10685803 11769727 12691051 12069264 12357885 59573730 0 0 0 59573730 5294 4781 4449 15788 75969 106281 5294 4781 4449 15788 75969 106281 10691097 11774508 12695500 12085052 12433854 59680011 0.99820 0.99940 0.00180 0.00060 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 448033 40160 5840 110336 383697 0.76000 0.24000 0 0 962264 962264 33465691 20747830 12717861 5815119 4967273 847846 14527971 ENTRANCE FEE DEPOSITS 22000 OTHER CURRENT LIABILITIES 1880 ENTRANCE FEE REFUNDS PAYABLE 23760485 CAPITAL LEASE 106503 23890868 12382025 844 844 12381181 0 12381181 12224885 0 12224885 0 12224885 0 0 0 1 0 1 0 1 0 PART I, LINE 5 SOME BONUSES WERE CONTINGENT ON OCCUPANCY AND THEREFORE REVENUE. PART I, LINE 6 SOME BONUSES WERE CONTINGENT ON OCCUPANCY AND THEREFORE REVENUE. PART I, LINE 7 SOME OF THE EMPLOYEES OF THE ORGANIZATION RECEIVE DISCRETIONARY BONUSES BASED ON PERFORMANCE. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION UTILIZED LIFE CARE SERVICES, LLC TO SUPERVISE OPERATIONS OF THE FACILITY. THE EXECUTIVE DIRECTOR OF POMPERAUG WOODS, KEVIN MOSHIER, AND HC ADMINISTRATOR, CASSIE HALEY, ARE EMPLOYEES OF LIFE CARE SERVICES, LLC. DURING CALENDAR YEAR 2018, KEVIN RECEIVED $168,752 OF REPORTABLE COMPENSATION, $38,474 OF DEFERRED COMPENSATION AND $15,207 OF NONTAXABLE BENEFITS FROM LIFE CARE SERVICES, LLC WHILE CASSIE RECEIVED $94,527 OF REPORTABLE COMPENSATION AND $10,213 OF BENEFITS FROM LIFE CARE SERVICES, LLC FOR PROVIDING MANAGEMENT SERVICES TO POMPERAUG WOODS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY JANET WALKER, VICE PRESIDENT OF THE BOARD, BEFORE FILING. THE ORGANIZATION WILL PROVIDE A COMPLETE COPY OF FORM 990 TO ALL VOTING MEMBERS PRIOR TO AND AFTER FILING FORM 990. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST POLICY IS SIGNED OFF BY EACH BOARD MEMBER ANNUALLY. ANY CONFLICTS ARE REVIEWED BY THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15B THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LIFE CARE SERVICES, LLC, (LCS) WHICH PROVIDES MANAGEMENT SERVICES TO POMPERAUG WOODS. THE COMPENSATION OF THE FINANCE DIRECTOR IS DETERMINED BY THE EXECUTIVE DIRECTOR USING COMPARABLE DATA, AND IS APPROVED BY THE PRESIDENT OF THE BOARD. LCS REVIEWS COMPENSATION ON A NATIONAL LEVEL USING A THIRD PARTY SURVEY. INCREASES ARE REVIEWED BY THE DIRECTOR OF OPERATIONS, LCS HR AND THE EXECUTIVE OFFICERS OF LCS FOR APPROVAL. POMPERAUG WOODS DOES A WAGE AND HOUR REVIEW ANNUALLY AND USES A THIRD PARTY WAGE AND HOUR SURVEY TO COMPARE WAGES. ALL INCREASES ARE REVIEWED BY THE EXECUTIVE DIRECTOR AND THE BOARD APPROVES WAGES AND ADJUSTMENTS ANNUALLY WITH THE ANNUAL BUDGET. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THERE HAVE BEEN NO CHANGES TO THE PROCESS DURING THE YEAR.