2019-10-23T14:46:18-05:00 2018-12-31 593070669 MOORE STEPHENS LOVELACE PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2018-01-01 591031820 PLYMOUTH HARBOR INC PLYM 9413652600 700 JOHN RINGLING BLVD SARASOTA FL 34236 HARRY E HOBSON PRESIDENT/CEO 9413652600 2019-10-23 1 NORMAN B NEAL CPA P00071411 4077405400 104.178.77.115 2019-10-23 14:44:13 ED P AA06F16595B971911646E1ABD4EF9FD1205D715B 7FC0E18F63597829422D687723989F114BEB8769 2018 2020-01-14 16:20:31Z HARRY E HOBSON 700 JOHN RINGLING BLVD SARASOTA FL 34236 35052439 0 X WWW.PLYMOUTHHARBOR.ORG X 1961 FL PLYMOUTH HARBOR IS A CHURCH-SPONSORED, NOT-FOR-PROFIT COMMUNITY OF DISTINCTION FOR OLDER ADULTS COMMITTED TO PROVIDING THE MOST POSITIVE AGING EXPERIENCE POSSIBLE FOR ITS RESIDENTS. 15 15 471 15 0 0 1385852 475204 25305768 29834076 153096 1044809 812020 433594 27656736 31787683 15500 31305 0 0 12803377 15439519 0 0 149826 12619240 16053691 25438117 31524515 2218619 263168 129617822 125230459 100063580 97131299 29554242 28099160 PLYMOUTH HARBOR IS A CHURCH-SPONSORED NOT-FOR-PROFIT COMMUNITY OF DISTINCTION FOR OLDER ADULTS COMMITTED TO PROVIDING THE MOST POSITIVE AGING EXPERIENCE POSSIBLE FOR ITS RESIDENTS. 0 0 28025716 28985838 CARING FOR SENIOR ADULTS THROUGH THE OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF 214 INDEPENDENT APARTMENT UNITS, 60 ASSISTED LIVING APARTMENT UNITS, A LICENSED HOME HEALTH AGENCY AND 56 BED SKILLED NURSING CENTER. 105116 31305 475204 THE PLYMOUTH HARBOR FOUNDATION - ENSURING THE APPROPRIATE STEWARDSHIP OF CONTRIBUTED FUNDS, DEVELOPING FUNDRAISING STRATEGIES THAT SUPPORT THE MOST POSITIVE AGING EXPERIENCE POSSIBLE, AND PROVIDING FUNDING FOR INNOVATIVE PROGRAMS AND SERVICES IN THE REGION. 363463 877130 THE LEGACY FUND PROVIDES SUPPORT FOR OPERATING AND MAINTAINING A LIFE CARE FACILITY AIDING NEEDY RESIDENTS OF THE CORPORATION. 28494295 1 1 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 78 0 1 471 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X NATALLIA DZIATSEL CPA 9413652600 700 RINGLING BLVD SARASOTA FL 34236 BRIAN D HALL CHAIRMAN 1.00 0.00 X X 0 0 0 CINDY MALKIN VICE CHAIRMAN 1.00 0.00 X X 0 0 0 NORA PATTERSON SECRETARY 1.00 0.00 X X 0 0 0 WILLIAM WOLTJEN TREASURER 1.00 0.00 X X 0 0 0 TOM BELCHER TRUSTEE 1.00 0.00 X 0 0 0 KATHRYN ANGELL CARR TRUSTEE 1.00 0.00 X 0 0 0 JOHN M CRANOR III TRUSTEE 1.00 0.00 X 0 0 0 LEE DELIETO SR TRUSTEE 1.00 0.00 X 0 0 0 CADE SIBLEY TRUSTEE 1.00 0.00 X 0 0 0 MYRON ROBINSON TRUSTEE 1.00 0.00 X 0 0 0 JON F SWIFT TRUSTEE 1.00 0.00 X 0 0 0 MARIE E UNDERWOOD TRUSTEE 1.00 0.00 X 0 0 0 DALE N WOODLING TRUSTEE 1.00 0.00 X 0 0 0 ALAN B GRINDAL TRUSTEE 1.00 0.00 X 0 0 0 JAMES D MCGEE TRUSTEE 1.00 0.00 X 0 0 0 TOM ELLIOTT TRUSTEE 1.00 0.00 X 0 0 0 HARRY E HOBSON PRESIDENT/CEO 40.00 0.00 X 668898 0 24998 NATALLIA DZIATSEL VICE PRESIDENT/CFO 40.00 0.00 X 153728 0 5434 JOSEPH J DEVORE SVP OF HEALTH SERVICES 40.00 0.00 X 163422 0 11245 GEORGE W MCGONAGILL VP OF FACILITIES 40.00 0.00 X 154486 0 8918 GORDON OKAWA VP OF MARKETING 40.00 0.00 X 153729 0 23381 REBECCA S PAZKOWSKI SVP OF PHILANTHROPY 40.00 0.00 X 148462 0 16517 TENA WILSON VICE PRESIDENT OF RESIDENT & EMPLOYEE RELATIONS 40.00 0.00 X 120148 0 15940 1562873 0 106433 12 0 1 0 WILLIS A SMITH CONSTRUCTION 5001 LAKEWOOD RANCH BLVD N SARASOTA FL 34240 CONSTRUCTION 4148166 REHABCARE 8401 E CYPRESS DR PEMBROKE PINES FL 33025 REHABILITATION AND THERAPY 633155 TAMPA BAY TRANE SERVICE 902 N HIMES AVE TAMPA FL 33609 REPAIRS AND MAINTENANCE 262113 WRBC ARCHITECTS ENGINEERS 44 CENTRAL STREET BANGOR ME 04401 ARCHITECTS 205867 VALCOURT BUILDING SERVICES OF FLORIDA 4695 18TH ST E SARASOTA FL 34236 CONSTRUCTION/MAINTENANCE SERVICES 156319 13 475204 475204 MONTHLY SERVICE FEES 623000 21163286 21163286 ENTRANCE FEES 623000 8670790 8670790 29834076 901153 70502 830651 3408412 3018823 245933 389589 -245933 143656 143656 CAPITAL REIMBURSEMENTS 623000 433594 433594 433594 31787683 30338172 0 974307 31305 31305 853058 693896 159162 11023760 9552847 1355103 115810 239613 190305 45756 3552 2407919 2269695 133098 5126 915169 798488 108918 7763 46509 5380 41129 46500 46500 113037 113037 1480841 1019530 461311 191629 31846 155179 4604 358124 235535 117153 5436 51886 9466 42420 1837045 1836338 707 24194 11409 9888 2897 827058 827058 6704976 6698278 6698 752509 727509 25000 FOOD 1110517 1110517 MEDICAL, OXYGEN, AND DR 858436 858436 SUPPLIES 456641 418186 37754 701 LINENS AND UNIFORMS 287285 287285 906504 767949 134618 3937 31524515 28494295 2880394 149826 607084 3084929 110818 64685 0 592560 1820631 1279887 69101 103650 490790 641145 143772108 53926111 85017133 89845997 41373249 29617606 129016 0 129617822 125230459 3514978 1958764 60275412 42083602 35000000 25902076 1273190 27186857 100063580 97131299 X 25853874 24743291 3609838 3355869 90530 0 29554242 28099160 129617822 125230459 X 263168 -2083602 365352 X X 0 1 X 1 0 X 21908 922308 2461095 1385852 475204 5266367 21956426 23813539 23993495 25305768 29834076 124903304 21978334 24735847 26454590 26691620 30309280 130169671 0 0 0 130169671 116098 115907 149637 220485 901153 1503280 116098 115907 149637 220485 901153 1503280 154625 397379 812020 433594 1797618 22094432 25006379 27001606 27724125 31644027 133470569 0.97530 0.98300 0.01130 0.00590 X 1 286 198 88 0 13906717 55000 -742855 1255931 11962931 12161627 90530 1654560 13906717 11477104 547064 233621 96162 12161627 11630413 262873 374487 41695 11477104 11136519 300238 301156 53379 54121 11630413 0.99570 0.00000 0.00430 0 1 1 4384390 4384390 125640007 50099836 75540171 11337004 3826275 7510729 2410707 2410707 89845997 CASH AND CASH EQUIVALENTS 5700826 F ACCRUED INTEREST 74229 F CORPORATE BONDS 3444392 F U.S. GOVERNMENT OBLIGATIONS 3014914 F MUTUAL FUNDS 12096699 F CERTIFICATE OF DEPOSITS 1008005 F CORPORATE STOCK 4278541 F 29617606 DEFERRED ENTRANCE FEES 26928313 INTEREST RATE SWAP 258544 27186857 29956396 -2083602 365352 -1718250 31674646 113037 113037 31787683 31411478 0 31411478 113037 113037 31524515 PART IV, LINE 1B: PLYMOUTH HARBOR, INC. OFFERS A CASH MANAGEMENT SERVICE TO ITS HEALTHCARE RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF EACH RESPECTIVE RESIDENT. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET UNREALIZED GAIN (LOSS) ON GIFT ANNUITIES CHANGE IN VALUE OF SWAP INTEREST AGREEMENT PART XI, LINE 4B - OTHER ADJUSTMENTS: . 0 SCHOLARSHIPS 17 31305 FAIR MARKET VALUE X 1 1 X X X X 0 1 0 0 0 0 0 0 0 HARRY E HOBSON PRESIDENT/CEO 387033 0 0 0 281865 0 13125 0 11873 0 693896 0 0 0 NATALLIA DZIATSEL VICE PRESIDENT/CFO 153728 0 0 0 0 0 0 0 5434 0 159162 0 0 0 JOSEPH J DEVORE SVP OF HEALTH SERVICES 163422 0 0 0 0 0 5737 0 5508 0 174667 0 0 0 GEORGE W MCGONAGILL VP OF FACILITIES 154486 0 0 0 0 0 3469 0 5449 0 163404 0 0 0 GORDON OKAWA VP OF MARKETING 153729 0 0 0 0 0 5781 0 17600 0 177110 0 0 0 REBECCA S PAZKOWSKI SVP OF PHILANTHROPY 148462 0 0 0 0 0 5074 0 11443 0 164979 0 0 0 PART I, LINE 4B PLYMOUTH HARBOR, INC. HAS AN EMPLOYEE DEFERRED COMPENSATION PLAN OPEN TO CERTAIN KEY EMPLOYEES UNDER INTERNAL SECTION 457(F) THAT IS A NON-TAX QUALIFIED RETIREMENT PLAN. THESE FUNDS REMAIN THE PROPERTY OF PLYMOUTH HARBOR, INC. THE ORGANIZATION HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. KEY EXECUTIVE (HARRY HOBSON, CEO) PARTICIPATES IN THE DEFERRED COMPENSATION PLAN UNDER IRC SEC. 457(F); THE SUBSTANTIALLY VESTED DATE WAS JANUARY 1, 2018 AND THE CURRENT YEAR COMPENSATION OF THE CEO INCLUDES A DISTRIBUTION FROM A RABBI TRUST OF $281,865. THIS IS A ONE-TIME EVENT AND IS NOT REPRESENTATIVE OF THE AVERAGE ANNUAL COMPENSATION FOR THIS POSITION. A SARASOTA COUNTY HEALTH FACILITIES AUTHORITY 596000848 2015-12-10 26000000 SEE SUPPLEMENTAL INFORMATION BELOW 0 0 0 A 26000000 203740 25796260 2015 0 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 THE NORTHERN TRUST COMPANY 12.000000000000 0 0 0 0 1 SCHEDULE K, ROW A, PART I(F) THE PROCEEDS OF THE SERIES 2015 NOTES WERE USED TO (A) FINANCE THE CONSTRUCTION COSTS FOR THE EXPANSION OF AN EXISTING CONTINUING CARE RETIREMENT COMMUNITY, (B) REFUND ALL OF THE THEN OUTSTANDING MORTGAGE NOTE PAYABLE, AND (C) PAY THE COST OF ISSUANCE OF THE SERIES 2015 NOTES. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS REVIEWED IN ITS ENTIRETY BY THE CHIEF FINANCIAL OFFICER. ANY QUESTIONS ARE RESOLVED WITH THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE RETURN. IN ADDITION, A COPY IS PROVIDED TO EACH INDEPENDENT VOTING MEMBER OF THE BOARD FOR REVIEW BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND EMPLOYEES. NEW BOARD MEMBERS COMPLETE AND SUBMIT A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT AT ORIENTATION. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND SUBMIT A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THESE STATEMENTS ARE REVIEWED BY THE BOARD PRESIDENT AND CHIEF EXECUTIVE OFFICER. ANY BOARD MEMBER HAVING A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS PROHIBITED FROM VOTING OR USING HIS/HER PERSONAL INFLUENCE ON THE MATTER, AND SHOULD NOT BE COUNTED AS PART OF A QUORUM FOR THE MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION COMMITTEE, WHICH IS INDEPENDENT WITH RESPECT TO ALL COMPENSATION DECISIONS AND CONSISTS OF SEVERAL INDEPENDENT BOARD MEMBERS, AND AN INDEPENDENT CONSULTANT EVALUATES THE PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER. THE CEO PERFORMS ANNUAL EVALUATIONS OF OTHER TOP MANAGEMENT OFFICIALS. THE ORGANIZATION UTILIZES COMPARABILITY SURVEYS, CONDUCTED BY THE HUMAN RESOURCES DIRECTOR, TO DETERMINE THE COMPENSATION OF THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE PRESIDENT OF THE BOARD OF DIRECTORS REVIEWS THE EVALUATIONS AND PROVIDES WRITTEN APPROVAL OF COMPENSATION DECISIONS. PLYMOUTH HARBOR, INC. HAS AN EMPLOYEE DEFERRED COMPENSATION PLAN OPEN TO CERTAIN KEY EMPLOYEES UNDER INTERNAL SECTION 457(F) THAT IS A NON-TAX QUALIFIED RETIREMENT PLAN. THESE FUNDS REMAIN THE PROPERTY OF PLYMOUTH HARBOR, INC. THE ORGANIZATION HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. KEY EXECUTIVE, HARRY HOBSON, CEO, PARTICIPATES IN THE DEFERRED COMPENSATION PLAN UNDER IRC SEC. 457(F). THE VESTED DATE WAS JANUARY 1, 2018. THE CURRENT YEAR COMPENSATION OF THE CEO INCLUDES A DISTRIBUTION FROM RABBI TRUST OF $281,865. THIS IS A ONE-TIME EVENT AND IS NOT A REPRESENTATIVE OF AVERAGE ANNUAL COMPENSATION FOR THIS POSITION. 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 AT THE FACILITY. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 417,481. NET UNREALIZED GAIN (LOSS) ON CHARITABLE REMAINDER TRUSTS -52,129. FORM 990, PART XII, LINE 2C OVERSIGHT OF FINANCIAL STATEMENT AUDIT: THE ORGANIZATION'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE PLYMOUTH HARBOR FOUNDATION LLC 700 JOHN RINGING BLVD SARASOTA FL 34236 000000000 TO SUPPORT THE PLYMOUTH HARBOR FACILITY. FL 556912 4278230 PLYMOUTH HARBOR INC