2019-05-14T13:34:18-05:00 2018-06-30 390859910 Baker Tilly Virchow Krause LLP 1650 Market Street Ste 4500 Philadelphia PA 191037341 990 2017-07-01 231314352 Quarryville Presbyterian Retirement Community QUAR 7177867321 625 Robert Fulton Highway Quarryville PA 175661400 Diane E Aston CFO 7177867321 2019-05-14 1 Kerri N Bogda P00760402 2159720701 96.89.178.186 2019-05-14 12:50:26 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F58787FA80410BAE38B710EAF9FCC5760AD3BCDF 2017 2019-02-21 02:37:17Z Robert B Hayward Jr 625 Robert Fulton Highway Quarryville PA 175661400 32996623 0 X www.quarryville.com X 1948 PA To provide for the spiritual, physical, emotional, and social needs of our residents. 12 9 503 145 140062 -32990 53288 135001 23989287 24297105 196131 532396 214078 197039 24452784 25161541 495755 582506 0 0 14089219 14409528 0 0 235 10927683 11026674 25512657 26018708 -1059873 -857167 63265661 65158862 52199676 53654896 11065985 11503966 X To provide for the spiritual, physical, emotional, and social needs of our residents through high-quality facilities, services, and personal care in a manner faithful to the Bible and honoring our Lord, Jesus Christ. 0 0 10929834 0 12383964 Our goal at QV is to provide for the spiritual, physical, emotional, and social needs of our residents through high-quality facilities, services, and personal care. In our skilled care center, we provide superb medical staff, backed by carefully trained caregivers and rehabilitation therapists, who are ready to serve our residents. For those who need memory care support, we offer secure residences, staffed by dementia-certified, licensed teams.During the fiscal year, 249 individuals were served. As of 6/30/18, there were 104 residents receiving skilled care services and we provided $3,293,735 worth of unreimbursed care to medical assistance residents as part of our charitable mission. We received 11,151 hours of service from 145 volunteers throughout our community. 8115184 37885 5735906 At QV our independent living residents can set aside the worldly cares of maintaining a house while living in the security of a respected continuing care retirement community. There are all the clubs, activities, spiritual, and learning opportunities a resident could want, along with all the conveniences of a small town. In addition, residents have the security of knowing therapies, personal care, and skilled care are available if needed. QV has embarked on a major expansion, adding new cottages and a new community center with a swimming pool. During the fiscal year, 284 individuals were served. As of 6/30/2018, there were 248 residents occupying residential apartments and cottages and we provided $37,885 worth of financial assistance to residents who have run short on resources. 3980356 544621 4919273 In our personal care center, QV provides assistance with the tasks of daily living under the 24 hour supervision of a licensed practical nurse. In addition, there are social and recreational events, wellness, spiritual and educational programs available and we offer our residents the convenience of a beauty shop, convenience store, bank, transportation services, and guest rooms for families, all within our campus. Our goal is to help each resident live as independently as possible. For those who need memory care support, we offer secure residences, staffed by dementia-certified, licenced teams.During the fiscal year, 95 individuals were served. As of 6/30/2018, there were 68 residents occupying personal care apartments provided. We provided $538,621 worth of financial assistance to residents who have run short of resources.Diaconal support is provided to residents who have demonstrated the inability to pay and are not eligible for third-party reimbursement. Certain residents qualify for charity care upon admission or when their financial resources are depleted. Diaconal support amounted to $576,506 in 2018 and $491,500 in 2017 and is reported as an expense on the Form 990. 23025374 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 150 0 503 1 1 1 0 0 0 0 0 0 0 0 0 X 12 9 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 PA X Diane E Aston VPCFO 7177867321 625 Robert Fulton Highway Quarryville PA 175661400 Bruce Peters Chairman 1.00 X X 10538 0 0 Dr Guy Richardson Vice-Chairman 1.00 X X 0 0 0 Dr Charles Hartzell Secretary 1.00 X X 0 0 0 Dr Bruce Fiol Board Member/CHAPLAIN 1.00 X 64389 0 0 Mark Van Gilst Board Member 1.00 X 0 0 0 George Mackenzie Jr Board Member 1.00 X 0 0 0 Thomas Harr Board Member 1.00 X 0 0 0 Dr Guy Webster Board Member 1.00 X 0 0 0 Dr Jonathan Sneller Board Member 1.00 X 0 0 0 David Schempp Board Member 1.00 X 0 0 0 Robert Hayward Jr President, CEO 40.00 X X 250711 0 43533 Eric Youngdale Board Member 1.00 X 0 0 0 Diane Aston VP/CFO 40.00 X 159171 0 29709 Joel Clausen VP Healthcare 40.00 X 126249 0 37779 Lawrence Roff Chaplain 40.00 X 53015 0 31658 Deborah Allred Director of Nursing 40.00 X 108020 0 15663 Dr David Weston Former Board Member 0.00 X 17292 0 0 William Graybill Former Board Member/Chaplain 0.00 X 14932 0 0 804317 0 158342 5 1 1 0 B K Campbell Enterprises Inc 1771 Limestone Road Cochranville PA 19330 Construction Services 1151996 Select Rehabilitation Inc PO Box 809056 Chicago IL 606809056 Therapy Services 781259 Wohlsen Construction Company PO Box 4612 Lancaster PA 17604 Building Contractors 254251 Nickel Mine Floor Covering Inc 349 Buck Road Quarryville PA 175660000 Flooring Contractor 146544 Iddings Electric Inc 325 West Main Street Suite C New Holland PA 17557 Electrical Contractor 141101 7 135001 135001 Skilled Care Services 623000 12387864 12383964 3900 Residential Living Svc 623000 6989968 5735906 1254062 Personal Care Services 623000 4919273 4919273 24297105 215280 215280 148990 118160 30830 30830 30830 7988001 25797 7684082 12600 303919 13197 317116 4197 312919 44919 20240 24679 24679 Farm Operation 110000 135865 135865 Postage Income 900099 2977 2977 POS Income 900099 1532 1532 1156 1156 141530 25161541 23039143 140062 1847335 6000 6000 576506 576506 914923 400432 514491 9863302 9103375 759927 491024 82856 408168 2382040 2249538 132502 758239 683011 75228 28140 28140 152900 7500 145400 1261 1261 80918 80918 1366069 1320927 45142 176365 176365 2328060 2225584 102288 188 13917 13917 1711547 1705732 5815 50779 43701 7078 23943 15298 8645 46637 46637 3541834 3321649 220185 116107 93472 22635 Other Operational Exp. 496773 213064 283662 47 Med Supplies/svc 477231 477054 177 NH Assessment tax 276673 276673 Farm Expenses 137520 137520 26018708 23025374 2993099 235 830220 949881 631042 941903 1948392 2391277 58575 76024 560329 602793 107815975 55135783 51497773 52680192 7396182 7135981 200884 240739 142264 140072 63265661 65158862 3239073 4598110 14360004 16706421 21221080 20366838 77882 116137 865710 1286203 187787 12435927 10393400 52199676 53654896 X 11053474 11479984 2511 13982 10000 10000 11065985 11503966 63265661 65158862 X -857167 -81774 1376922 X 0 1 X 1 0 X 14525 206782 31963 53288 135001 441559 20448885 21236891 21868568 22654763 23039143 109248250 1346756 1298920 1277828 1334524 1302881 6560909 21810166 22742593 23178359 24042575 24477025 116250718 3300 8518 3725 22850 11525 49918 0 3300 8518 3725 22850 11525 49918 116200800 361893 363412 362731 333001 364270 1785307 361893 363412 362731 333001 364270 1785307 8383 8383 12293 11668 5574 62132 5665 97332 22192735 23117673 23546664 24437708 24846960 118141740 0.98360 0.98290 0.01510 0.01580 X Schedule A, Part III, Line 12, Explanation of Other Income: Other Income - 2013 Amount: $ 12,293. 2014 Amount: $ 11,668. 2015 Amount: $ 2,988. 2016 Amount: $ 4,028. 2017 Amount: $ 2,688. Postage - 2015 Amount: $ 2,586. 2016 Amount: $ 3,104. 2017 Amount: $ 2,977. Right-of-Way Payment - 2016 Amount: $ 55,000. 0 0 0 0 0 0 0 0 1 1261 1261 0 Part II-B, Line 1: The organization pays dues to a member organization dedicated to issues involving continuing care facilities and help and support for the elderly. The percentage of dues dedicated to lobbying is 5.9%. The organization paid $21,374 in dues for a total of $1,261 dues allocated to lobbying. 0 1 X 12241 7 12248 12235 6 12241 12230 5 12235 12255 -25 12230 12286 -31 12255 0.00000 0.81650 0.18350 0 0 307031 975391 1282422 1188908 47101913 20865201 27425620 75308 18906528 12264689 6717147 310826 38950070 22005893 17255003 52680192 Liabilities to Residents 5510494 Accrued Pension Liability 4882906 10393400 26018583 -81774 800416 718642 25299941 -138400 -138400 25161541 25580602 138400 138400 25442202 576506 576506 26018708 Part IV, Line 2b: The funds held belong to the residents who are not able to manage their own finances. The funds are used to to pay for services the organization provides to the resident and also provide the resident with funds for their own personal needs. The resident can request a payment from the account by completing a check request form or can obtain cash by completing a petty cash voucher. The residents receive a monthly statement showing the account activity and balance. Part V, Line 4: Endowments Funds are used for nursing scholarships. Part XI, Line 2d - Other Adjustments: Diaconal Support -576,506. Minimum Pension Liability Adjustment 1,376,922. Part XI, Line 4b - Other Adjustments: Rental Expenses -118,160. Cost of Goods Sold -20,240. Part XII, Line 2d - Other Adjustments: Rental Expenses 118,160. Cost of Goods Sold 20,240. Part XII, Line 4b - Other Adjustments: Diaconal Support 576,506. 1 Quarryville Fire Department 217 E State St Quarryville PA 17566 236297242 501(c)(3) 6000 Purchase of 7 handheld gas detection meters 1 0 Charity care is provided to residents of QPRC who have run out of money. 16 0 576506 Difference between amount charged and amount received as payment Write off of amounts due to QPRC for services rendered to residents who have been approved for charity care. Part I, Line 2: Diaconal support is provided to residents who demonstrate their financial resources have been depleted, they are unable to pay for services rendered, and they are not eligible for third party reimbursement, via a financial assistance application. Personal spending for those that qualify is monitored and services provided by QPRC above the resident's monthly income is written off as charity care. Because the organization provided charity assistance to residents who are unable to pay for these services, it is reported as an expense under assistance to individuals. X X 1 1 X X X X 0 0 0 0 0 0 0 0 0 Robert Hayward Jr President, CEO 247571 0 53 0 3087 0 6431 0 37102 0 294244 0 0 0 Diane Aston VP/CFO 158971 0 52 0 148 0 4099 0 25610 0 188880 0 0 0 Joel Clausen VP Healthcare 125128 0 1057 0 64 0 2204 0 35575 0 164028 0 0 0 Dr David Weston Former Board Member 17292 0 0 0 0 0 0 0 0 0 17292 0 0 0 William Graybill Former Board Member/Chaplain 14932 0 0 0 0 0 0 0 0 0 14932 0 0 0 Part I, Line 1a The Chaplain is provided housing, including utilities, free of charge. The organization conforms to the non-taxable housing allowance guidelines per the IRS' rules and regulations. Note that, while the housing is not taxable for federal tax purposes, it is taxable for Medicare and as such is included in the Chaplain's box 5, w-2 base compensation. The value of the housing allowance is $15,000. In addition, board members who become residents may receive tax gross-up payments to mitigate the tax effect of the entrance fee discounts provided by Quarryville. During the calender year, Bruce Fiol received a board discount valued at $13,362 and a tax gross-up payment of $1,336. Bruce Peters received a board discount valued at $9,904 and a tax gross-up payment of $634. Former board member Dr. David Weston received a board discount of $15,720 and a tax gross-up payment of $1,572. Susan Graybill (wife of William Graybill, deceased board member) received a board discount of $4,312 and a tax gross up payment of $431. Stephen Phillips, former officer, received a board discount of $1,814. A Quarryville Borough Authority 232325364 2013-09-03 4000000 Project financing 0 0 0 B Paradise Township Sewer Authority 232486384 2015-07-02 7500000 Capital Improvements 0 0 0 A 386477 4000000 50001 3949999 2015 0 0 1 1 B 328680 7500000 71763 4211510 3216727 2016 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 Form 990, Part VI, Section A, line 2 Jonathan Sneller and Bruce Fiol have a family relationship. Form 990, Part VI, Section A, line 8b The committees do not have the authority to act on behalf of the board. All matters are taken to full board for approval and action. Form 990, Part VI, Section B, line 11b The CFO and CEO will perform the initial review of the form 990. The Form 990 will then be reviewed by the Audit and Finance Committee. Once approved, each member of the governing body will receive a copy of the Form 990 by e-mail, prior to filing the return. Form 990, Part VI, Section B, line 12c Each year during annual ethics training all employees are required to sign a code of ethics/conflict of interest statement. All conflict of interest statements are reviewed by human resources. Any disclosures are reviewed by the CFO and the CEO. Reports of ethical issues are reviewed and resolved by the head of the ethics committee and the CEO. The Board of Directors also sign the code of ethics/conflict of interest statement annually. There is a place on the form for the disclosure of relationships, such as through family or business contacts, that could be considered a conflict of interest. In the event a matter involving a potential or actual conflict of interest arises, the party to the conflict shall fully disclose the conflict's nature and extent immediately to the compliance officer who, after making a thorough review of the circumstances, will report to the QPRC Board of Directors who will determine appropriate action to be taken. Form 990, Part VI, Section B, line 15 The officers and key employees' salaries are recommended by the Compensation Committee of the Board of Directors and are approved by the full Board. Salary surveys and Forms 990 of other Not-for-Profits are used for comparative purposes to ensure any compensation decisions are within fair market range for the industry. Deliberations and decisions are documented in the minutes of the Executive Committee. The Finance committee recommends approval of the budget to the full board. The budget includes a maximum percentage increase in salary for all staff, which includes key employees. The job performance of each employee is taken into consideration as part of the performance review process. Form 990, Part VI, Section C, line 19 The form 990 is available on Guidestar and is also available upon request. The Disclosure Statements as required by the Department of Insurance are also available upon request. The organization will make its governing documents and conflict of interest policy available upon request. The organization includes a copy of its financial statements with the state registration filed with the Pennsylvania Department of State, Bureau of Charitable Organizations. These documents are a matter of public record and can be viewed at the bureau office. Form 990, Part XI, line 9: Minimum Pension Liability Adjustment 1,376,922.