2018-05-17T06:41:24-05:00 2017-12-31 621046406 JOHNSON HICKEY & MURCHISON PC 2215 OLAN MILLS DRIVE CHATTANOOGA TN 37421 990 2017-01-01 581838041 THE SENIOR LIVING FOUNDATION INC SENI 7703999988 4488 NORTH SHALLOWFORD ROAD NO 103 DUNWOODY GA 30338 WINSTON ALLEN PORTER III MANAGING DIRECTOR 7703999988 2018-05-16 BARRY R HUGGINS P00627334 4237560052 2017 2022-09-23 18:48:47Z WINSTON ALLEN PORTER III DUNWOODY VILLAGE PKWY 115 ATLANTA GA 30350 11973223 0 X N/A X 2008 GA THE ORGANIZATION WAS FORMED TO PROMOTE HEALTH BY OFFERING ELDERLY CITIZENS VIABLE CHOICES IN ALTERNATE LIVING ARRANGEMENTS DESIGNED TO MEET THEIR VARIOUS LEVELS OF NEEDS. 5 4 361 230 0 0 1459 20293 12268358 11942808 -1559 2 8815 10120 12277073 11973223 0 0 0 0 6963332 7117366 0 0 0 5609377 5440960 12572709 12558326 -295636 -585103 15612673 15083437 18129615 18185179 -2516942 -3101742 THE ORGANIZATION WAS FORMED TO PROMOTE HEALTH BY PROVIDING ELDERLY CITIZENS VIABLE CHOICES IN ALTERNATE LIVING ARRANGEMENTS DESIGNED TO MEET THEIR 0 0 11122443 11952928 CARE FOR THE ELDERLY WHICH INCLUDES INTERMEDIATE OR SKILLED NURSING CARE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY,AND EXTENSIVE ACTIVITIES PROGRAMMING. TOTAL PATIENT DAYS WERE 40,884 DURING THE YEAR ENDED 12/31/17. 11122443 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 0 1 8 0 361 1 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 GA X X THE SENIOR LIVING FOUNDATION INC 7703999988 4488 NORTH SHALLOWFORD RD DUNWOODY GA 30338 WINSTON ALLEN PORTER III MANAGING DIRECTOR 12.00 X X 50000 0 0 DAVID MARVIN DIRECTOR 1.00 X 0 0 0 CHUCK POWELL DIRECTOR 1.00 X 0 0 0 STEVE PICKIN CHAIRMAN OF THE BOARD 1.00 X 0 0 0 CHRIS MORRISON DIRECTOR 1.00 X 0 0 0 50000 0 0 0 0 0 0 MIDDLE TN PHARMACY SERVICES 661 EAST LANE STREET SHELBYVILLE TN 37163 PHARMACY 453772 CENTRAL HEALTH SYSTEMS LLC 1530 DUNWOODY VILLAGE PKWY ATLANTA GA 30338 MANAGEMENT FEES 450000 GORDON FOOD SERVICE PO BOX 88029 CHICAGO IL 60680 FOOD SERVICES 351590 PROGRESSIVE MEDICAL CONCEPTS 5020 BU BOWMAN DRIVE STE 600 BUFORD GA 30518 MEDICAL SERVICES 234657 MAKLINE 7327 OAK RIDGE HWY SUITE 104 KNOXVILLE TN 37931 DIETARY AND LAUNDRY SUPPLIES 152067 5 20293 20293 NET PATIENT REVENUE 623000 11942808 11942808 11942808 2 2 BEAUTY & BARBER 623000 6020 6020 MISCELLANEOUS 623000 2500 2500 MEALS 623000 1600 1600 10120 11973223 11952928 0 2 50000 50000 5780861 5371498 409363 42366 39366 3000 771495 736297 35198 472644 438892 33752 450000 450000 50026 45023 5003 11600 10440 1160 594889 396319 198570 65577 65577 13659 6359 7300 240930 216778 24152 26822 24140 2682 2784 1305 1479 1125152 1012637 112515 399023 359122 39901 252081 226873 25208 DRUG AND MEDICAL SUPPLI 745060 745060 LICENSES AND PERMITS 583084 583084 RAW FOOD 390329 390329 BAD DEBT 338233 338233 151711 115111 36600 12558326 11122443 1435883 0 375061 445276 1656672 1446610 62097 60736 7483507 2532146 5320081 4951361 8198762 8179454 15612673 15083437 1447042 1344057 10363489 10363489 3206724 2922688 3112360 3554945 18129615 18185179 X -2523582 -3108684 6640 6942 -2516942 -3101742 15612673 15083437 X -585103 303 X 0 0 0 X 2344 5980 1585 1459 20293 31661 11830765 11849938 12011335 12277174 11952928 59922140 11833109 11855918 12012920 12278633 11973221 59953801 0 0 0 59953801 94 249 657 317 2 1319 94 249 657 317 2 1319 11833203 11856167 12013577 12278950 11973223 59955120 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 129651 129651 6952691 2360344 4592347 401165 171802 229363 4951361 GOODWILL 8107191 NET DEFERRED FINANCING COSTS 50409 PATIENT TRUST FUNDS 21854 8179454 NOTE PAYABLE CROSSVILLE ASSOCIATES 93065 PATIENT TRUST FUNDS 30674 PROMISSARY NOTE 2901206 NOTE PAYABLE WINSTON PORTER JR 180000 N/P RELATED PARTY 350000 3554945 PART IV, LINE 2B: MONEY HELD BY THE ORGANIZATION FOR PATIENT'S PERSONAL USE IN A SEPARATE BANK ACCOUNT. A THE HEALTH AND EDUCATIONAL FACILITIES BOARD OF THE CITY OF CROSSVILLE TN 2010-02-01 10363489 PURCHASE OF NURSING HOME 0 0 0 A 10363489 10363489 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 CENTRAL HEALTH SYSTEMS LLC PART V 450000 MANAGEMENT FEES 0 PART IV SECTION (B) WINSTON PORTER 99% OWNER IN CROSSVILLE ASSOCIATES LLC, IS THE FATHER OF THE MANAGING DIRECTOR WINSTON PORTER III. WINSTON PORTER OWNS 49% OF THE MANAGEMENT COMPANY WHO MANAGES THE NURSING HOME.WINSTON PORTER III DOES NOT CONTROL OR OWN THE MANAGEMENT COMPANY. WINSTON PORTER THE III DOES NOT PARTICIPATE IN THE EVALUATION OR SELECTION OF THE MANAGEMENT COMPANY WHICH OPERATES THE NURSING HOME.THE MANAGEMENT COMPANY OFFERS A STANDARD CONTRACT THAT IS SIMILAR TO OTHERS IN THE INDUSTRY. THE PROPERTY BID OUT MANAGEMENT AGREEMENTS TO INSURE THAT ANY MANAGEMENT AGREEMENT RATE THAT THE NONPROFIT PAYS ARE KEPT AT OR BELOW FAIR MARKET VALUE FOR SUCH SERVICES FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WILL BE REVIEWED BY THE BOARD BEFORE IT IS FILED FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE SIGNS A STATEMENT THAT HE HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY AND HAS READ AND UNDERSTANDS THE POLICY, AND AGREES TO COMPLY WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY THE BOARD FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: INCREASE IN TEMPORARILY RESTRICTED FUND BALANCE 303. SLF NO1 LLC 456 WAYNE AVENUE CROSSVILLE TN 38555 271506824 NURSING HOME TN -535102 15082234 THE SENIOR LIVING FOUNDATION INC SOLE MEMBER OF SLF NO1 LLC SLF NO1 LLC 456 WAYNE AVENUE CROSSVILLE TN 38555 271506824 NURSING HOME TN 501(C)3 LINE 11 THE SENIOR LIVING FOUNDATION INC SOLE MEMBER OF SLF NO1 LLC 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SLF#1 LLC C 50000 CASH