2018-05-14T13:51:35-05:00 2017-06-30 390859910 baker tilly virchow krause llp 1650 MARKET STREET STE 4500 PHILADELPHIA PA 191037341 990 2016-07-01 231314352 Quarryville Presbyterian Retirement Community QUAR 7177867321 625 Robert Fulton Highway Quarryville PA 175661400 diane e aston CFO 7177867321 2018-05-14 1 JULIUS C GREEN CPA P00350393 2159720701 X 96.89.178.186 2018-05-14 09:26:52 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 41D52B76DFE0CA0C5E5ED141E25DBC48D8427C36 2016 2021-01-29 14:40:06Z Robert B Hayward Jr 625 Robert Fulton Highway Quarryville PA 175661400 28797756 0 X www.quarryville.com X 1948 PA To provide for the spiritual, physical, emotional, and social needs of our residents. 12 8 495 169 147615 -17617 31963 53288 23146397 23989287 396736 196131 206977 214078 23782073 24452784 531243 495755 0 0 13398978 14089219 0 0 0 9843786 10927683 23774007 25512657 8066 -1059873 64924347 63265661 55465971 52199676 9458376 11065985 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 10637279 0 12249878 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, 238 INDIVIDUALS WERE SERVED. AS OF 6/30/2017, THERE WERE 104 RESIDENTS RECEIVING SKILLED CARE SERVICES AND WE PROVIDED $3,061,799 WORTH OF UNREIMBURSED CARE TO MEDICAL ASSISTANCE RESIDENTS AS PART OF OUR CHARITABLE MISSION. We received 12,186 hours of service from 169 volunteers throughout our community. 7955846 36623 7027237 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, 268 INDIVIDUALS WERE SERVED. AS OF 6/30/2017, THERE WERE 232 RESIDENTS OCCUPYING RESIDENTIAL APARTMENTS AND COTTAGES AND WE PROVIDED $36,623 WORTH OF financial ASSISTANCE RESIDENTS who have run short on resources. 3883308 459132 4712172 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, LICENSED TEAMS.DURING THE FISCAL YEAR, 99 INDIVIDUALS WERE SERVED. AS OF 6/30/2017, THERE WERE 67 RESIDENTS OCCUPYING PERSONAL CARE APARTMENTS PROVIDED AND WE PROVIDED $454,877 WORTH OF financial ASSISTANCE 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 $491,500 in 2017 and $519,413 in 2016 and is reported as an expense on the Form 990. THE ORGANIZATION PROVIDES UNCOMPENSATED CARE, SUBSIDIES AND OTHER SUPPORT OF THOSE IN NEED TO MANY OF THE PROGRAMS AND INDIVIDUALS IT SERVES. THE COST OF UNCOMPENSATED CARE PROVIDED TOTALED APPROXIMATELY $3,440,000 AND $2,780,000 IN 2017 AND 2016, RESPECTIVELY. UNCOMPENSATED CARE INCLUDES DIACONAL SUPPORT (INCLUDED ABOVE AS AN EXPENSE/GRANT) AS WELL AS SERVICES TO RESIDENTS WHERE THE COST OF PROVIDING THE SERVICES EXCEEDS THE THIRD PARTY REIMBURSEMENT RECEIVED. 22476433 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 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 173 0 1 495 1 1 1 0 0 0 0 0 0 0 0 0 X 12 8 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 CFO 7177867321 625 Robert Fulton Highway quarryville PA 175661400 Bruce Peters Chairman 1.00 X X 8508 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 1.00 X 46376 0 0 Mark Van Gilst Board Member 1.00 X 0 0 0 Dr William Graybill Board Member (dec. June 2017) 1.00 X 18809 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 240475 0 42113 Eric Youngdale Board Member 1.00 X 0 0 0 Diane Aston CFO 40.00 X 151250 0 28866 Stephen Phillips Chaplain (Res. Dec. 2016) 40.00 X 81341 0 22452 Joel Clausen Administrator 40.00 X 119880 0 35055 Lawrence Roff Chaplain 40.00 X 13705 0 3165 Deborah Allred Administrator 40.00 X 105022 0 11210 DR DAVID WESTON FORMER BOARD MEMBER 0.00 X 17292 0 0 802658 0 142861 4 1 1 0 B K CAMPBELL ENTERPRISES INC 1771 limestone road COCHRANVILLE PA 19330 Construction Services 1958908 SELECT REHABILITATION INC PO BOX 809056 CHICAGO IL 606809056 Therapy Services 805482 Judith L Bushong 162 Hopkins Mill Road New Providence PA 17560 Grounds/Landscaping 395129 Andrews Excavating LLC 5 W Willow Road Willow Street PA 17584 Excavating 262847 WOHLSEN CONSTRUCTION COMPANY PO BOX 4612 LANCASTER PA 17604 BLDG CONTRACTORS 183463 7 53288 53288 Skilled care services 623000 12249878 12212919 36959 Residential living ser 623000 7027237 5729672 1297565 Personal Care services 623000 4712172 4712172 23989287 208059 208059 124942 121006 3936 3936 3936 4061597 150441 4067277 156689 -5680 -6248 -11928 2709 -14637 3104 0 3104 3104 Farm operation 110000 144906 144906 RIGHT-OF-WAY PAYMENT 900099 55000 55000 Other Income 900099 4028 4028 3104 3104 207038 24452784 22654763 147615 1597118 4255 4255 491500 491500 927176 451660 475516 9377884 8616289 761595 560930 70699 490231 2498698 2331139 167559 724531 652382 72149 26089 26089 144374 7500 136874 1230 1230 76565 76565 1402805 1350603 52202 206976 206549 427 2165702 2069074 96628 32087 5688 26399 1663560 1658188 5372 39645 34177 5468 24868 10921 13947 50131 50131 3463589 3271302 192287 115717 92076 23641 med supplies/svc 622888 622867 21 Other Operational Exp. 476246 197415 278831 NH assessment tax 282018 282018 farm expenses 133086 133086 107 107 25512657 22476433 3036224 0 1753230 830220 1023003 631042 2366651 1948392 22858 58575 481197 560329 103019936 51522163 51340026 51497773 6620107 7396182 1172952 200884 144323 142264 64924347 63265661 3873429 3239073 15072723 14360004 22026867 21221080 82027 77882 865710 14410925 12435927 55465971 52199676 X 9445870 11053474 2506 2511 10000 10000 9458376 11065985 64924347 63265661 X -1059873 518652 2148830 X 0 1 X 1 0 X 55105 14525 206782 31963 53288 361663 21050368 20448885 21236891 21868568 22654763 107259475 1302445 1346756 1298920 1277828 1334524 6560473 22407918 21810166 22742593 23178359 24042575 114181611 4081 3300 8518 3725 22850 42474 0 4081 3300 8518 3725 22850 42474 114139137 411014 361893 363412 362731 333001 1832051 411014 361893 363412 362731 333001 1832051 8383 8383 7895 12293 11668 5574 62132 99562 22826827 22192735 23117673 23546664 24437708 116121607 0.98290 0.98050 0.01580 0.01690 X Schedule A, Part III, Line 12, Explanation of Other Income: other income - 2012 Amount: $ 7,895. 2013 Amount: $ 12,293. 2014 Amount: $ 11,668. 2015 Amount: $ 2,988. 2016 Amount: $ 4,028. Postage - 2015 Amount: $ 2,586. 2016 Amount: $ 3,104. RIGHT-OF-WAY PAYMENT - 2016 Amount: $ 55,000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1230 1230 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 $20,855 IN DUES FOR A TOTAL OF $1,230 DUES ALLOCATED TO LOBBYING. 0 1 X 12235 6 12241 12230 5 12235 12255 -25 12230 12286 -31 12255 12388 -102 12286 0.00000 0.81690 0.18310 0 0 307031 975390 1282421 1188908 44913229 19651114 26451023 64033 17572657 11175377 6461313 243451 37755237 20695672 17303016 51497773 liabilities to residents 5975819 accrued pension liability 6460108 12435927 26749772 518652 1657330 2175982 24573790 -121006 -121006 24452784 25142163 121006 121006 25021157 491500 491500 25512657 Part IV, Line 2b: THE FUNDS HELD BELONG TO RESIDENTS WHO ARE NOT ABLE TO MANAGE THEIR OWN FINANCES. THE FUNDS ARE USED TO PAY FOR SERVICES THE ORGANIZATION PROVIDES to the resident AND ALSO TO 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 -491,500. MINIMUM PENSION LIABILITY ADJUSTMENT 2,148,830. Part XI, Line 4b - Other Adjustments: rental expenses -121,006. Part XII, Line 2d - Other Adjustments: Rental expenses 121,006. Part XII, Line 4b - Other Adjustments: Diaconal support 491,500. 1 CHARITY CARE IS PROVIDED TO RESIDENTS OF QPRC WHO HAVE RUN OUT OF MONEY. 18 491500 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 have demonstrated their inability to pay via a financial assistance application, and are not eligible for third-party reimbursement. Certain residents qualify for charity care upon admission or when their financial resources are depleted. Personal spending for those who qualify is monitored and services provided by QPRC above their monthly income are written off as charity care. Because the organization provides charity assistance to residents who are unable to pay for these services, it is reported as an expense (990 Part IX, line 2) 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 237724 0 53 0 2698 0 6167 0 35946 0 282588 0 0 0 Diane Aston CFO 151049 0 53 0 148 0 3897 0 24969 0 180116 0 0 0 Joel Clausen Administrator 119759 0 57 0 64 0 636 0 34419 0 154935 0 0 0 DR DAVID WESTON FORMER BOARD MEMBER 17292 0 0 0 0 0 0 0 0 0 17292 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. The Chaplain received a tax gross-up payment of $1,243 as well. The current chaplain also received a housing allowance of $3,750. In addition, BOARD MEMBERS WHO BECOME RESIDENTS MAY RECEIVE TAX GROSS-UP PAYMENTS TO MITIGATE THE TAX EFFECT OF ENTRANCE FEE DISCOUNTS PROVIDED BY QUARRYVILLE. DURING THE CALENDAR 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 $6,602 AND A TAX GROSS-UP PAYMENT OF $1,905. former board member Dr. David weston received a board discount of $15,720 and a tax gross-up payment of $1,572. A quarryville borough authority 232325364 2013-09-03 4000000 Project financing 0 0 0 B PARADISE TOWNSHIP SEWER AUTHORITY 2015-07-02 7500000 CAPITAL IMPROVEMENTS 0 0 0 A 278560 4000000 50001 3949999 2015 0 0 1 1 B 154249 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 signs 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 2,148,830.