2017-01-23T14:57:26-06:00 2016-06-30 390859910 Baker Tilly Virchow Krause LLP One Liberty Place Philadelphia PA 191037341 990 2015-07-01 221717575 Heath Village Inc HEAT 9088524801 430 Schooleys Mountain Road Hackettstown NJ 078404099 Patrick E Brady CEO 9088524801 2017-01-19 1 Julius C Green CPA P00350393 2159720701 2015 2021-01-29 14:40:06Z Patrick E Brady 430 Schooleys Mountain Road Hackettstown NJ 078404099 27316257 0 X www.heathvillage.com X 1962 NJ RETIREMENT COMMUNITY OFFERING INDEPENDENT LIVING, ASSISTED LIVING, AND SKILLED NURSING CARE. 12 11 435 62 51838 -2047 411019 354265 23817593 24849551 553996 334732 133056 178748 24915664 25717296 12310 10050 0 0 12869468 13879930 0 0 8483 9101884 9041376 21983662 22931356 2932002 2785940 48292229 50121238 10439787 9249576 37852442 40871662 X Heath Village was formed for the purpose of planning, building and operating a retirement community. Heath Village is a multi-denominational Christian community for all people, regardless of race, creed or ethnic origin. Heath Village believes it is important that retired persons have a living environment that fosters a meaningful life with security, dignity, fellowship and personal and spiritual well-being. To achieve these objectives and purpose, Heath Village provides retired persons with appropriate living accommodations, as well as social, recreational, educational, religious and other programs and services that promote individual independence in living with the availability of supportive services when needed. Heath Village encourages interaction between Heath Village employees, its residents and the community at large. 0 0 19407871 10050 24849551 Heath Village is a full service retirement community with no life care fees and optional entrance fees, making it an affordable choice for today's retiree who wants to remain active, involved and independent. The 100+ acre community offers a variety of living accommodations including: 151 independent apartments ranging in size from studio to two-bedrooms; 10 cottage style apartments which include two bedrooms, a single car garage, utility room, two baths, an eat-in kitchen and a three-season porch; 41 hotel-style apartments which include housekeeping services and three meals per day; 40 residential healthcare beds and 99 skilled nursing beds, both licensed by the New Jersey State Department of Health. For the fiscal year ended June 30, 2016, the independent apartments served 259 residents, the residential health care unit served 51 residents, and the skilled nursing unit served 365 in-patients and 31 out-patients. The facility provided $712,722 in benevolent care across all levels of care. All residents of the community enjoy around the clock security, a wireless emergency/nurse call alert system, WiFi, maintenance services, transportation services, pastoral services, and social activities both on campus and off campus in addition to a swimming pool and Jacuzzi, community garden, shuffle board court, bocce court, nature/walking trail, library, fitness center, bank, computer center, gift shop, beauty salon, craft shop, chapel, art studio, and numerous other amenities. Residents of the community continue to participate in over 40 resident groups and organizations, including the Bocce Ball League, Wii Bowling League, Bridge Players, Mahjong, and Book Discussion Group, to name a few. During the fiscal year, players and on-lookers also enjoyed the annual Bocce game against the Heath Village administration. Two new fitness programs were also added during the year, yoga and Zumba Gold, both of which are very beneficial to the participants. Volunteers who reside on-campus continued the efforts of the facility's thrift store known as the Friendship Store, which generated proceeds of $9,785 to support the benevolent care fund.Residents continue to enjoy parties at the pool along with water aerobics in the summer season. Other on-campus events included the annual dog show, outside concerts, lectures, and cocktail parties. The annual Family Day event was successful, with over 400 residents, employees, and family members in attendance for the "Frozen Meets the Minions" themed celebration. The residents also attended various off-campus trips during the fiscal year including numerous trips to local restaurants, Hunterdon Hills Playhouse, New Jersey Symphony Orchestra, Paper Mill Playhouse, and the very popular annual mystery trip. There was even an over-night trip to Cape May which included a dolphin and whale watch cruise, tour of the Physick Estate, a dinner theater, and a stop at Cape May Lighthouse.While the residential healthcare and skilled nursing units have their own dining room facilities, all residents and guests of the community have the option of dining in the main dining room for a restaurant style dining option, the grill room for a fine dining experience, the pub, or in the cafe for a less formal setting. Residents also enjoy various special dining events in the main dining facilities throughout the year including Birthday Night, holiday dinners, a resident anniversary celebration, and a newcomer's reception. The Activities and Dining departments worked together to introduce some new special events with musical entertainment such as a Polynesian Luau, a clambake, and cocktail parties utilizing the outside courtyard area. The Concert Under the Stars series was also offered outside in the courtyard.The skilled nursing unit boasts an in-patient and out-patient rehabilitation center which provides physical, occupational, and speech therapy. In addition to the rehab services, the independent residents may also benefit from limited home health services and out-patient nursing care. During the fiscal year ending June 30, 2016, the skilled nursing unit continued to provide a variety of therapeutic activities including visits from pet therapy dogs, certified music therapy, art therapy and Tai Chi. The Men's Club made special gardening carts that were designed to be used by wheelchair-bound patients, allowing them to plant flowers and herbs. The facility also hosts a monthly Parkinson's support group and Senior Seminars, all of which are open to the public. 19407871 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 117 0 1 435 1 1 1 0 0 0 0 1 1 0 0 0 0 X 12 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 0 0 NJ X ANTHONY PUCCIO 9086845018 422 Schooleys Mountain Road Hackettstown NJ 078404099 Patrick e Brady CEO/Executive Director 40.00 0.50 X X 497174 0 91833 Peter R Van Brunt Chair 0.30 0.30 X X 0 0 0 Harold S Lappin Secretary/Treasurer 0.25 0.30 X X 0 0 0 L Allison Garde Vice Chair 0.30 0.30 X X 0 0 0 Sanders Davis Trustee 0.30 0.30 X 0 0 0 Judith Griffiths Trustee 0.30 0.00 X 0 0 0 Mary Allice Horn Trustee 0.30 0.00 X 0 0 0 Herbert Korte Trustee 0.30 0.50 X 0 0 0 Carol McKinney Trustee 0.30 0.25 X 0 0 0 Arthur Sheninger Trustee 0.30 0.00 X 0 0 0 Mark Tomkins Trustee 0.30 0.30 X 0 0 0 Floyd Smith Trustee-Resident Representative 0.30 0.00 X 0 0 0 Mary Ellen Bove Chief operating officer 40.00 0.50 X 207115 0 28179 Anthony Puccio chief financial officer 40.00 0.50 X 155581 0 25248 Vivian Blandura Director of Nursing 40.00 0.00 X 110362 0 23343 Janice Cipriani Director of Marketing 40.00 0.00 X 106162 0 16316 1076394 0 184919 5 0 1 0 Sodexo Inc and Affiliates PO BOX 360170 Pittsburgh PA 15251 Food Service 1450439 Lecesse Construction Services LLC 75 Thruway Park Dr w Henrietta NY 14586 Construction 1441784 Chris Brands Construction Co 710 Laurel Hill Road Bangor PA 18013 Carpenter 886322 KDA Architects One Echelon Plaza 227 Laurel Road Voorhees NJ 08043 architect 515603 Heath Care Management Inc 422 Schooleys Mntn Rd Hackettstown NJ 07840 Landscaping, Therapy,Housekeeping Svcs 323735 12 27845 326420 354265 Net Resident Service Rev 623000 24849551 24849551 24849551 409889 409889 31018 30142 876 876 876 1473750 550 1549457 0 -75707 550 -75157 -75157 4880 27845 8529 -3649 -3649 54 0 54 54 12280 10833 1447 1447 Meals 722210 61606 61606 Non-Resident Revenue 721000 52588 52588 Guest Rooms 900099 21700 21700 44126 -750 44876 180020 25717296 24849551 51838 461642 10050 10050 977898 977898 9410366 8462603 943610 4153 335251 314763 19325 1163 2377505 2094948 282557 778910 667600 110960 350 157264 151264 6000 16084 16084 68110 68110 427 427 62867 62867 765212 651547 113665 56218 53401 2817 958770 841159 117611 195470 15567 179903 1418546 1418546 37803 30094 7709 57125 36407 20718 108016 108016 2888119 2888119 261694 11350 250344 Food 1220001 1207180 12821 Nursing Home Assessment 300777 300777 BAD DEBT EXPENSE 226574 226574 Resident Program Expens 60331 60331 181968 137550 44418 22931356 19407871 3515002 8483 153484 176093 5017026 6685978 1344567 1394783 3011951 2861093 106649 103038 166420 96517 69894632 37997084 30855883 31897548 6351040 5747395 319062 312792 966147 846001 48292229 50121238 3974957 4192914 2195556 2055863 2888011 1804329 748877 727274 632386 469196 10439787 9249576 X 34004211 37038070 3848231 3833592 37852442 40871662 48292229 50121238 X 2785940 173195 60085 X 0 1 X 1 0 X 333866 254197 421039 411019 354265 1774386 21744521 22196902 23133988 23817593 24849551 115742555 22078387 22451099 23555027 24228612 25203816 117516941 0 0 0 117516941 405090 364262 315229 475911 440907 2001399 405090 364262 315229 475911 440907 2001399 51838 51838 156842 300871 303792 141872 128176 1031553 22640319 23116232 24174048 24846395 25824737 120601731 0.97440 0.97620 0.01660 0.01460 X Schedule A, Part III, Line 12, Explanation of Other Income: Other Revenue - 2012 Amount: $ 4,450. 2013 Amount: $ 3,721. MEALS - 2011 Amount: $ 65,306. 2012 Amount: $ 91,226. 2013 Amount: $ 72,020. 2014 Amount: $ 64,463. 2015 Amount: $ 61,606. LATE FEE INCOME - 2011 Amount: $ 12,887. 2012 Amount: $ 3,361. 2013 Amount: $ 11,400. 2014 Amount: $ 13,516. 2015 Amount: $ 20,551. GUEST ROOMS - 2011 Amount: $ 28,110. 2012 Amount: $ 28,755. 2013 Amount: $ 26,860. 2014 Amount: $ 27,185. 2015 Amount: $ 21,700. FIREWOOD SALES - 2011 Amount: $ 975. 2012 Amount: $ 1,250. RESIDENT MAINTENANCE SERVICES - 2011 Amount: $ -5,107. 2012 Amount: $ -6,720. LOAN INCOME - 2011 Amount: $ 39,697. 2012 Amount: $ 117,918. 2013 Amount: $ 164,155. Refund of Escrow bal - settlement litigation income - 2011 Amount: $ 1,024. 2012 Amount: $ 515. gift shop - 2011 Amount: $ 1,249. 2012 Amount: $ 2,846. 2014 Amount: $ 3,822. 2015 Amount: $ 3,441. thrift store revenue - 2011 Amount: $ 12,701. 2014 Amount: $ 10,574. 2015 Amount: $ 9,785. Miscellaneous Income - 2012 Amount: $ 6,720. 2013 Amount: $ 5,947. 2014 Amount: $ 8,878. 2015 Amount: $ 11,093. Insurance Recovery - 2012 Amount: $ 50,550. 2013 Amount: $ 1,500. gross inventories - 2013 Amount: $ 21,408. 2014 Amount: $ 16,230. Partnership Gain/Loss - 2013 Amount: $ -3,219. 2014 Amount: $ -2,796. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 427 427 0 Part II-B, Line 1: HEATH VILLAGE PAID REGULAR MEMBERSHIP DUES TO LEADING AGE OF NJ OF $17,792 on April 15, 2016, OF WHICH 2.4% OR $427 WENT TOWARDS LOBBYING ACTIVITY. 0 1 X 4592220 4592220 50744096 30378814 20365282 9171920 5981675 3190245 5386396 1636595 3749801 31897548 Annuities Payable 428432 DERIVATIVE FINANCIAL INSTRUMENTS 38363 due to affiliate 2401 469196 X 25997844 173195 109628 282823 25715021 2275 2275 25717296 22978624 49543 49543 22929081 2275 2275 22931356 Part IV, Line 2b: Security deposits and PNA (personal needs allowance) funds held in trust for patients and residents. Funds are segregated and held in an interest-bearing bank account. Part X, Line 2: The Village accounts for uncertainty in income taxes by prescribing a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold has been met. Management determined that there were no tax uncertainties that met the recognition threshold in 2016 and 2015. Part XI, Line 2d - Other Adjustments: Change in fair value of derivative financial instruments 60,085. Intercompany Wage Reimbursement 8,569. Rental Expenses 30,142. gift shop expenses 10,832. Part XII, Line 2d - Other Adjustments: Rental Expenses 30,142. GIFT SHOP EXPENSES 10,832. Intercompany Wage Reimbursement 8,569. Benefit Gala 32725 27845 4880 2720 500 5309 32725 27845 4880 2720 500 5309 8529 -3649 0 Centenary Stage Company 400 jefferson st hackettstown NJ 07840 221500484 501(c)(3) 10000 sponsorship for the 2015-2016 season. 1 0 Part I, Line 2: HEATH VILLAGE MADE A DONATION TO SPONSOR AN UNRELATED TAX-EXEMPT ORGANIZATION AND RECEIVED AN ACKNOWLEDGMENT LETTER FROM THE DONEE ORGANIZATION. X X X X 0 1 0 0 0 0 0 1 0 Patrick e Brady CEO/Executive Director 327174 0 170000 0 0 0 63250 0 28583 0 589007 0 0 0 Mary Ellen Bove Chief operating officer 187115 0 20000 0 0 0 10797 0 17382 0 235294 0 0 0 Anthony Puccio chief financial officer 155581 0 0 0 0 0 8140 0 17108 0 180829 0 0 0 Part I, Line 4b The CEO has a deferred compensation arrangement. The organization paid him $47,500 ON 6/10/16 FOR THE DEFERRED COMP THAT WAS AWARDED ON 7/1/13. Part I, Line 7 The CEO determines the COO's bonus at the CEO's discretion. the CEO's bonus is determined in accordance with an employment agreement. The board has discretion to adjust the CEO's bonus due to extraordinary circumstances. A NEW JERSEY ECONOMIC DEVELOPMENT AUTHORITY 222045817 2007-12-31 8657215 See supplemental information 0 0 0 B NeW JERSEY ECONOMIC DEVELOPMENT AUTHORITY 222045817 2010-12-09 779535 See supplemental information 0 0 0 A 7056436 8657215 165816 1194000 7297399 2006 1 1 1 1 B 575985 779535 779535 2010 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 0 0 1 1 1 Capital One NA 1.500000000000 0 0 0 1 1 B 0 0 1 0 1 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: NEW JERSEY ECONOMIC DEVELOPMENT AUTHORITY Date the Rebate Computation was Performed: 04/29/2013 Schedule K, Part I, line f: Issue A: The purpose of the bond issuance was to refund portions of two prior issues which were issued June 20, 1996 and August 11, 1999, and to finance costs of renovating a residential and comprehensive health care facility, including the costs of a food service facility for residents and staff, the main lobby, a fitness center, a club room for residents and an expanded activities room. Schedule K, Part I, line f: Issue B: The purpose of the bond issuance was to refund a portion of a prior issue which was issued August 11, 1999. Schedule K, Part IV, Line 2: Issue A: The portions of the issue used for the current refunding new money satisfied the 6-month rebate exception. The portion of the issue used for the advance refunding invested below the bond yield until the refunded bonds were paid. Schedule K, Part IV, Line 2c: All of gross proceeds subject to arbitrage rebate were expended prior to the computation date. At the end of the computation period during which gross proceeds subject to arbitrage rebate were finally expended no arbitrage rebate was due. Accordingly, no further rebate computations will be made unless gross proceeds subject to arbitrage rebate arise at a later date. Schedule K, Part IV, Line 6: ISSUE A: THE PORTION OF THE ISSUE USED FOR THE ADVANCE REFUNDING WAS HELD IN A YIELD RESTRICTED REFUNDING ESCROW UNTIL THE REFUNDED BONDS WERE PAID. Form 990, Part VI, Section A, line 1 Heath Alliance for Care Executive Committee The Executive Committee shall consist of seven (7) members, including the President, Vice-President, Secretary, Treasurer, Assistant Secretary, Assistant Treasurer, and immediate Past President. Five (5) members shall constitute a quorum for the transaction of all business. The Executive Committee shall meet to transact emergency business between Board meetings as is necessary. The Executive Committee shall have all powers and duties of the Board except it shall not have the power to remove or elect a Trustee or the CEO or to approve or disapprove the operating or capital expense budgets. However, in times deemed by them to be of emergency, the Executive Committee may approve expenditures not in the budgets but not to exceed such amounts as currently established by the Board. The Secretary of the Board shall keep minutes of all meetings of the Executive Committee and send copies of said minutes to all Board members. The Executive Committee meets at the call of the President or upon written request of any other two members thereof. Form 990, Part VI, Section A, line 2 Mary Alice Horn, Trustee on the Heath Village Board of Trustees is married to Norris Horn, Trustee on the Heath Alliance for Care Board of Trustees. Heath Alliance for Care is the non-profit parent corp of Heath Village. This was identified on the Conflict of Interest form completed by Mary Alice Horn on 6/14/16. Form 990, Part VI, Section A, line 6 The sole member of Heath Village is Heath Alliance for Care, Inc. (the "Alliance"), a related not-for-profit organization. Form 990, Part VI, Section A, line 7a All members of the Board of Trustees shall be appointed by the Board of Trustees of Heath Alliance (the non-profit parent corporation). The Heath Village Resident Council may nominate one resident voting member to the Board of Trustees for a three year term. A majority vote of the current members of the Board of Trustees of Heath Alliance shall be required for the appointment of said resident member. The President of the Board of Trustees of Heath Alliance shall appoint both the Chairperson ("Chair") and the Vice-Chairperson ("Vice Chair") of the Board of Trustees of Heath Village for a one year renewable term from among the Trustees of Heath Village. Both positions shall be included in all counts of Trustees. Vacancies in the Board occurring between terms shall be filled for the unexpired portion of the term by a majority vote of the Trustees of Heath Alliance. Form 990, Part VI, Section A, line 7b The Board of Trustees of Heath Alliance for Care has authority over the Heath Village Board of Trustees on various duties as identified in the Heath Village Bylaws. Heath Alliance for Care is the non-profit Parent Corporation of Heath Village. All members of the Board of Trustees shall be appointed by the Board of Trustees of Heath Alliance for Care. The President of the Board of Heath Alliance shall appoint the Chairperson and Vice-Chairperson of the Board of Trustees of Heath Village. Heath Alliance shall employ an Executive Director of Heath Village. The Executive Director shall report to the Chief Executive Officer of Heath Alliance. The Chief Executive Officer of Heath Alliance shall be a Trustee of Heath Village. Any new contract or agreement that involves an amount in excess of the limits currently established by the Board entered into by the Board of Trustees of Heath Village or Canterbury Village shall be presented to the proper Standing Committee for recommendation to the Board for approval or disapproval. They must also adopt an annual Capital Budget and Operating Budget, which limits any powers otherwise existing to disburse and to contract to disburse funds of Heath Village. If, for any reason, the Heath Village Board of Trustees does not act, its duties may be performed by the appropriate committee of Heath Alliance for Care. Heath Alliance has authority to approve the following with respect to resident services: policy development for programs and services, guidelines for recognizing contributions of Heath Village, and any major changes and/or new policy recommendations including recommendations of Bylaw changes. All amendments to the Heath Village Bylaws are subject to approval by the Board of Trustees of Heath Alliance. Heath Alliance has the authority to approve the following with respect to facilities: changes, additions, alterations and expenditures that should be made to maintain the Heath Village property in good condition, expansion of the facilities, and the final formulation of Master Plan for Heath Village. Form 990, Part VI, Section B, line 11 The Senior Accountant, Controller, and CEO review the form prior to filing. The Heath Alliance for Care Finance and Corporate Development Committee reviews the form at a board meeting. Then the final form is distributed to all members of the Heath Village Board prior to filing. Form 990, Part VI, Section B, line 12c All board members and officers are required to complete the Disclosure of Possible Conflict of Interest form on an annual basis. The Personnel and Policy Committee is responsible for distributing, collecting and reviewing all disclosure statements on an annual basis. Board members are required to refrain from discussing, as well as voting on, such matters in which a conflict of interest exists. In some instances, the individual has been respectfully asked to resign from their position on the board as a result of a disclosed conflict. In instances where a conflict or potential conflict of interest exists, the Board of Trustees must determine by a majority vote of the disinterested trustees present, that the transaction or arrangement is in the organization's best interest and for its own benefit, is fair and reasonable to the organization, and that the organization cannot obtain a more advantageous transaction or arrangement with reasonable efforts. The CEO also reviews the completed forms and retains a file of completed forms after the process of collecting and reviewing them is completed each year. Form 990, Part VI, Section B, line 15a The CEO's compensation is determined as follows per an executed employment agreement: "Employee's base salary in each subsequent year of the period of employment shall be reasonably adjusted and the reasonability of such adjustment shall be made with reference to the annual compensation surveys produced by the American Association of Homes and Services for the Aging and the New Jersey Hospital Association for like organizations in the northern New Jersey area, and such other relevant salary surveys that may be available from time to time from other independent industry and professional organizations. Upon consideration of relevant salary data of employees performing services commensurate with those performed by employee and the percentage increase given to Village management, the Personnel and Policy Committee, or any successor committee of the Alliance Board, in its sole discretion, subject to approval by the Alliance Board, may adjust such base salary increases." In addition, his incentive bonus is also compared in the same manner. The Director of Human Resources also provides the Board with information for similar facilities from Guidestar. This was last provided to the Board on 6/20/16 for the CEO's last annual review completed at a board meeting on 7/12/16. This compensation determination process is documented in the board minutes. No other employee's compensation is determined in this manner. The compensation for the COO and Controller are both determined by the CEO upon hire. Raises are awarded at the CEO's discretion upon completion of their annual performance review. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, Section B, LINE 14: The organization is working on developing a document retention and destruction policy. The organization hopes to have a final policy in place by 6/30/17. Form 990, Part XI, line 9: Change in fair value of derivative financial instruments 60,085. HEATH ALLIANCE FOR CARE INC 422 SCHOOLEYS MOUNTAIN ROAD HACKETTSTOWN NJ 07840 223395211 SUPPORTING ORGANIZATION NJ 501(C)(3) 11 TYPE I N/A 0 THE HOUSE OF THE HOLY COMFORTER 33 MT PLEASANT AVE WEST ORANGE NJ 07052 221487578 RESIDENTIAL/ASSISTED LIVING HEALTH CARE FACILITY NJ 501(C)(3) 9 heath alliance for care inc 0 HEATH CARE MANAGEMENT INC 443 SCHOOLEYS MOUNTAIN ROAD HACKETTSTOWN NJ 07840 223330650 CONSULTING NJ N/A C 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 0 1