2017-07-25T12:13:36-05:00 2016-09-30 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2015-10-01 061073286 POMPERAUG WOODS INC POMP 2032626555 80 HERITAGE ROAD SOUTHBURY CT 06488 KEVIN MOSHIER EXECUTIVE DIRECTOR 2032626555 2017-07-20 1 ELIZABETH SOLECKI P00235171 8605614000 2017-07-19 2015 2021-01-29 14:40:06Z KEVIN MOSHIER 80 HERITAGE ROAD SOUTHBURY CT 06488 11775743 0 X WWW.POMPERAUGWOODS.COM X 1988 CT TO PROVIDE CONTINUOUS CARE FOR RETIRED PEOPLE. 7 7 227 48 0 0 24475 4020 10619947 11727198 -7157 1342 41381 38509 10678646 11771069 0 0 0 0 5628180 5982907 0 0 0 5241279 5358972 10869459 11341879 -190813 429190 21419055 21755464 35120899 35028118 -13701844 -13272654 TO PROVIDE CONTINUOUS CARE FOR RETIRED PEOPLE. 0 0 8398973 11765707 POMPERAUG WOODS IS A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF 131 LIVING UNITS, 8 ASSISTED LIVING UNITS, AND 37 NURSING BEDS. SERVICES PROVIDED INCLUDED MEDICAL CARE, FOOD, CLEANING AND LAUNDRY. 8398973 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 62 0 1 227 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X POMPERAUG WOODS INC 2032626555 80 HERITAGE ROAD SOUTHBURY CT 06488 JANE C CONNERY DIRECTOR 1.00 X 0 0 0 JAMES WALLACE TREASURER 1.00 X X 0 0 0 MARK LANCOR DIRECTOR 1.00 X 0 0 0 GAIL E SEYMOUR DIRECTOR 1.00 X 0 0 0 WILLIAM B NEIL JR PRESIDENT 1.00 X X 0 0 0 JANET WALKER VICE PRESIDENT 1.00 X X 0 0 0 JAMES R STRUB SECRETARY 1.00 X X 0 0 0 KEVIN MOSHIER EXECUTIVE DIRECTOR 40.00 X 0 0 0 LANA SMOLITSKY FINANCE DIRECTOR 40.00 X 94739 0 2376 94739 0 2376 0 0 0 0 LIFE CARE SERVICES 400 LOCUST STREET DES MOINES IA 50309 MANAGEMENT IT CONSULTANT 486958 HERITAGE HEALTH CARE 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY SERVICES 318115 MUELLER HOME IMPROVEMENTS 157 OAK DRIVE WATERTOWN CT 06795 REMODELING SERVICES 156879 3 4020 4020 RESIDENT SERVICE REVENUE 623000 7106210 7106210 HEALTH CENTER FEES 623000 3413440 3413440 AMORTIZATION OF ENTRANCE FEES 623000 1207548 1207548 11727198 4781 4781 3439 -3439 -3439 -3439 30180 1235 28945 28945 MISC. REVENUE 623000 9564 9564 9564 11771069 11765707 0 1342 105822 105822 4878692 3934112 944580 13612 13612 612072 533639 78433 372709 316037 56672 437333 15481 421852 10833 10833 30340 30340 54842 54842 303510 126408 177102 23054 23054 650280 650280 46844 17389 29455 43466 43466 1283352 1283352 180678 180678 ANCILLARY EXPENSES 634309 245614 388695 FOOD & SUPPLIES 611932 533321 78611 THERAPY 535085 535085 PROMOTIONAL SALES 421900 13597 408303 91214 82738 8476 11341879 8398973 2942906 0 128765 170973 4135045 4262959 444262 1134113 37972 42441 285323 274887 37854656 22170157 16304192 15684499 83496 185592 21419055 21755464 1616561 1329006 6871866 7331960 1406804 750000 25225668 25617152 35120899 35028118 X -13763413 -13336233 61569 63579 -13701844 -13272654 21419055 21755464 429190 0 X 0 1 X 1 0 X 22321 50935 31980 24475 4020 133731 9488606 10182911 10315690 10661328 11765707 52414242 9510927 10233846 10347670 10685803 11769727 52547973 0 0 0 52547973 7287 7078 5783 5294 4781 30223 7287 7078 5783 5294 4781 30223 9518214 10240924 10353453 10691097 11774508 52578196 0.99940 0.99910 0.00060 0.00070 X 962264 962264 31438861 17627505 13811356 5453531 4542652 910879 15684499 ENTRANCE FEE DEPOSITS 26000 OTHER CURRENT LIABILITIES 5992 UNEARNED ENTRANCE FEES 815000 ENTRANCE FEE REFUNDS PAYABLE 24725648 CAPITAL LEASE 44512 25617152 11771069 0 11771069 0 11771069 11341879 0 11341879 0 11341879 LIFE CARE SERVICES KEVIN MOSHIER, OFFICER, IS A KEY EMPLOYEE OF LIFE CARE SERVICES 437333 MANAGEMENT FEES 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION UTILIZED LIFE CARE SERVICES, LLC TO SUPERVISE OPERATIONS OF THE FACILITY. THE EXECUTIVE DIRECTOR OF POMPERAUG WOODS, KEVIN MOSHIER, IS AN EMPLOYEE OF LIFE CARE SERVICES, LLC. DURING CALENDAR YEAR 2015, HE RECEIVED $164,817 OF REPORTABLE COMPENSATION AND $27,076 OF NONTAXABLE BENEFITS FROM LIFE CARE SERVICES, LLC FOR PROVIDING MANAGEMENT SERVICES TO POMPERAUG WOODS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS REVIEWED BY JANET WALKER, VICE PRESIDENT OF THE BOARD, BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION PROVIDES ANNUAL EDUCATION REGARDING THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 PART VI, SECTION B, LINE 15: THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LIFE CARE SERVICES, LLC, WHICH PROVIDES MANAGEMENT SERVICES TO POMPERAUG WOODS. THE COMPENSATION OF THE FINANCE DIRECTOR IS DETERMINED BY THE EXECUTIVE DIRECTOR USING COMPARABLE DATA, AND IS APPROVED BY THE PRESIDENT OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.