2016-08-12T12:52:43-05:00 2015-09-30 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2014-10-01 060658099 ELIM PARK BAPTIST HOME INC ELIM 2032723547 140 COOK HILL ROAD CHESHIRE CT 064103736 ZELL GASTON CHIEF FINANCIAL OFFICER 2032723547 2016-08-12 1 ELIZABETH SOLECKI P00235171 8605614000 2016-08-12 2014 2016-09-27 15:27:22Z ZELL GASTON 140 COOK HILL ROAD CHESHIRE CT 064103736 28875857 0 X WWW.ELIMPARK.ORG X 1906 CT ELIM PARK WAS FOUNDED IN 1906 BY THE SWEDISH BAPTIST CONFERENCE WITH THE MISSION TO CARE FOR AND PROVIDE A HOME OF REST FOR THE FRAIL AND ELDERLY MEMBERS OF THEIR CONFERENCE. SINCE OUR INCORPORATION, OUR MISSION HAS EXPANDED AND MATURED, AND WE ARE NO LONGER A "HOME OF REST," BUT RATHER A HOME WHERE RESIDENTS CAN FLOURISH AND LIVE ACTIVE, INSPIRED, FULFILLING LIVES. THE INTERDENOMINATIONAL NATURE OF OUR ORGANIZATION WELCOMES OLDER ADULTS OF ALL FAITHS, WITH A CARING STAFF AND CHRIST-CENTERED ENVIRONMENT THAT ALLOWS THEM TO GROW IN SPIRITUAL HEALTH AS WELL AS MEETING THEIR PHYSICAL NEEDS. OUR MISSION IS TO PROVIDE QUALITY CARE THROUGH EXCITING CULTURAL AND FITNESS PROGRAMS AND A BROAD SPECTRUM OF HEALTH SERVICES IN A CHRIST-CENTERED ENVIRONMENT. ELIM PARK LOOKS UPON ITS MISSION AS AN EXTENSION OF THE CHURCH MINISTRY WITHIN THE BAPTIST GENERAL CONFERENCE AND GIVES ADMISSION PRIORITY TO ITS MEMBERS. 12 12 551 170 0 0 426960 338364 26903780 28269600 145183 237293 26359 30600 27502282 28875857 0 0 0 0 15055565 15489753 0 0 316703 11623703 11779668 26679268 27269421 823014 1606436 73158528 72210984 64824744 73357606 8333784 -1146622 X ELIM PARK WAS FOUNDED IN 1906 BY THE SWEDISH BAPTIST CONFERENCE WITH THE MISSION TO CARE FOR AND PROVIDE A HOME OF REST FOR THE FRAIL AND ELDERLY MEMBERS OF THEIR CONFERENCE. SINCE OUR INCORPORATION, OUR MISSION HAS EXPANDED AND MATURED, AND WE ARE NO LONGER A "HOME OF REST," BUT RATHER A HOME WHERE RESIDENTS CAN FLOURISH AND LIVE ACTIVE, INSPIRED, FULFILLING LIVES. THE INTERDENOMINATIONAL NATURE OF OUR ORGANIZATION WELCOMES OLDER ADULTS OF ALL FAITHS, WITH A CARING STAFF AND CHRIST-CENTERED ENVIRONMENT THAT ALLOWS THEM TO GROW IN SPIRITUAL HEALTH AS WELL AS MEETING THEIR PHYSICAL NEEDS. OUR MISSION IS TO PROVIDE QUALITY CARE THROUGH EXCITING CULTURAL AND FITNESS PROGRAMS AND A BROAD SPECTRUM OF HEALTH SERVICES IN A CHRIST-CENTERED ENVIRONMENT. ELIM PARK LOOKS UPON ITS MISSION AS AN EXTENSION OF THE CHURCH MINISTRY WITHIN THE BAPTIST GENERAL CONFERENCE AND GIVES ADMISSION PRIORITY TO ITS MEMBERS. 0 0 24400752 28269600 THE CONSTELLATION OF SERVICES OFFERED AT ELIM PARK HAS ENHANCED LIFE FOR OUR RESIDENTS AND CONTINUES TO MAKE A POSITIVE IMPACT ON OUR COMMUNITY. THROUGH OUR MISSION OF PROVIDING QUALITY CARE THROUGH COMPREHENSIVE WELLNESS PROGRAMS AND MEDICAL FACILITIES IN A CHRIST-CENTERED ENVIRONMENT, WE ARE ABLE TO NURTURE THE WHOLE PERSON AND FOCUS ON TOTAL WELLNESS OF MIND, BODY AND SPIRIT. OUR SUB-ACUTE CARE, SHORT-TERM REHABILITATION AND WELLNESS PROGRAMS WORK TOGETHER TO ENSURE THAT RESIDENTS ARE LEADING THE MOST PRODUCTIVE LIFESTYLES APPROPRIATE TO THEIR VARIED LEVELS OF INDEPENDENCE. SHOULD A RESIDENT'S DEPENDENCY LEVEL INCREASE, OUR SKILLED NURSING FACILITY UNIT PROVIDES A SMOOTH TRANSITION TO ON-SITE NURSING CARE. ELIM PARK'S NON-PROFIT STATUS ALLOWS US TO CHANNEL REVENUE BACK INTO PROGRAMS AND SITE IMPROVEMENTS TO ENRICH THE LIVES OF OUR RESIDENTS. BENEFITS TO THE COMMUNITY INCLUDE A BROAD SPECTRUM OF OUT-PATIENT AND THERAPEUTIC SERVICES, AQUATIC THERAPY, HOSTING COMMUNITY EVENTS, OFFERING A PROFESSIONAL ENTERTAINMENT SERIES, AND OPENING OUR CAMPUS FOR USE BY LOCAL CIVIC GROUPS AND ORGANIZATIONS. WE CONTINUE TO UPGRADE OUR PHYSICAL PLANT TO MAINTAIN THE HIGHEST SAFETY STANDARDS AND A WELCOME ENVIRONMENT. WE MAKE TECHNOLOGICAL IMPROVEMENTS WHICH CONTRIBUTE TO THE WELL-BEING AND COMFORT OF OUR RESIDENTS. WE MAINTAIN THE CHRIST-CENTERED COMMUNITY THAT OUR FOUNDING CHURCHES ENVISIONED AS THE CORNERSTONE UPON WHICH ELIM PARK CONTINUES TO GROW. 24400752 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 85 0 1 551 1 0 0 0 0 0 0 0 0 0 1 0 X 12 12 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X ZELL GASTON CHIEF FINANCIAL OFFICER 2032723547 140 COOK HILL ROAD CHESHIRE CT 064103736 J RAY ADAMS DIRECTOR 2.00 2.00 X 0 0 0 ROBERTO ECKER TREASURER 2.00 X X 0 0 0 TERRENCE BRENNAN IMMEDIATE PAST CHAIR 2.00 X 0 0 0 BRENT ALLEN DIRECTOR 2.00 X 0 0 0 CHRIS NELSON CHAIR 2.00 X X 0 0 0 CHRISTINE CHRISTGAU DIRECTOR 2.00 X 0 0 0 DAVID TUELL JR DIRECTOR 2.00 X 0 0 0 DAVE MCNEILL DIRECTOR 2.00 X 0 0 0 GLENN MASON DIRECTOR 2.00 X 0 0 0 PAUL DELACY DIRECTOR 2.00 X 0 0 0 PAULETTE ANNON SECRETARY 2.00 X X 0 0 0 SAM CALIGURI VICE CHAIR 2.00 X X 0 0 0 RONALD DISCHINGER PRESIDENT 37.50 X 219039 0 45602 ZELL GASTON CHIEF FINANCIAL OFFICER 37.50 X 151511 0 16536 CHRIS NEWTON VICE PRESIDENT 37.50 X 117347 0 17496 LINDA LANGLAIS DIRECTOR OF NURSING 37.50 X 118102 0 6778 CYNTHIA COUTO LPN 37.50 X 103329 0 14957 PAULINE PARRISH MARKETING DIRECTOR 37.50 X 112209 0 8965 821537 0 110334 6 0 1 0 SODEXO INC & AFFILIATES 1020 STONY HILL ROAD 225 YARDLEY PA 19067 DIETARY/MAINTENANCE/HOUSEKEEPING 3098296 THE MASTERS CONSTRUCTION CORP PO BOX 1037 AVON CT 06001 CONSTRUCTION 690990 ROBERT P COSMA DBA MAGNUM INDUSTRIES LLC 45 FARMCLIFF DRIVE GLASTONBURY CT 06033 CONSTRUCTION 388451 MARK CONNOR DBA CONNOR ARCHITECTURE LLC 1656 MASSACHUSETTS AVENUE LEXINGTON MA 02420 ARCHITECTURE 203726 CT COMPUTER SERVICE INC PO BOX 35 PLANTSVILLE CT 06479 IT 188769 9 338364 23087 338364 R&B, NURSING, ANCILLARY 623990 12575794 12575794 MEDICARE/MEDICAID PAYMENTS 623990 11222548 11222548 AMORTIZATION OF ENTRANCE FEES 623990 4171862 4171862 MISCELLANEOUS 623990 299396 299396 28269600 190545 190545 30600 0 30600 30600 30600 44062 2686 0 0 44062 2686 46748 46748 28875857 28269600 0 267893 583876 583876 11678801 11557022 121779 311914 268246 37430 6238 1929352 1848787 60424 20141 985810 916803 49291 19716 32704 32704 76702 76702 336663 336663 250393 230362 20031 1521921 1521921 48721 48721 588761 588761 3238293 3238293 294667 294667 DIETARY 2082496 2082496 ADMINISTRATIVE AND GENE 1609975 1481177 128798 ANCILLARY 632201 632201 NURSING 344398 344398 721773 721773 27269421 24400752 2551966 316703 14696406 12040819 233140 309301 3432050 4254162 430299 388665 97985873 44207332 51987157 53778541 466113 453414 1913363 986082 73158528 72210984 2820774 3035749 41183204 27923645 16649279 15968415 3237499 1770512 933988 24659285 64824744 73357606 X 7173776 -2366920 1160008 1220298 8333784 -1146622 73158528 72210984 X 1606436 -310572 -10776270 X 0 1 X 1 0 X 185044 97412 177483 426960 338364 1225263 24319422 24414882 26424007 26903780 28269600 130331691 24504466 24512294 26601490 27330740 28607964 131556954 0 0 0 131556954 188175 171075 102920 133164 221145 816479 188175 171075 102920 133164 221145 816479 24692641 24683369 26704410 27463904 28829109 132373433 0.99380 0.99330 0.00620 0.00670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2182443 416273 -57630 51515 2489571 1965807 299259 73477 156100 2182443 1415411 525774 185773 161151 1965807 1178062 468472 -124882 106241 1415411 1617731 96905 5537 542111 1178062 0.00000 0.02170 0.97830 0 1 1 631079 631079 81881208 36802048 45079160 9924705 6234021 3690684 5548881 1171263 4377618 53778541 DUE TO THIRD-PARTY REIMBURSEMENT AGENCIES 332505 CHARITABLE GIFT ANNUITIES 118942 OTHER LONG-TERM LIABILITIES 196629 ADVANCED PAYMENTS 270742 INTEREST SWAP VALUATION 247725 DUE TO AFFILIATE 271551 ENTRANCE FEE REFUNDS PAYABLE 23221191 24659285 28036282 -310572 -529003 -839575 28875857 0 28875857 27269422 1 1 27269421 0 27269421 PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN NET UNREALIZED LOSS ON SWAPS -500,423. CHANGE IN CHARITABLE GIFT ANNUITIES -28,580. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 1. X 1 1 X X X 0 0 0 0 0 0 0 0 0 RONALD DISCHINGER PRESIDENT 218979 0 0 0 60 0 10062 0 35540 0 264641 0 0 0 ZELL GASTON CHIEF FINANCIAL OFFICER 151451 0 0 0 60 0 6932 0 9604 0 168047 0 0 0 PART I, LINE 1A THE PRESIDENT OF ELIM PARK IS REQUIRED TO LIVE ON THE FACILITY CAMPUS AS A CONDITION OF EMPLOYMENT. A CONNECTICUT INNOVATIONS INCORPORATED 061423798 2012-12-21 17714000 REFINANCING OF CDA BONDS 0 0 0 A 1745585 17714000 321009 17392991 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 1 FIRST NIAGARA BANK NA 10.000000000000 0 0 0 0 0 A 0 PART II, LINE 11: $17,335,167 OF OTHER SPENT PROCEEDS WAS USED TO CURRENTLY REFUND PRIOR ISSUES. VITAL HEALTHCARE COMMUNICATIONS LLC SUBSTANTIAL CONTRIBUTOR 131359 SERVICE AND SUPPORT OF COMMUNICATIONS SYSTEMS 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION UTILIZED SODEXO INC. TO MANAGE ITS DIETARY, LAUNDRY, HOUSEKEEPING AND MAINTENANCE FUNCTIONS DURING THE TAX YEAR. THE MANAGEMENT OF THESE FUNCTIONS INCLUDED THE MANAGEMENT OF PERSONNEL (INCLUDING HIRING AND TERMINATION OF EMPLOYEES FOR THESE DEPARTMENTS), AND THE RESPONSIBILITY OF PREPARING A COST BUDGET AND CONTROLLING/MONITORING ACTUAL COSTS IN ACCORDANCE WITH THE BUDGET. FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEES HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED BY THE CONTROLLER AND CFO. THE FORM 990 IS PROVIDED TO THE FULL BOARD FOR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, DISCLOSURES ARE FILLED OUT BY EACH DIRECTOR. THESE ARE REVIEWED ANNUALLY TO ENSURE COMPLIANCE. IF AN ISSUE COMES UP, IT IS ADDRESSED AT THAT TIME. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS INDEPENDENT STUDIES. THE COMMITTEE THEN DISCUSSES AND VOTES. THIS ACTION IS DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE AVAILABLE TO RESIDENTS AND POTENTIAL RESIDENTS. THEY ARE ALSO AVAILABLE IN THE ANNUALLY FILED DISCLOSURE STATEMENT TO THE STATE OF CT. FORM 990, PART XI, LINE 9: CHANGE IN NET UNREALIZED LOSS ON SWAPS -500,423. CHANGE IN CHARITABLE GIFT ANNUITIES -28,580. CHANGE IN ACCOUNTING PRINCIPLE- REFUNDABLE ADVANCE FEES -10,247,266. ROUNDING -1. FORM 990, PART III, LINE 1: ORGANIZATION'S MISSION (CONTINUATION OF FORM 990, PART III) OLDER ADULTS OF ALL FAITHS ARE WELCOME ON OUR INTERDENOMINATIONAL CAMPUS WHERE THEY CAN ENJOY PERSONAL AND SPIRITUAL GROWTH, SOCIAL INTERACTION AND LIFE-ENRICHING PROGRAMS WITH ALL THE COMFORTS OF HOME. RESIDENTS HAVE THE FREEDOM TO CREATE A UNIQUE RETIREMENT EXPERIENCE AND BUILD MEANINGFUL RELATIONSHIPS WITH SUPPORT FROM OUR TEAM OF CARING, DEDICATED PROFESSIONALS. CONNECTICUT ALLIANCE FOR LONG TERM CARE 217 AVERY HEIGHTS HARTFORD CT 06106 061465316 ADMINISTER PROVIDER BASED NETWORK TO PROVIDE COST-EFFECTIVE HEALTH CARE CT 501(C)(3) 11A N/A 0 ELIM PARK LEGACY FOUNDATION INC 140 COOK HILL ROAD CHESHIRE CT 06410 900436482 TO SUPPORT ELIM PARK CT 501(C)(3) 11A N/A 1 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 ELIM PARK LEGACY FOUNDATION INC E 271551 AMOUNT LOANED