2015-02-16T12:19:35-06:00 2014-06-30 593070669 MOORE STEPHENS LOVELACE PA 701 BRICKELL AVENUE SUITE 550 MIAMI FL 33131 990 2013-07-01 161676092 ALDERSGATE HEALTHCARE INC ALDE 3055565654 5300 W 16TH AVENUE HIALEAH FL 33012 NICK ANTONACCI EXECUTIVE DIRECTOR 3055565654 2015-02-17 1 LAWRENCE SCHIFF CPA P00479457 3058199555 2013 2016-02-25 16:41:14Z NICK ANTONACCI 5300 W 16TH AVENUE HIALEAH FL 33012 12649491 0 X N/A X 2003 FL THE ORGANIZATION OPERATES A NURSING FACILITY AND PROVIDES NURSING SERVICES TO PRIVATE RESIDENTS AND BENEFICIARIES OF FEDERAL AND STATE FUNDED PROGRAMS. 13 13 237 18 0 0 0 0 12930699 12627316 0 0 19548 22175 12950247 12649491 4410 100 0 0 6709772 6907909 0 0 0 5734316 6118503 12448498 13026512 501749 -377021 5092873 4883212 1588666 1756026 3504207 3127186 X THE ORGANIZATION OPERATES A NURSING FACILITY AND PROVIDES NURSING SERVICES TO PRIVATE RESIDENTS AND BENEFICIARIES OF FEDERAL AND STATE FUNDED PROGRAMS. 0 0 11078077 100 12649491 THE ORGANIZATION OPERATES A 120-BED NURSING HOME THAT PROVIDES SKILLED AND INTERMEDIATE CARE NURSING SERVICES TO PRIVATE RESIDENTS AND BENEFICIARIES OF FEDERAL AND STATE FUNDED PROGRAMS. 11078077 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 25 0 1 237 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X BILL CONOL 3055565654 5300 W 16TH AVENUE HIALEAH FL 33012 WILLIAM JACOBS PRESIDENT 1.00 1.00 X X 0 0 0 PAUL LANDRUM TREASURER 1.00 1.00 X X 0 0 0 GERTRUDE STEWART SECRETARY 0.50 0.50 X X 0 0 0 CRAIG W NELSON DIRECTOR 0.50 0.50 X 0 0 0 AVIS BROWN DIRECTOR 0.50 0.50 X 0 0 0 TASHA L SMITH DIRECTOR 0.50 0.50 X 0 0 0 LYN FARR VICE PRESIDENT 0.50 0.50 X X 0 0 0 MARLENE LIEBERMAN DIRECTOR 0.50 0.50 X 0 0 0 ODETTE LIGHTBOURNE DIRECTOR 0.50 0.50 X 0 0 0 MARIA REGO DIRECTOR 0.50 0.50 X 0 0 0 JAKE ROUDENBUSH DIRECTOR 0.50 0.50 X 0 0 0 REV GUILLERMO SANCHEZ DIRECTOR 0.50 0.50 X 0 0 0 JEAN TAXIS DIRECTOR 0.50 0.50 X 0 0 0 NICK ANTONACCI EXECUTIVE DIRECTOR 10.00 10.00 X 0 0 0 MARTA DELGADO ADMINISTRATOR 40.00 0.00 X 136771 0 10873 EUNICE FOMBU DIRECTOR OF NURSING 40.00 0.00 X 131329 0 17169 268100 0 28042 2 0 0 0 AGENCY FOR HEALTH CARE ADMINISTRATION 2727 MAHAN DRIVE TALLAHASSEE FL 32308 QUALITY ASSESSMENT FEE 662883 DOS HEALTH MANAGEMENT 300 71ST STREET STE 400 MIAMI BEACH FL 33141 MANAGEMENT FEE 466920 PARTNER RX LLC 6555 NOVA DRIVE SUITE 304 DAVIE FL 33317 PHARMACY 418981 SYSCO FOOD SERVICES PO BOX 64000-A MIAMI FL 33164 FOOD SERVICE 415449 GORDON FOOD SERVICE 3301 NW 125TH STREET MIAMI FL 33167 FOOD SERVICE 233873 5 RESIDENT SERVICE REVENUE 623000 12627316 12627316 12627316 OTHER REVENUE 623000 22175 22175 22175 12649491 12649491 0 0 100 100 5280947 4720047 560900 1158875 1036206 122669 468087 408742 59345 615579 615579 22937 22937 36000 36000 420757 420757 27428 27428 443503 99168 344335 2201737 2104409 97328 19166 15936 3230 71328 71328 23792 23792 SUPPLIES 884463 850968 33495 QUALITY ASSESSMENT FEE 665057 665057 PHARMACY MEDICARE EXPEN 410017 410017 BAD DEBT EXPENSE 264831 264831 11908 10511 1397 13026512 11078077 1948435 0 1702131 278376 1256924 1868357 6060 6060 101759 127220 789698 292896 348928 496802 1677071 2106397 5092873 4883212 840077 1260924 748589 495102 1588666 1756026 X 3504207 3127186 3504207 3127186 5092873 4883212 -377021 0 X X 0 1 X 1 0 X 12718586 13713665 14311371 12930699 12627316 66301637 12718586 13713665 14311371 12930699 12627316 66301637 0 0 0 66301637 36574 42417 24591 19548 22175 145305 12755160 13756082 14335962 12950247 12649491 66446942 0.99780 0.99790 0.00000 0.00000 X 1 125294 1575 126869 0 388659 44925 343734 401039 247971 153068 496802 DUE FROM RELATED PARTIES 2080582 OTHER RECEIVABLES 25815 2106397 OTHER LIABILITIES 55102 DUE TO MEDICARE 345000 DUE TO MEDICAID 95000 495102 12649491 0 12649491 0 12649491 13026512 0 13026512 0 13026512 PART IV, LINE 1B: THE COMPANY OFFERS A CASH MANAGEMENT SERVICE TO ITS RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF EACH RESPECTIVE RESIDENT, TO BE DISBURSED ONLY AS REQUESTED AND, ACCORDINGLY, THESE FUNDS ARE EXCLUDED FROM THE ACCOMPANYING FINANCIAL STATEMENTS. THE COMPANY HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. AT JUNE 30, 2014 AND 2013, THESE FUND BALANCES APPROXIMATED $127,000 AND $125,000, RESPECTIVELY. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED MANAGEMENT DUTIES TO DOS HEALTH SERVICES, INC. THROUGH A BOARD-APPROVED CONTRACT. FORM 990, PART VI, SECTION B, LINE 11 THE ACCOUNTING DIRECTOR CONDUCTS A COMPREHENSIVE REVIEW OF THE FORM 990 BEFORE IT IS FILED WITH THE IRS. A COPY OF THE FORM 990 IS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS BEFORE ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT-OF-INTEREST POLICY COVERS ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS. IT IS THE RESPONSIBILITY OF ALL PERSONS COVERED TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES WHEN DETERMINED. THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD OF DIRECTORS REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE DISCLOSURE PROCESS AND DETERMINES WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO THE ORGANIZATION. THE PERSON WITH THE CONFLICT OF INTEREST WILL BE EXCLUDED FROM DISCUSSION AND APPROVAL OF SUCH TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT AUDIT FIRM AND OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. ALDERSGATE RETIREMENT INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 161676095 OPERATES ASSISTED AND INDEPENDENT LIVING FACILITY FL 501(C)(3) LINE 9 N/A 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 ALDERSGATE RETIREMENT INC D 2080582 FAIR MARKET VALUE SUSANNA WESLEY INC K 2315000 FAIR MARKET VALUE