2015-06-18T08:06:15-05:00 2014-12-31 410746749 CLIFTONLARSONALLEN LLP 101 N TRYON STREET SUITE 1000 CHARLOTTE NC 28246 990 2014-01-01 570647976 ROLLING GREEN VILLAGE ROLL 8649879800 1 HOKE SMITH BLVD GREENVILLE SC 29615 LYNNE LENTZ FINANCIAL SERVICES DIRECTOR 8649879800 2015-06-17 1 JOHN NORMAN P01506766 7049985200 2014 2016-04-25 22:37:26Z ROBERT J BENSON 1 HOKE SMITH BLVD GREENVILLE SC 29615 15674238 0 X WWW.ROLLINGGREENVILLAGE.COM X 1977 SC ROLLING GREEN VILLAGE'S MISSION IS TO SERVE SENIOR ADULTS BY PROVIDING AN ENVIRONMENT THAT ENRICHES THEIR QUALITY OF LIFE AND FOSTERS THE HIGHEST LEVEL OF INDEPENDENCE POSSIBLE IN A SETTING NURTURED BY AND ESTABLISHED ON CHRISTIAN IDEALS. 10 10 351 30 0 0 14221 4948 14447900 15654928 11844 14362 0 0 14473965 15674238 0 35562 0 0 6969420 7047410 0 0 0 6973004 7693533 13942424 14776505 531541 897733 25112564 25231776 27081963 26178447 -1969399 -946671 THE MISSION OF ROLLING GREEN VILLAGE IS TO SERVE SENIOR ADULTS BY PROVIDING AN ENVIRONMENT THAT ENRICHES QUALITY OF LIFE AND FOSTERS THE HIGHEST LEVEL OF INDEPENDENCE POSSIBLE IN A SETTING NURTURED BY AND ESTABLISHED ON CHRISTIAN IDEALS. 0 0 12284744 35562 15654928 THE LICENSED AREAS INCLUDE 24 HOUR CARE INCLUDING ASSISTANCE WITH BATHING, DRESSING, MEDICATION ADMINISTRATION, THREE WELL BALANCED MEALS EACH DAY WITH ACCOMMODATIONS FOR SPECIAL DIETS WHEN PRESCRIBED BY A PHYSICIAN, WEEKLY HOUSEKEEPING WITH DAILY TIDYING OF APARTMENT FLAT, LAUNDRY AND PERSONAL LAUNDRY SERVICES, EMERGENCY CALL SYSTEM TO LICENSED NURSE AVAILABLE 24-HOURS, A DAY FULL ACTIVITIES PROGRAM, UTILITIES INCLUDING ELECTRICITY, GAS, WATER, SEWER, AND EXTENDED BASIC CABLE TELEVISION. MANY OTHER SERVICES ARE ALSO AVAILABLE AT AN ADDITIONAL CHARGE SUCH AS BEAUTY AND BARBER, ESCORTS TO PHYSICIAN APPOINTMENTS, PERSONAL AND MEDICAL SUPPLIES, AND GUEST MEALS. 12284744 1 0 0 0 0 1 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 45 0 1 351 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 SC X LYNNE LENTZ 8649879800 1 HOKE SMITH BLVD GREENVILLE SC 29615 X X CURTIS ASKEW CHAIRMAN OF STRATEGIC COMM/TRUSTEE 5.00 X X 0 0 0 S MARTIN ATKINS CHAIRMAN OF THE BOARD 7.00 X X 0 0 0 CATRIONA CARLISLE TRUSTEE 5.00 X 0 0 0 ROY CHAMLEE III CHAIRMAN OF GOVERNANCE COMM/TRUSTEE 5.00 X X 0 0 0 RONNIE O COLSON CHAIRMAN OF FINANCE COMM/TRUSTEE 5.00 X X 0 0 0 ROBBY DAVIS VICE CHAIRMAN OF THE BOARD 5.00 X X 0 0 0 REBECCA FAULKNER TRUSTEE 5.00 X 0 0 0 SYLVIA FRAZIER SECRETARY OF THE BOARD 5.00 X X 0 0 0 DAVID LEDBETTER TRUSTEE 5.00 X 0 0 0 DUKE MCCALL TRUSTEE 5.00 X 0 0 0 BOB BENSON PARTIAL YEAR EXECUTIVE DIRECTOR 40.00 X 0 0 0 HOPE BROWN PARTIAL YEAR EXECUTIVE DIRECTOR 40.00 X 0 0 0 RYAN TOERNER ADMINISTRATOR 40.00 X 0 0 0 0 0 0 0 0 0 0 LIFE CARE COMPANIES LLC 400 LOCUST STREET SUITE 820 DESMOINES IA 50309 SEE SCHEDULE O 936640 HERITAGE HEALTHCARE 536 OLD HOWELL ROAD GREENVILLE SC 29615 THERAPY SERVICES 767398 PHARMACY CONSULTANTS PO BOX 715268 COLUMBUS OH 43271 PHARMACY 284222 ALLISON DONALD E PO BOX 176 PIEDMONT SC 29673 REFURBISHMENTS 196741 4 4948 4948 FACILITY FEES 623000 9795948 9795948 RESIDENT FEES 623000 3847453 3847453 HOME FEES 623000 1293534 1293534 ENTRANCE FEES 623000 384771 384771 ANCILLARY SERVICES 623000 319820 319820 13402 13402 15654928 6578 6578 7784 0 7784 7784 7784 15674238 15654928 0 14362 35562 35562 610958 350751 260207 5206597 4000025 1206572 22666 12828 9838 755186 542874 212312 452003 339454 112549 902371 767015 135356 51850 51850 41700 41700 19905 19905 1098420 923155 175265 836197 836197 96945 82192 14753 94935 80695 14240 24583 21572 3011 987251 839163 148088 123358 104854 18504 27914 22135 5779 1520645 1520645 412212 350380 61832 FOOD SUPPLIES 943701 943701 MEDICAL SUPPLIES 511546 511546 14776505 12284744 2491761 0 6001012 6786819 760333 829248 39637 58120 591645 669438 34693186 17979860 17551111 16713326 168826 174825 25112564 25231776 1050879 1139390 13116431 12985010 12150000 11475000 764653 579047 27081963 26178447 X -2016289 -992553 46890 45882 -1969399 -946671 25112564 25231776 897733 124995 0 X 0 1 X 1 0 X 17890 14950 13547 14221 4948 65556 11656452 12069609 11897498 14447903 15654725 65726187 11674342 12084559 11911045 14462124 15659673 65791743 0 0 0 65791743 68620 21115 8318 8275 6578 112906 68620 21115 8318 8275 6578 112906 -71776 -71776 11742962 12033898 11919363 14470399 15666251 65832873 0.99940 0.99790 0.00170 0.00330 X 13 1 2046 8656 0 0 36655 102325 1 1 1208023 0 1441 9055 1200409 991930 214470 1623 1208023 660644 329430 1856 991930 312742 346576 1326 660644 280617 11692 20433 312742 1.00000 0 0 846417 846417 30502853 15730520 14772333 3079414 1511579 1567835 264502 737761 -473259 16713326 PROSPECTIVE RESIDENT DEPOSITS 5000 INTEREST RATE SWAP INSTRUMENTS 329659 CAPITAL LEASE OBLIGATIONS 244388 579047 X 15800240 124995 3029 128024 15672216 2021 2021 15674237 14776504 0 14776504 0 14776504 PART V, LINE 4: TO BE HELD IN PERPETUITY WITH 5% OF THE AVERAGE FAIR MARKET VALUE OF THE ACCOUNTS FOR THE PAST 16 QUARTERS BEING RELEASED TO A SELF-RESTRICTED ACCOUNT FOR THE BENEFIT OF FINANCIALLY DISTRESSED RESIDENTS. PART X, LINE 2: THE ORGANIZATION HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE ORGANIZATION FILES AS A TAX-EXEMPT ORGANIZATION. SHOULD THE STATUS BE CHALLENGED IN THE FUTURE, THE 2011, 2012, AND 2013 TAX YEARS ARE OPEN FOR EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE ORGANIZATION ADOPTED GUIDANCE IN THE INCOME TAX STANDARD REGARDING RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE IMPLEMENTATION HAS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 3,029. . PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS 2,021. 1 BENEVOLENT ASSISTANCE 2 31050 PART I, LINE 2: RGV WILL GIVE FINANCIAL ASSISTANCE TO RESIDENTS WHO QUALIFY AND HAVE IDENTIFIED A NEED. THERE IS A HARDSHIP APPLICATION THAT MUST BE FILLED OUT BY THE RESIDENT (OR POA). THE APPLICATION REQUIRES SEVERAL YEARS' TAX RETURNS AMONG OTHER DETAILED FINANICAL INFORMATION ABOUT THE RESIDENT. WHEN THE NEED IS CALCULATED (INCOME LESS OUTGOING EXPENSES) AND A DOLLAR VALUE IS OBTAINED, THE REQUEST IS THEN BROUGHT TO THE TRUSTEE FINANCE COMMITTEE TO DETERMINE IF THE HARDSHIP REQUEST IS APPROVED. A ROLLING GREEN VILLAGE 570647976 NONEAVAIL 2011-12-15 13500000 TO REFUND 1998 BOND AND FINANCE CAPITAL IMPROVEMENTS. 0 0 0 A 13500000 227601 7810542 5461857 0 1 1 1 A 0 1 1 1 1 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 LIFE CARE SERVICES PERFORMS MANAGEMENT DUTIES OF EXECUTIVE DIRECTOR AND ADMINISTRATOR. FORM 990, PART VI, SECTION B, LINE 11 BOARD MEMBERS AND MANAGEMENT REVIEW AND APPROVE THE 990 VIA AN E-MAILED FILE AND VOTE AT THE NEAREST BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION CONTINUALLY MONITORS WHETHER A BOARD MEMBER HAS A CONFLICT OF INTEREST. IF A BOARD MEMBER HAS A CONFLICT OR IS PERCEIVED TO HAVE A CONFLICT, THAT BOARD MEMBER MAY NOT PARTICIPATE IN THE DISCUSSION AND VOTING ON THE TOPIC FROM WHICH THE CONFLICT ARISES FORM 990, PART VI, SECTION B, LINE 15 LIFE CARE SERVICES DETERMINES THE SALARIES AND BENEFITS FOR THE EXECUTIVE DIRECTOR AND THE ADMINISTRATOR. THE EXECUTIVE DIRECTOR AND THE HUMAN RESOURCES DIRECTOR DETERMINE THE SALARIES FOR OTHER OFFICERS BASED ON WAGE STUDIES AND MARKET ANALYSIS FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE AT RESIDENT MEETINGS AND A COPY OF THE ANNUAL AUDIT IS KEPT IN THE RESIDENT LIBRARY PART VII SECTION B INDEPENDENT CONTRACTORS: MANAGEMENT SERVICES AND REIMBURSABLE EXPENSES, INCLUDING SALARIES AND BENEFITS OF THE EXECUTIVE DIRECTOR AND ADMINISTRATOR.