2015-04-28T09:33:12-05:00 2014-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2014-01-01 020446675 PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM INC PETE 6039240062 150 RIVERMEAD ROAD PETERBOROUGH NH 03458 MARTIN J CONLEY III CFO 6039240062 2015-04-27 1 JULIUS GREEN CPA P00350393 2159720701 2014 2016-04-25 22:37:26Z RIVERMEAD WILLIAM H JAMES JR 150 RIVERMEAD ROAD PETERBOROUGH NH 03458 25570875 0 X WWW.RIVERMEAD.ORG X 1991 NH CCRC COMMITTED TO PROVIDING EXCELLENT HOUSING AND HEALTH CARE SERVICES TO ITS RESIDENTS. 17 16 367 25 0 0 34895 122747 13479888 15823703 394564 869086 231135 344347 14140482 17159883 550 92487 0 0 7586773 8403642 0 0 0 9027250 10328224 16614573 18824353 -2474091 -1664470 78058309 75456969 93586952 93655879 -15528643 -18198910 X RIVERMEAD IS A PROGRESSIVE NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY THAT ADVOCATES FOR AN ENRICHED LIFESTYLE WITH CULTURAL AND EDUCATIONAL OPPORTUNITIES. WE CONTINUOUSLY STRIVE TO PROVIDE HIGH-QUALITY, HOLISTIC LIFECARE PROGRAMS AND HEALTHCARE SERVICES IN A FINANCIALLY RESPONSIBLE MANNER. IN SERVING THIS COMMITMENT, WE SEEK TO PROVIDE A POSITIVE AND SUPPORTIVE WORK ENVIRONMENT. 0 0 16336441 92487 15823703 INDEPENDENT LIVING:RIVERMEAD HAS 154 INDEPENDENT LIVING RESIDENCES AVAILABLE FOR INDIVIDUALS AGED 62 AND OLDER. THESE RESIDENCES ARE AVAILABLE UNDER A LIFECARE CONTRACT, WHICH GUARANTEES RESIDENTS ACCESS TO ASSISTED LIVING, MEMORY SUPPORT AND SKILLED NURSING CARE WITH NO SIGNIFICANT CHANGE IN THEIR MONTHLY FEES AS THEY MOVE BETWEEN LEVELS OF CARE. RIVERMEAD'S POLICY IS TO NEVER TERMINATE A RESIDENCY AGREEMENT SOLELY BASED UPON A RESIDENT'S INABILITY TO PAY HIS OR HER MONTHLY FEE IN FULL. RIVERMEAD PROVIDED OVER $89,000 IN CHARITABLE ASSISTANCE TO RESIDENTS IN 2014.HEALTH CARE SERVICES: RIVERMEAD HAS 49 ASSISTED LIVING RESIDENCES, 17 MEMORY SUPPORT RESIDENCES, 27 SKILLED NURSING RESIDENCES AND A HOME HEALTH PROGRAM.PROGRAMS & AMENITIES:RIVERMEAD IS COMMITTED TO PROVIDING QUALITY PROGRAMS, SERVICES AND AMENITIES TO ENRICH RESIDENTS' LIVES INCLUDING: EXCEPTIONAL DINING EXPERIENCES, THERAPY SERVICES, HOUSEKEEPING, MAINTENANCE, A WELLNESS CENTER, AN INDOOR POOL, TRANSPORTATION, TWO LIBRARIES, A MOVIE THEATER, A WOODWORKING SHOP, A GREEN HOUSE, AN ART GALLERY, WALKING TRAILS, CROQUET AND BOCCE COURTS AND RAISED GARDEN BEDS. 16336441 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 41 0 1 367 1 0 0 0 0 0 0 0 0 0 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X MARTIN J CONLEY III 6033710431 150 RIVERMEAD RD PETERBOROUGH NH 03458 G CLAY HOLLISTER CHAIR 1.00 X X 0 0 0 MICHAEL J RAFFERTY VICE CHAIR 1.00 X X 0 0 0 JAMES C ADAMS TREASURER 1.00 X X 0 0 0 RICHARD R FERNALD SECRETARY 3.00 X X 0 0 0 JEFFREY R CROCKER TRUSTEE 1.00 X 0 0 0 CHRISTOPHER J FLYNN TRUSTEE 1.00 X 0 0 0 MARY FORSSELL TRUSTEE 1.00 X 0 0 0 JANET S GRANT TRUSTEE 1.00 X 0 0 0 BETSEY HARRIS TRUSTEE 1.00 X 0 0 0 HEATHER J LEACH TRUSTEE 1.00 X 0 0 0 JOHN H MORISON III TRUSTEE 1.00 X 0 0 0 CONSTANCE G OLIVER TRUSTEE 1.00 X 0 0 0 SUSAN A PETERSEN TRUSTEE 1.00 X 0 0 0 THEODORE RENNA MD TRUSTEE 1.00 X 0 0 0 JOHN ROUND TRUSTEE 1.00 X 0 0 0 CALVIN SHOLL TRUSTEE 1.00 X 0 0 0 EVE MA STONE TRUSTEE 1.00 X 0 0 0 WILLIAM H JAMES JR CHIEF EXECUTIVE OFFICER 40.00 X 199320 0 25256 M KAREN WIREIN THRU 82014 CHIEF FINANCIAL OFFICER 40.00 X 106115 0 17363 MICHAEL HENEGHAN INTERIM CHIEF FINANCIAL OFFICER 40.00 X 47156 0 0 MARTIN J CONLEY III CHIEF FINANCIAL OFFICER-BEG. 12/2014 40.00 X 6769 0 0 JAN EATON DIRECTOR OF MARKETING 40.00 X 127866 0 20646 KARYN MINER DIRECTOR OF HEALTH SVCS 40.00 X 137010 0 19439 DOUGLAS SHARP DIRECTOR OF FACILITIES 40.00 X 113976 0 27082 738212 0 109786 5 0 1 0 MORRISON MANAGEMENT SPECIALIST PO BOX 102289 ATLANTA GA 30368 DINING SERVICES 490484 FLOORING CONCEPTS INC 255 FROST HILL ROAD MARLBOROUGH NH 03455 CONSTRUCTION SERVICES 332090 HUNTER NORTH ASSOCIATES LLC PO BOX 56346 ATLANTA GA 30343 SECURITY SERVICES 232055 W RINDGE BUILDERS LTD 350 RIVER ST JAFFREY NH 03452 CONSTRUCTION SERVICES 195692 HUTTER CONSTRUCTION 810 TURNPIKE RD NEW IPSWICH NH 03071 CONSTRUCTION SERVICES 187276 9 122747 40064 122747 RESIDENT SERVICE FEES 623000 8881439 8881439 EARNED ENTRANCE FEES 623000 2764438 2764438 ASSISTED LIVING FEES 623000 2013822 2013822 HEALTH CENTER FEES 623000 1194664 1194664 SPECIAL CARE UNIT FEES 623000 969340 969340 15823703 381179 381179 8898049 850 8410992 0 487057 850 487907 487907 CABLE TELEVISION REVENUE 900099 95577 95577 GUEST MEAL REVENUE 900099 65172 65172 GUEST ROOM RENTAL 900099 29356 29356 154242 154242 344347 17159883 15823703 0 1213433 2600 2600 89887 89887 401979 401979 6331937 5446207 885730 173793 142123 31670 1042677 860476 182201 453256 372213 81043 34474 34474 107924 107924 1424 1424 63287 63287 847172 806785 40387 19335 19335 492097 295868 196229 74923 74923 2132412 2132412 57664 40754 16910 1941102 1941102 2732387 2732387 193780 193780 FOOD 802378 802378 REPAIRS AND MAINTENANCE 299866 299866 RESIDENT ENRICHMENT 245801 80111 165690 MEDICAL SUPPLIES 72418 72418 209780 25074 184706 18824353 16336441 2487912 0 1000 1000 5414530 4164888 351890 83125 26320 22735 337814 400095 75583651 24117891 53057005 51465760 17441810 17954510 1427940 1364856 78058309 75456969 4514136 1360667 53967694 57967222 34965420 34003024 210636 139702 114330 93586952 93655879 X -15921992 -18688400 183106 266172 210243 223318 -15528643 -18198910 78058309 75456969 X -1664470 -267472 -751400 13075 X 0 1 X 1 0 X 14188 61196 255591 34895 122747 488617 11723712 12718804 11586314 13479888 15823703 65332421 11737900 12780000 11841905 13514783 15946450 65821038 0 0 0 65821038 330430 433765 418647 375108 381179 1939129 330430 433765 418647 375108 381179 1939129 210833 207391 207341 231135 344347 1201047 12279163 13421156 12467893 14121026 16671976 68961214 0.95450 0.95130 0.02810 0.03210 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE GUEST ROOM RENTAL CABLE TELEVISION REVENUE GUEST MEAL REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1424 1424 0 PART II-B, LINE 1: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC. IS A MEMBER OF LEADINGAGE MAINE AND NEW HAMPSHIRE AND THE LEADINGAGE NATIONAL ASSOCIATION. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS ARE AVAILABLE FOR LOBBYING EXPENDITURES ON BEHALF OF PETERBOROUGH RETIREMENT COMMUNITY TO FURTHER OUR EXEMPT PURPOSE. PETERBOROUGH RETIREMENT COMMUNITY DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. 1 9424 20733 20127 10030 0 393350 95740 13050 12650 489490 351534 27380 16164 1728 393350 340790 14323 3579 351534 331708 8441 9239 8598 340790 324916 10696 3904 331708 0.00000 0.46000 0.54000 0 0 2265575 2265575 56352238 15323514 41028724 9997227 4836051 5161176 6968611 3958326 3010285 51465760 GIFT ANNUITIES PAYABLE 114330 114330 X 16752312 -267472 -140099 -407571 17159883 0 17159883 18671179 0 18671179 153174 153174 18824353 PART IV, LINE 1B: RIVERMEAD MAINTAINS A RESIDENT TRUST ACCOUNT FOR RESIDENTS IN ITS ASSISTED LIVING AND SKILLED NURSING. PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY RIVERMEAD HAS BEEN LIMITED BY DONORS TO SPECIFIC PURPOSES. TEMPORARILY RESTRICTED NET ASSETS ARE AVAILABLE FOR THE FOLLOWING PURPOSES: NURSE EDUCATION, FINANCIAL ASSISTANCE AND COMMUNITY PROJECTS, EMPLOYEE ASSISTANCE, AND OTHER USES. PERMANENTLY RESTRICTED NET ASSETS HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY RIVERMEAD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT FINANCIAL ASSISTANCE AND COMMUNITY PROJECTS. PART X, LINE 2: RIVERMEAD ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING 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 IS MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2014 OR 2013. RIVERMEAD'S BUSINESS ORGANIZATION EXEMPT INCOME TAX RETURNS FOR THE YEARS PRIOR TO 2011 ARE NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 13,075. ASSISTANCE TO RESIDENTS -89,887. INVESTMENT FEES -63,287. PART XII, LINE 4B - OTHER ADJUSTMENTS: ASSISTANCE TO RESIDENTS 89,887. INVESTMENT FEES 63,287. 1 CHARITABLE ASSISTANCE WITH RESIDENT MONTHLY FEES 2 89887 0 PART I, LINE 2: MANAGEMENT IDENTIFIES RESIDENTS WHO MAY NEED CHARITABLE ASSISTANCE TO PAY THEIR MONTHLY FEES. ONCE IDENTIFIED, A REVIEW IS CONDUCTED OF THE RESIDENT'S FINANCES AND, IF THE RESIDENT TRULY HAS AN INABILITY TO PAY HIS OR HER MONTHLY FEE IN FULL, THEN THE REQUEST IS SENT TO THE CEO FOR APPROVAL. X X X 1 0 0 0 0 0 0 1 0 WILLIAM H JAMES JR CHIEF EXECUTIVE OFFICER 180568 0 18752 0 0 0 3901 0 21355 0 224576 0 0 0 KARYN MINER DIRECTOR OF HEALTH SVCS 129758 0 7252 0 0 0 5226 0 14213 0 156449 0 0 0 PART I, LINE 4A M. KAREN WIREIN RECEIVED A SEVERANCE UPON TERMINATION OF EMPLOYMENT IN THE AMOUNT $13,497.07, PAID TO HER IN THREE EQUAL INSTALLMENTS OF $4,499.03 ON 9/11/14, 9/25/14, 10/9/14. PART I, LINE 7 THE MANAGEMENT BONUS IS CONTINGENT ON EXCEEDING BUDGETED NET OPERATING INCOME. MULTIPLE FACTORS ARE CONSIDERED IN DETERMINING BONUSES FOR MANAGERS INCLUDING OCCUPANCY, ACTUAL VS. BUDGETED RESULTS, RESIDENT SATISFACTION SURVEYS, STAFFING LEVELS, ETC. A NEW HAMPSHIRE HEALTH AND EDUCATON FACILITIES AUTHORITY 020279866 644614Q36 2011-12-15 21644378 EXPANSION OF FACILITY 0 0 0 B NEW HAMPSHIRE HEALTH AND EDUCATON FACILITIES AUTHORITY 020279866 2013-12-23 13550000 REFUNDING ISSUE OF SERIES 1998 BONDS 0 0 0 A 21670000 2644632 2798135 654617 15982549 67699 2013 0 0 0 1 B 727000 13550000 228202 2014 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 PART II, LINE 3 THE DIFFERENCE BETWEEN THE TOTAL PROCEEDS OF ISSUE REPORTED IN PART II, LINE 3 AND THE ISSUE PRICE IN PART I, COLUMN (E) FOR BOND A REPRESENTS ORIGINAL ISSUE DISCOUNT. X 1 40064 QUOTED MARKET VALUE 0 0 0 0 PART I, COLUMN (B): THE NUMBER REPORTED IN COLUMN (B) REPRESENTS THE NUMBER OF DONORS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WILL BE REVIEWED BY THE AUDIT COMMITTEE IN DEPTH. UPON RECOMMENDATION FOR APPROVAL BY THE AUDIT COMMITTEE, THE 990 WILL BE PROVIDED TO THE ENTIRE BOARD FOR THEIR REVIEW AND APPROVAL. CONTACT INFORMATION FOR THE CEO, CFO, AUDIT COMMITTEE AND 990 PREPARER (BAKER TILLY) WILL BE PROVIDED TO ALL BOARD MEMBERS SHOULD THEY HAVE QUESTIONS OR CONCERNS. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE AND OFFICER OF RIVERMEAD MUST BE EVER COGNIZANT AND AWARE OF POSSIBLE CONFLICT OF INTEREST SITUATIONS. ANY SUCH POSSIBLE CONFLICT MUST BE FULLY DISCLOSED IN WRITING TO THE BOARD OF TRUSTEES, AND WILL BE CONSIDERED BY THE BOARD FOR DISCUSSION, APPROVAL, OR ANY OTHER APPROPRIATE ACTION IN ACCORDANCE WITH THE REQUIREMENTS OF APPLICABLE LAW, AND ONLY IF THE MATTER SERVES THE BEST INTERESTS OF RIVERMEAD. RIVERMEAD IDENTIFIES POSSIBLE CONFLICTS OF INTEREST BY HAVING ALL TRUSTEES AND OFFICERS COMPLETE CONFLICT OF INTEREST QUESTIONNAIRES ANNUALLY. THE CEO IS RESPONSIBLE FOR ENSURING ALL QUESTIONNAIRES ARE COMPLETED. THE BOARD OF TRUSTEES REVIEWS EACH POTENTIAL CONFLICT OF INTEREST. BOARD MEMBERS WITH A CONFLICT ARE REQUIRED TO ABSTAIN FROM VOTING ON THE MATTER. NEW HAMPSHIRE AND FEDERAL LAWS REGARDING DISCLOSURE OF CONFLICTS OF INTEREST ARE FOLLOWED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CEO IS DETERMINED BY THE BOARD OF TRUSTEES USING DATA FROM THE LEADINGAGE NATIONAL SALARY SURVEY AND FROM FORM 990 DATA FROM COMPARABLE REGIONAL ORGANIZATIONS. THE CEO'S ANNUAL PERFORMANCE REVIEW IS ALSO CONSIDERED IN DETERMINING HIS ANNUAL COMPENSATION PACKAGE. THIS PROCESS IS DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. COMPENSATION OF OTHER MANAGEMENT STAFF IS DETERMINED BY THE CEO AND HR DIRECTOR. A COMPENSATION STUDY WAS CONDUCTED IN 2014. THIS STUDY RESULTED IN THE DEVELOPMENT OF WAGE GRADES FOR EACH POSITION WITHIN THE ORGANIZATION. THIS TOOL WILL BE UPDATED PERIODICALLY AND IS AN INTEGRAL PART OF DETERMINING COMPENSATION FOR NEW HIRES AND ADJUSTMENTS TO COMPENSATION FOR CURRENT EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE INCLUDED IN RIVERMEAD'S DISCLOSURE STATEMENT AND UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 13,075.