2014-05-13T07:46:48-05:00 2013-12-31 621404815 MATHENEY STEES & ASSOCIATES PC 6136 SHALLOWFORD ROAD SUITE 101 CHATTANOOGA TN 374217214 990 2013-01-01 621827399 SENIORTRUST OF FLORIDA INC CO CUMBERLAND & OHIO CO OF TX AS RECEIVER SENI 6158902020 511 UNION STREET NO SUITE NASHVILLE TN 37219 JAMES A SKINNER PRESIDENT OF CUMBERLAND & OHIO CO 6158902020 2014-05-12 1 WILLIAM C MATHENEY P00439757 4238947400 2014-05-12 2013 2015-11-30 17:44:51Z JAMES A SKINNER 511 UNION STREET NO SUITE NASHVILLE TN 37219 53779263 0 X N/A X 2000 TN PROVIDING LONG-TERM NURSING HOME CARE X 0 0 708 0 0 0 764 0 35999196 9035448 -6656 781253 5186884 23039476 41180188 32856177 0 0 0 0 21062827 5097722 0 0 0 17290116 4505807 38352943 9603529 2827245 23252648 31939732 14916962 40275418 0 -8335686 14916962 X PROVIDING LONG-TERM NURSING HOME CARE 0 1 7084874 32856177 PROVIDED LONG-TERM HEALTH CARE. 7084874 1 0 0 0 0 0 0 0 0 0 0 0 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 0 1 1 0 0 0 0 1 95 0 1 708 1 0 0 0 0 0 0 0 0 0 0 X 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 X JAMES A SKINNER 6158506007 500 UNION STREET NASHVILLE TN 37219 X CUMBERLAND OHIO CO OF TEXAS RECEIVER 0.00 X 0 0 0 0 0 0 0 0 0 0 WALLER LANSDEN DORTCH & DAVIS 511 UNION STREET NASHVILLE TN 37219 LEGAL SERVICES 250395 1 NURSING HOME CARE 623000 9035448 9035448 9035448 4339 4339 21700000 20923086 776914 776914 776914 FORGIVENESS OF DEBT 900099 23026921 23026921 MISC REVENUE 900099 12555 12555 23039476 32856177 32856177 0 0 3716229 3550676 165553 119982 100126 19856 817777 453781 363996 443734 399044 44690 542989 542989 242840 242840 22 22 6262 4709 1553 19652 13839 5813 613822 613822 303632 303632 22566 22566 SUPPLIES 1130863 1122542 8321 MISCELLANEOUS EXPENSE 876806 448637 428169 PURCHASED SERVICES 228019 202637 25382 STATE TAX FEE 216149 216149 302185 269080 33105 9603529 7084874 2518655 0 8646946 11765138 2771933 0 264093 10251 0 0 19896117 350392 3151824 31939732 14916962 18842582 0 21336859 95977 0 40275418 0 X -8335686 14916962 -8335686 14916962 31939732 14916962 23252648 0 X 0 0 0 X -532 223 250327 764 250782 38293436 37755160 38250773 35999196 9035448 159334013 38292904 37755383 38501100 35999960 9035448 159584795 0 0 0 159584795 2154 1845 2483 4339 10821 2154 1845 2483 4339 10821 211363 5186884 22031942 27430189 38295058 37755383 38714308 41189327 31071729 187025805 0.85330 0.97140 0.00010 0.00060 X 0 DEPOSITS 151824 ESCROW DEPOSITS 3000000 3151824 X PART X, LINE 2: THE COMPANY IS A TAX-EXEMPT ENTITY AS DESCRIBED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE FOR FEDERAL AND STATE INCOME TAX PURPOSES. THE FAILURE OF THE COMPANY TO MAINTAIN ITS TAX-EXEMPT STATUS WOULD HAVE AN ADVERSE EFFECT ON THE COMPANY'S FINANCIAL POSITION, RESULTS OF OPERATIONS, AND CASH FLOWS. LAND, BUILDING AND EQUIPMENT 2013-04-30 2338211 NET BOOK VALUE ACCORDING TO DEPRECIATION SCHEDULE. DIVERSICARE OF CHANUTE LLC 530 WEST 14TH STREET CHANUTE KS 66720 LLC LAND, BUILDING AND EQUIPMENT 2013-04-30 2700040 NET BOOK VALUE ACCORDING TO DEPRECIATION SCHEDULE. DIVERSICARE OF COUNCIL GROVE LLC 400 SUNSET DRIVE COUNCIL GROVE KS 66846 LLC LAND, BUILDING AND EQUIPMENT 2013-04-30 4983038 NET BOOK VALUE ACCORDING TO DEPRECIATION SCHEDULE. DIVERSICARE OF HAYSVILLE LLC 215 NORTH LAMAR AVENUE HAYSVILLE KS 67060 LLC LAND, BUILDING AND EQUIPMENT 2013-04-30 1646927 NET BOOK VALUE ACCORDING TO DEPRECIATION SCHEDULE. DIVERSICARE OF SEDGWICK LLC 712 NORTH MONROE AVENUE SEDGWICK KS 67135 LLC LAND, BUILDING AND EQUIPMENT 2013-04-30 2040858 NET BOOK VALUE ACCORDING TO DEPRECIATION SCHEDULE. DIVERSICARE OF LARNED LLC 1114 WEST 11TH STREET LARNED KS 67550 LLC LAND, BUILDING AND EQUIPMENT 2013-02-05 3552808 NET BOOK VALUE ACCORDING TO DEPRECIATION SCHEDULE. ST CHARLES HOLDINGS LLC 3750 OSAGE PARKWAY SUITE 200 OSAGE BEACH MO 65075 LLC LAND, BUILDING AND EQUIPMENT 2013-02-05 2350579 NET BOOK VALUE ACCORDING TO DEPRECIATION SCHEDULE. BOONE HOLDINGS LLC 3750 OSAGE PARKWAY SUITE 200 OSAGE BEACH MO 65075 LLC LAND 2013-02-05 0 NET BOOK VALUE ACCORDING TO DEPRECIATION SCHEDULE. JASPER HOLDINGS LLC 3750 OSAGE PARKWAY SUITE 200 OSAGE BEACH MO 65075 LLC 0 0 0 0 FORM 990, PART III, LINE 3 THE ORGANIZATION CEASED PROVIDING LONG-TERM HEALTHCARE TO PATIENTS IN FEBRUARY 2013 FOR ALL MISSOURI FACILITIES AND MARCH 2013 FOR ALL KANSAS FACILITIES. ALL PROPERTY PLANT AND EQUIPMENT WAS SOLD TO AN UNRELATED BUSINESS AND NHI TOOK OVER THE REMAINING DEBT OWED BY SENIORTRUST FORM 990, PART VI, SECTION A, LINE 3 NHC PERFORMED MANAGEMENT DUTIES UNDER A SPECIFIC WRITTEN MANAGEMENT AGREEMENT WHICH ARE CUSTOMARILY PERFORMED BY EMPLOYEES OF THE NURSING HOMES. THE CONTRACT WITH NHC WAS TERMINATED ON THE DATE THE NURSING FACILITIES CEASED OPERATIONS. FORM 990, PART VI, SECTION A, LINE 8A THE ORGANIZATION DID NOT DOCUMENT ANY MEETINGS OR WRITTEN ACTIONS ON BEHALF OF THE BOARD OF DIRECTORS, THE CHANCERY COURT FOR THE STATE OF TENNESSEE, 20TH JUDICIAL DISTRICT, TURNED THE COMPANY OVER TO A RECEIVER IN 2011. THE BOARD OF DIRECTORS RESIGNED AND ALL BOARD RESPONSIBILITIES WERE TURNED OVER TO THE COURT APPOINTED RECEIVER. THE RECEIVER ACT AS A BOARD OF ONE AND AS LISTED ON PAGE 7. FORM 990, PART VI, SECTION A, LINE 8B THERE WAS NOT A FORMAL COMMITTEE THAT WAS AUTHORIZED TO ACT ON BEHALF OF THE GOVERNING BOARD FOR 2013. THE RECEIVED WAS AUTHORIZED TO ACT AS A BOARD OF ONE. FORM 990, PART VI, SECTION B, LINE 11 THE CHANCERY COURT FOR THE STATE OF TENNESSEE, 20TH JUDICIAL DISTRICT, TURNED THE COMPANY OVER TO A RECEIVER IN 2011. FOR 2013, THE RECEIVER REVIEWS AND APPROVES THE 990 BEFORE FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS CALCULATED BY AN INDEPENDENT PERSON AND REVIEWED ANNUALLY BY ANOTHER. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANUTE HEALTHCARE CENTER LLC 530 WEST 14TH STREET CHANUTE KS 66720 753175623 LONG-TERM NURSING HOME CARE KS N/A CHARLEVOIX HEALTHCARE CENTER LLC 1221 BOONSLICK ROAD ST CHARLES MO 63301 870735831 LONG-TERM NURSING HOME CARE MO N/A COLUMBIA HEALTHCARE CENTER LLC 1801 TOWNE DRIVE COLUMBIA MO 65201 753175615 LONG-TERM NURSING HOME CARE MO N/A COUNCIL GROVE HEALTHCARE CENTER LLC 400 SUNSET DRIVE COUNCIL GROVE KS 66846 753175620 LONG-TERM NURSING HOME CARE KS N/A HAYSVILLE HEALTHCARE CENTER LLC 215 N LAMAR STREET HAYSVILLE KS 67060 753175626 LONG-TERM NURSING HOME CARE KS N/A JOPLIN HEALTHCARE CENTER LLC 2810 JACKSON ROAD JOPLIN MO 64804 753175612 LONG-TERM NURSING HOME CARE MO N/A LARNED HEALTHCARE CENTER LLC 1114 W 11TH STREET LARNED KS 67550 753175628 LONG-TERM NURSING HOME CARE KS N/A SEDGWICK HEALTHCARE CENTER LLC 712 MONROE AVENUE SEDGWICK KS 67135 753175631 LONG-TERM NURSING HOME CARE KS N/A