2014-11-13T14:32:17-06:00 2013-12-31 410746749 CliftonLarsonAllenLLP 5001 Spring Valley Road Suite 600W Dallas TX 75244 990 2013-01-01 751094140 Grace Presbyterian Ministries Inc GRAC 2144131523 550 E Ann Arbor Ave Dallas TX 75216 Steve Kearney CFO 2144131523 2014-11-12 1 Michael Siegel P01587323 9723835700 2013 2015-11-30 17:44:51Z Godwin Dixon 6100 Colwell Blvd Suite 225 Irving TX 75216 33759677 0 X www.gracepresbyterianvillage.org X 1962 TX Grace Presbyterian Village is a continuing care retirement community founded in 1962 and located on 27 beautiful wooded acres in Oak Cliff. We are a member of Dallas-based Presbyterian Communities and Services, a not-for-profit organization, and we pledge to enrich the lives of those we serve by providing exceptional care and services in a faith-based culture. Our wide range of services includes residential living, assisted living, skilled nursing and rehabilitation, outpatient therapy, and Alzheimer's and dementia care. Our programs and services are available to persons without regard to race, color, religion, national origin, gender, or disability. 3 3 648 0 0 0 911395 1997586 29514439 31156877 190795 1124 418140 604090 31034769 33759677 1062309 1386362 0 0 17018133 18266111 0 0 0 13480844 15882179 31561286 35534652 -526517 -1774975 51818789 55413679 7982460 12706040 43836329 42707639 X Grace Presbyterian Village is a continuing care retirement community founded in 1962 and located on 27 beautiful wooded acres in Oak Cliff. We are a member of Dallas-based Presbyterian Communities and Services, a not-for-profit organization, and we pledge to enrich the lives of those we serve by providing exceptional care and services in a faith-based culture. Our wide range of services includes residential living, assisted living, skilled nursing and rehabilitation, outpatient therapy, and Alzheimer's and dementia care. Our programs and services are available to persons without regard to race, color, religion, national origin, gender, or disability. 0 0 15287573 533885 11998450 Provided skilled nursing and Alzheimer's and dementia care to our community residents, including Medicare and Medicaid patients. 759838 183501 4123971 Provided assisted and independent living services. 11185748 668976 15034456 Provided Hospice services through Faith Presbyterian Hospice in the Dallas area to about 1270 unduplicated patients. 27233159 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 179 0 648 1 0 0 0 0 0 0 0 0 0 0 X 3 3 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X David Earnshaw 2144131562 6100 Colwell Blvd Suite 225 Irving TX 75039 Mike Wright Chairman 1.00 1.00 X X 0 0 0 Howard Chase Secretary 1.00 1.00 X 0 0 0 Ron Gafford Trustee 1.00 1.00 X 0 0 0 Godwin Dixon President/CEO 9.00 31.00 X 0 324624 42026 Brenda Terry VP of Operations 9.00 31.00 X 0 187513 28327 Steve Kearney CFO 9.00 31.00 X 0 50292 2169 Kliff Rodgers Past CFO 9.00 31.00 X 0 169387 30500 Cynthia Douglas VP of Clinical Program Dev 35.00 5.00 X 194359 0 9437 John Mark Lenhard Executive Director-CCRC 40.00 0.00 X 118420 0 34817 312779 731816 147276 2 0 1 0 Pharmerica PO Box 409251 Atlanta GA 30384 Pharmacy Services 869449 US Foodservice Inc 950 S Shiloh Road Garland TX 75042 Food and Supplies 724410 Salus Solutions LLC 7330 Fern Ave Suite 502 Shreveport LA 71105 Contract Labor 717017 Baylor University Medical Center PO Box 842022 Dallas TX 75284 Hospice Care 590708 Texas Healthcare Pharmacy 7413 Peeble Drive Fort Worth TX 76118 Pharmacy Services 573266 19 1948325 49261 1997586 Resident Revenue 623000 31156877 31156877 31156877 1124 1124 Other Miscellaneous Revenue 900099 392343 392343 Chargeable Supplies 900099 105553 105553 Beauty Shop 900099 70512 70512 35682 35682 604090 33759677 31156877 0 605214 1386362 1386362 194359 194359 16538216 12788449 3749767 48124 37213 10911 122749 94918 27831 1362663 1053702 308961 2082754 2082754 24288 24288 17943 17943 2144698 1658423 486275 46663 46663 96859 74898 21961 120958 93533 27425 858420 663787 194633 451358 349020 102338 29758 29758 78682 78682 1465550 1133261 332289 1845308 1845308 Medical & Therapy Expen 2946839 2946839 0 Food 703440 703440 0 Bad Debts 639004 639004 Outside Services 635831 491667 144164 1693826 1164895 528931 35534652 27233159 8301493 0 147882 148188 3790556 6217536 22967 25029 116377 570027 37843496 17612275 21068584 20231221 26291012 27142419 381411 1079259 51818789 55413679 2882106 3923689 2686093 2469764 2414261 6312587 7982460 12706040 X 17612505 15837530 25859820 26506105 364004 364004 43836329 42707639 51818789 55413679 -1774975 646285 0 X X 0 1 X 1 0 X 768933 1079034 1103045 911395 1997586 5859993 26051787 28050655 28168129 29514439 31156877 142941887 26820720 29129689 29271174 30425834 33154463 148801880 0 0 0 148801880 214172 236341 248226 184795 1124 884658 214172 236341 248226 184795 1124 884658 -625166 418140 604090 397064 27034892 29366030 28894234 31028769 33759677 150083602 0.99150 0.99360 0.00590 0.00780 X Schedule A, Part III, Line 12, Explanation of Other Income: Other Income - 2011 Amount: $ -625,166. 2012 Amount: $ 418,140. 2013 Amount: $ 604,090. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8387043 8387043 22732152 12784392 9947760 1113583 424100 689483 3520981 2634980 886001 2089737 1768803 320934 20231221 Interest in Net Assets-PC&SF 27142419 F 27142419 Intercompany 6224448 Sweep overdraft 88139 6312587 X Part X, Line 2: The Organization's income tax returns are subject to review and examination by federal, state, and local authorities. The Organization is not aware of any activities that would jeopardize its tax-exempt status. The Organization reports any activities that are subject to tax on unrelated business income or excise or other taxes and files all proper returns related to these activities. The information tax returns for the years 2010 to 2013 are open to examination by federal, state, and local authorities. 1 Supplemental Assistance 163 1386362 Part I, Line 2: The organization provides assistance to residents of its CCRC campus who reach financial hardship and are unable to pay a portion of their monthly fees. An application for assistance is completed and submitted to the Executive Director and committee for review and approval prior to providing assistance. The resident's financial circumstances are periodically reviewed to determine if the resident still qualifies for assistance. X X X X 0 0 0 0 0 0 0 0 0 Godwin Dixon President/CEO 0 324624 0 0 0 0 0 18308 0 23718 0 366650 0 0 Brenda Terry VP of Operations 0 187513 0 0 0 0 0 12915 0 15412 0 215840 0 0 Kliff Rodgers Past CFO 0 169387 0 0 0 0 0 30500 0 0 0 199887 0 0 Cynthia Douglas VP of Clinical Program Dev 194359 0 0 0 0 0 7412 0 2025 0 203796 0 0 0 John Mark Lenhard Executive Director-CCRC 118420 0 0 0 0 0 11099 0 23718 0 153237 0 0 0 Form 990, Part VI, Section A, line 3 On 5/1/2008, Presbyterian Communities & Services was formed to provide management and shared services to Presbyterian Communities and Services Foundation and other affiliated organizations. Form 990, Part VI, Section B, line 11 The 990 is received by management to review and correct prior to submitting to the Finance Committee of the Board for review. Management meets with the Finance Committee, along with the outside preparer, to discuss the 990 return and recommend changes, if any. After the 990 has been finalized and approved by the Finance Committee, it is submitted to the Board of Directors for their review prior to sending to the IRS. Form 990, Part VI, Section B, line 12c We have a Compliance Officer (CO) who reviews all transactions of the organization that may result in a conflict of interest. The CO determines if the transaction would result in undue influence as a result of the relationship and not be pursued. The CO reports all conflicts of interest to the Board of Directors. Form 990, Part VI, Section B, line 15 The Board has a compensation committee that reviews the current compensation compared to like entities and makes recommendations to the Board for changes in compensation. The Board also uses an outside consultant to review compensation, independent of the compensation committee. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Form 990, Part XII, Line 2C: The Organization has not changed its oversight or selection process during the filing year. Presbyterian Communities and Services 6100 Colwell Blvd Ste 225 Irving TX 75039 261459224 Shared Services/Management TX 501(c)(3) Line 11b, II N/A 0 Presbyterian Communities and Services Foundation 6100 Colwell Blvd Ste 225 Irving TX 75039 751910084 Foundation for Affiliates TX 501(c)(3) Line 7 Presbyterian Communities & Services 0 Faith Presbyterian Providers Inc 4350 Sigma Rd Suite 400 Dallas TX 75244 383800779 Pallative/Hospice Services TX 501(c)(3) Line 9 Presbyterian Communities & Services 0 Presbyterian Village North 8600 Skyline Drive Dallas TX 75243 510190369 CCRC TX 501(c)(3) Line 9 Presbyterian Communities & Services 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0