2013-10-21T13:39:18-05:00 2012-12-31 570735924 ROBINSON GRANT & CO PA PO DRAWER 22959 HILTON HEAD ISLAND SC 29925 990 2012-01-01 570951170 THE CYPRESS CLUB INC CYPR 8436897000 20 LADY SLIPPER LANE HILTON HEAD ISLAND SC 299261372 SANDY GRIFFIN-BUKOSKEY 8436897000 2013-10-14 1 MICHAEL R PUTICH CPA P00853466 8438156161 2012 2016-02-25 16:41:14Z SANDY GRIFFIN-BUKOSKEY 20 LADY SLIPPER LANE HILTON HEAD SC 29926 16720763 0 X WWW.THECYPRESS.COM X 1992 SC THE CYPRESS CLUB, INC. WAS ESTABLISHED EXCLUSIVELY TO MAINTAIN HOUSING FOR THE ELDERLY, TO DIRECTLY PROVIDE HEALTH CARE, AND TO OPERATE THE FACILITY AT ITS LOWEST FEASIBLE AND ACCEPTABLE COST. 5 3 409 0 0 0 0 0 17022968 16717764 3224 977 4082 2022 17030274 16720763 0 0 0 0 10344920 10336483 0 0 0 5348249 5330013 15693169 15666496 1337105 1054267 13986419 15271959 1078272 1309545 12908147 13962414 X THE CYPRESS CLUB, INC. WAS ESTABLISHED AS A NON-PROPRIETARY, NON- SHAREHOLDER, NOT-FOR-PROFIT MUTUTAL BENEFIT CORPORATION UNDER THE LAWS OF SOUTH CAROLINA, EXCLUSIVELY TO MAINTAIN HOUSING FOR THE ELDERLY, TO DIRECTLY PROVIDE HEALTH CARE FOR THE PHYSICAL AND MENTAL WELL-BEING OF ITS RESIDENTS, AND TO OPERATE THE FACILITY AT ITS LOWEST FEASIBLE AND ACCEPTABLE COST. 0 0 6216738 8872009 THE CYPRESS CLUB HAS 322 RESIDENTIAL UNITS. THE RESIDENTS RECEIVE ACCESS TO DINING, HOUSEKEEPING, EXERCISE, AND SOCIAL ACTIVITIES TO PROMOTE GENERAL WELLBEING. 3747354 4127917 THE CYPRESS HAS AN ON-SITE HEALTH CARE CENTER WHICH IS LICENSED TOPERFORM NURSING CARE SERVICES. 3309795 3717838 THE CYPRESS OFFERS IN-HOME ASSISTED LIVING AND CLINIC SERVICES FORITS MEMBERS. 13273887 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 47 0 409 1 0 0 0 0 0 0 0 0 X 5 3 0 0 0 0 1 0 0 1 0 0 0 0 1 1 1 0 1 0 0 0 X LINDA HEISE 8436897000 20 LADY SLIPPER LANE HILTON HEAD ISLAND SC 299261372 JAMES P COLEMAN 8.00 X X 0 0 0 EVELYN JOHNSON 0.30 X 500 0 0 BOB RAEHN 0.30 X 500 0 0 SANDY GRIFFIN-BUKOSKEY 40.00 X X 0 133798 0 SUE JAMES 0.30 X 500 0 0 LINDA HEISE 40.00 X 118358 0 0 ANN HARRISON 40.00 X 105308 0 0 225166 133798 0 2 0 0 1 REHAB THERAPY SERVICES PO BOX 503534 ST LOUIS MO 63150 CONTRACT THERAPY 501334 MPP MICHAEL PARENT PAINTING 40 FULLER POINTE DR HILTON HEAD SC 29926 PAINTING 449785 LIFE CARE SERVICES LLC 400 LOCUST ST SUITE 820 DES MOINES IA 50309 MANAGEMENT 419800 FORTON & COMPANY PO BOX 2135 BLUFFTON SC 29910 WINDOW WASHING 140360 4 MEMBERSHIP INCOME 623990 8872009 8872009 HEALTH CENTER 623990 4127917 4127917 HOME HEALTH SERVICES 623990 3489713 3489713 CLINIC/RESPITECARE 623990 228125 228125 16717764 977 977 MISCELLANEOUS 623990 2022 2022 2022 16720763 16719786 0 977 700 700 8159025 7666016 493009 85420 70935 14485 1429061 1362056 67005 662277 636291 25986 1356474 1356474 1362 1362 17304 17304 179253 158464 20789 6161 6161 88710 88710 18722 8100 10622 417141 417141 22282 9154 13128 137763 137763 FOOD COSTS 1464851 1464851 THERAPY EXPENSE 569606 569606 OPERATING SUPPLIES 529568 529568 AUTO AND BUS EXPENSE 120286 120286 400530 261419 139111 15666496 13273887 2392609 0 1584814 2263154 1101721 1238420 10649112 11103852 75140 72201 566802 584502 8830 9830 13986419 15271959 998973 1200556 79299 108989 1078272 1309545 X 12908147 13962414 12908147 13962414 13986419 15271959 1054267 0 X 0 1 X 1 0 0 PREPAID FEES 28251 DEPOSIT - HC 80738 108989 16720763 0 16720763 0 16720763 15666496 0 15666496 0 15666496 X 0 0 0 0 0 0 0 0 0 SUPPLEMENTAL INFORMATION PART III COMPENSATION FROM AN UNRELATED ORGANIZATION 990, PART VII, SECTION A, LINE 5 COMPENSATION SHOWN FOR SANDY GRIFFIN-BUKOSKEY, EXECUTIVE DIRECTOR, WAS FROM AN UNRELATED ORGANIZATION, LIFE CARE SERVICES, LLC, THE MANAGEMENT COMPANY OF THE CYPRESS CLUB. THE CYPRESS OF HILTON HEAD ASSOCIATES LP DEVELOPER 938200 MANAGEMENT FEES 0 THE CYPRESS OF HILTON HEAD ASSOCIATES LP DEVELOPER 55767 ADMINISTRATIVE EXPENSES 0 FORM 990, PART VI, SECTION A, LINE 6 EACH PROPERTY OWNER AT THE CYPRESS IS A MEMBER. FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEES HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE TAX RETURN IS PROVIDED TO THE CONTROLLER OF THE ORGANIZATION FOR REVIEW BEFORE THE INCOME TAX RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C UPON ELECTION EACH DIRECTOR IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM WHICH IS MAINTAINED IN THE OFFICES OF THE ORGANIZATION AND WILL BE MADE AVAILABLE TO ANY MEMBERS UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS WILL BE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST AND APPROVAL OF MANAGEMENT AND THE BOARD OF DIRECTORS. THE CYPRESS OF HILTON HEAD OWNERS' ASSOC 20 LADY SLIPPER LANE HILTON HEAD ISLAND SC 29926 570951143 HOMEOWNERS ASSOC SC C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0