2013-08-14T08:04:18-05:00 2012-09-30 061009205 BLUM SHAPIRO & COMPANY PC CPA'S 29 S MAIN STREET PO BOX 272000 WEST HARTFORD CT 061272000 990 2011-10-01 061073286 POMPERAUG WOODS INC POMP 2032626555 80 HERITAGE ROAD SOUTHBURY CT 06488 KEVIN MOSHIER 2032626555 2013-08-13 1 ELIZABETH SOLECKI P00235171 8605614000 2011 2016-02-24 21:20:13Z KEVIN MOSHIER 80 HERITAGE ROAD SOUTHBURY CT 06488 9834425 0 X WWW.POMPERAUGWOODS.COM X 1988 CT TO PROVIDE CONTINUOUS CARE FOR RETIRED PEOPLE. 13 13 197 42 0 0 62403 22321 10081560 9446212 -33695 -3290 41233 42394 10151501 9507637 0 0 0 0 4877870 5023934 0 0 0 4796966 4968299 9674836 9992233 476665 -484596 24583356 25630458 27388036 28919734 -2804680 -3289276 TO PROVIDE CONTINUOUS CARE FOR RETIRED PEOPLE. 0 0 7364095 9489556 POMPERAUG WOODS IS A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF 134 LIVING UNITS, 7 ASSISTED LIVING UNITS, AND 37 NURSING BEDS. SERVICES PROVIDED INCLUDED MEDICAL CARE, FOOD, CLEANING AND LAUNDRY. 7364095 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 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 0 0 0 0 0 1 47 0 1 197 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X POMPERAUG WOODS INC 2032626555 80 HERITAGE ROAD SOUTHBURY CT 06488 EDWARD H WILLIAMS 1.00 X 0 0 0 KEN KERIN 1.00 X 0 0 0 ANN M PROPPER 1.00 X 0 0 0 ELISE ROMANIK 1.00 X 0 0 0 JANE C CONNERY 1.00 X 0 0 0 JAMES WALLACE 1.00 X 0 0 0 MARK LANCOR 1.00 X 0 0 0 GAIL E SEYMOUR 1.00 X 0 0 0 THOMAS M SUTNIK 1.00 X 0 0 0 WILLIAM B NEIL JR 1.00 X X 0 0 0 JANET WALKER 1.00 X X 0 0 0 ALBERT S REDWAY 1.00 X X 0 0 0 JAMES R STRUB 1.00 X X 0 0 0 KEVIN MOSHIER 40.00 X 141236 0 23618 LANA SMOLITSKY 40.00 X 80640 0 0 221876 0 23618 1 0 1 0 LIFE CARE SERVICES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MGMT CONSULTANT 403945 SUNDANCE REHABILITATION 6549 PAYSPHERE CIRCLE CHICAGO IL 60674 THERAPY SERVICES 286748 ZILNER MARKETING 8725 ROSEHILL ROAD LENEXA KS 66215 MARKETING SERVICES 270009 HOME HEALTH CARE SERVICES LLC PO BOX 402294 ATLANTA GA 30384 HOME CARE SERVICE 157953 MUELLER HOME IMPROVEMENTS 157 OAK DRIVE WATERTOWN CT 06795 REMODELING SERVICES 142898 5 22321 22321 RESIDENT SERVICE REVEN 623000 5804201 5804201 HEALTH CENTER FEES 623000 2490552 2490552 AMORTIZATION OF ENTRAN 623000 1151459 1151459 9446212 7287 7287 311577 322154 -10577 -10577 -10577 37472 4634 32838 32838 MISC. REVENUE 623000 9556 9556 9556 9507637 9488606 0 -3290 251730 83665 168065 3886838 3267197 619641 31608 31608 495403 448710 46693 358355 310578 47777 369961 8726 361235 14220 14220 22581 22581 263056 141706 121350 28222 28222 606436 606436 40042 35545 4497 247354 247354 1193708 1193708 152680 152680 ANCILLARY EXPENSES 486525 144673 341852 FOOD & SUPPLIES 453182 453182 MISCELLANEOUS 450977 112760 338217 PROMOTIONAL SALES 364728 3620 361108 274627 274627 9992233 7364095 2628138 0 20082 10451 4524426 5865677 1565606 1743332 42301 43675 253451 229222 35240236 17594031 18136985 17646205 40505 91896 24583356 25630458 4130849 5699385 18081333 19290986 3750000 3150000 1425854 779363 27388036 28919734 X -2836323 -3336995 31643 47719 -2804680 -3289276 24583356 25630458 -484596 0 X 0 1 1 X 0 X 5800 11050 6090 62403 22321 107664 9132713 9027490 9579384 10118454 9488606 47346647 9138513 9038540 9585474 10180857 9510927 47454311 0 0 0 47454311 88153 24950 13949 12066 7287 146405 88153 24950 13949 12066 7287 146405 7417 9278 16695 9226666 9063490 9606840 10202201 9518214 47617411 0.99660 0.99440 0.00310 0.00520 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 962264 962264 29401444 13625712 15775732 4876528 3968319 908209 17646205 ENTRANCE FEE DEPOSITS 16500 OTHER CURRENT LIABILITIES 17863 UNEARNED ENTRANCE FEES 745000 779363 9507637 9992233 -484596 -484596 9507637 0 9507637 0 9507637 9992233 0 9992233 0 9992233 0 0 0 0 0 0 0 0 0 KEVIN MOSHIER 109756 0 31480 0 0 0 5976 0 17642 0 164854 0 0 0 LIFE CARE SERVICES LLC (LCS) KEVIN MOSHIER IS AN OFFICER OF THE ORGANIZATION AND A KEY EMPLOYEE OF LCS 403945 MANAGEMENT SERVICES PROVIDED BY LCS 1 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION UTILIZED LIFE CARE SERVICES, LLC TO SUPERVISE OPERATIONS OF THE FACILITY. THE EXECUTIVE DIRECTOR OF POMPERAUG WOODS IS AN EMPLOYEE OF LIFE CARE SERVICES, LLC. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS REVIEWED BY WILLIAM NEIL, PRESIDENT OF THE BOARD, AND JANET WALKER, VICE PRESIDENT OF THE BOARD, BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION PROVIDES ANNUAL EDUCATION REGARDING THE POLICY. PART VI, SECTION B, LINE 15: THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LIFE CARE SERVICES, LLC, WHICH PROVIDES MANAGEMENT SERVICES TO POMPERAUG WOODS. THE COMPENSATION OF THE FINANCE DIRECTOR IS DETERMINED BY THE EXECUTIVE DIRECTOR USING COMPARABLE DATA, AND IS APPROVED BY THE PRESIDENT OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.