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HEARTHSTONE SENIOR COMMUNITIES INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HEARTHSTONE SENIOR COMMUNITIES INC (EIN 23-2856813)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201203209349305430
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-15T13:47:26-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN593070669EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOORE STEPHENS LOVELACE PABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1311 PARK PLACE BLVD SUITE 100AddressLine1
CityCLEARWATERCity
StateFLState
ZIP Code33759ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN232856813EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HEARTHSTONE SENIOR COMMUNITIES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHEARNameControl
Phone2153466454Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1TWO BALA CYNWYD PLAZA NO 300AddressLine1
CityBALA CYNWYDCity
StatePAState
ZIP Code19004ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameHOWARD JAFFEName
TitlePRESIDENTTitle
Phone5618017600Phone
Date Signed2012-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMELANIE A MCPEAKName
PTINP01346034PTIN
Phone7275314477Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonHOWARD JAFFENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1TWO BALA CYNWYD PLAZA NO 300AddressLine1
CityBALA CYNWYDCity
StatePAState
ZIP Code19004ZIPCode
FieldValueIRS element (for citing)
Gross Receipts95237871GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionTHE ENTITY IS ORGANIZED AND OPERATED FOR THE PROVISION OF SHORT AND LONG-TERM STAYS OFFERING POST ACUTE AND REHABILITATION SERVICES. THE ORGANIZATION PROVIDES THESE SERVICES BY PROVIDING ROOM AND BOARD, NURSING SERVICES, HEALTHCARE, THERAPY, RESIDENT SERVICES AND SECURITY AT AN AFFORABLE COST. THE ORGANIZATION STRIVES TO PROVIDE OPEN, DIVERSE, AND CARING ENVIRONMENTS FOR RESIDENTS, FAMILY MEMBERS AND STAFF.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees1745TotalNbrEmployees
Total Nbr Volunteers44TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year30000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year93084571ProgramServiceRevenuePriorYear
Program Service Revenue CY95173969ProgramServiceRevenueCY
Investment Income Prior Year43040InvestmentIncomePriorYear
Investment Income Current Year27767InvestmentIncomeCurrentYear
Other Revenue Prior Year55836OtherRevenuePriorYear
Other Revenue Current Year6135OtherRevenueCurrentYear
Total Revenue Prior Year93183447TotalRevenuePriorYear
Total Revenue Current Year95237871TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1567850GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY6030150GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year41332527SalariesEtcPriorYear
Salaries Etc Current Year40909877SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year47299771OtherExpensePriorYear
Other Expenses Current Year46017599OtherExpensesCurrentYear
Total Expenses Prior Year90200148TotalExpensesPriorYear
Total Expenses Current Year92957626TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2983299RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2280245RevenuesLessExpensesCY
Total Assets BOY35550558TotalAssetsBOY
Total Assets EOY43883578TotalAssetsEOY
Total Liabilities BOY6689171TotalLiabilitiesBOY
Total Liabilities EOY12741946TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY28861387NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY31141632NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE O.TO OPERATE ONE OR MORE NURSING HOMES OR PROVIDE OTHER HOUSING FOR THE ELDERLY AND DEVELOP MEDICAL PROGRAMS FOR THE CARE OF THE ELDERLY AND TO EDUCATE AND TRAIN HEALTHCARE PERSONNEL IN THE PROPER CARE OF THE ELDERLY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense82836939Expense
Revenue95180104Revenue
DescriptionTHE ORGANIZATION OPERATES 11 SKILLED NURSING FACILITIES, WITH A COMBINED CAPACITY OF 1240 BEDS, DEDICATED AND COMMITTED TO PROVIDING REHABILITATION AND SHORT AND LONG TERM NURSING AND MEDICAL CARE OF PATIENTS AND RESIDENTS. THE ORGANIZATION PROVIDES NUMEROUS ACTIVITIES AND PROGRAMS INCORPORATING AND PROMOTING FAMILY ACTIVITIES AND INVOLVEMENT WITH RESIDENTS AND STAFF. THESE ACTIVITIES PROMOTE A NORMALIZED ENVIRONMENT.Description
Total Program Service Expense82836939TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096164NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1745NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KANE FINANCIAL SERVICES CO AARON FETTESBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5612234188TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11675 PALM BEACH LAKES BLVD STE 800AddressLine1
CityWEST PALM BEACHCity
StateFLState
ZIP Code33401ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
HARRY DILLON MADONNA
PRESIDENT6.40XX466100978
ANN MULLEN
DIRECTOR1.00X800000
SANDRA OLIVER
DIRECTOR1.00X800000
JOHN S SEAL JR
DIRECTOR1.00X800000
BRIAN M WYATT
DIRECTOR1.00X800000
LYNDA K LOVELL
ADMINISTRATOR - CLEARWATER40.0010730607544X
MELISSA A FIJALKOWSKI
ADMINISTRATOR - EMERALD CO40.0011260007032X
FieldValueIRS element (for citing)
Total Reportable Comp From Org298516TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation15554TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
AEGIS THERAPIES INC
PO BOX 277365ATLANTAGA30384REHABILITATION8355419
HEALTHCARE SERVICES GROUP INC
3220 TILLMAN DRIVE STE 300BENSALEMPA19020HOUSEKEEPING AND LAUNDRY2414081
ELEUS HEALTH SERVICES LLC
1675 PALM BEACH LAKES BLVD SUITEWEST PALM BEACHFL33401CONSULTING1068037
BRIGID HEALTH SERVICES LLC
1675 PALM BEACH LAKES BLVD SUITEWEST PALM BEACHFL33401CONSULTING1013189
KANNON HEALTH SERVICES LLC
1675 PALM BEACH LAKES BLVD SUITEWEST PALM BEACHFL33401CONSULTING666945
FieldValueIRS element (for citing)
Number Of Contractors GT100 K23NumberOfContractorsGT100K
All Other Contributions30000AllOtherContributions
Total Contributions30000TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionRESIDENT SERVICE REVENDescription
Business Code623000BusinessCode
Total Revenue Column95173969TotalRevenueColumn
Related Or Exempt Function Income95173969RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue95173969TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column27767TotalRevenueColumn
Exclusion$27,767ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column6135TotalRevenueColumn
Related Or Exempt Function Income6135RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue6135TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column95237871TotalRevenueColumn
Related Or Exempt Function Income95180104RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$27,767ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total6030150Total
Program Services6030150ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total79588Total
Management And General79588ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total35956719Total
Program Services33070294ProgramServices
Management And General2886425ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total57423Total
Program Services38065ProgramServices
Management And General19358ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1698012Total
Program Services1477028ProgramServices
Management And General220984ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3118135Total
Program Services2874950ProgramServices
Management And General243185ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4760504Total
Program Services1908423ProgramServices
Management And General2852081ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1071756Total
Program Services28053ProgramServices
Management And General1043703ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total62715Total
Management And General62715ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12602296Total
Program Services12341544ProgramServices
Management And General260752ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total107647Total
Program Services34734ProgramServices
Management And General72913ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total459684Total
Program Services25656ProgramServices
Management And General434028ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total308698Total
Program Services53876ProgramServices
Management And General254822ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total7985687Total
Program Services7088885ProgramServices
Management And General896802ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total165481Total
Program Services15219ProgramServices
Management And General150262ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6386Total
Program Services462ProgramServices
Management And General5924ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total23560Total
Program Services23560ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total790770Total
Program Services750868ProgramServices
Management And General39902ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1763411Total
Program Services1733077ProgramServices
Management And General30334ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
STATE QUALITY ASSESSMEN65948376594837
PHARMACY26856722685672
FOOD2066342203252333819
BAD DEBT14247001424700

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3137453Total
Program Services2604363ProgramServices
Management And General533090ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total92957626Total
Program Services82836939ProgramServices
Management And General10120687ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2171606BOY
EOY905018EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3836664BOY
EOY3856601EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8959254BOY
EOY9433249EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY793802BOY
EOY1389719EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9333149LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2648535LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5218821BOY
EOY6684614EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY14570411BOY
EOY21614377EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY35550558BOY
EOY43883578EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6091992BOY
EOY5892910EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
EOY6000000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY597179BOY
EOY849036EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY6689171BOY
EOY12741946EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY28861387BOY
EOY31141632EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY28861387BOY
EOY31141632EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY35550558BOY
EOY43883578EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses2280245ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years727CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9378CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years23541CurrentTaxYearMinus2Years
Current Tax Year30000CurrentTaxYear
Total63646Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years75984363CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years79318070CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years87581437CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year93084572CurrentTaxYearMinus1Year
Current Tax Year95180104CurrentTaxYear
Total431148546Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years75985090CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years79327448CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years87604978CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year93084572CurrentTaxYearMinus1Year
Current Tax Year95210104CurrentTaxYear
Total431212192Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509431212192PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years581697CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years222229CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years44935CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year43040CurrentTaxYearMinus1Year
Current Tax Year27767CurrentTaxYear
Total919668Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years581697CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years222229CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years44935CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year43040CurrentTaxYearMinus1Year
Current Tax Year27767CurrentTaxYear
Total919668Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years395000CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years72000CurrentTaxYearMinus3Years
Current Tax Year Minus1 Year55836CurrentTaxYearMinus1Year
Current Tax Year6135CurrentTaxYear
Total528971Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years76961787CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years79621677CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years87649913CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year93183448CurrentTaxYearMinus1Year
Current Tax Year95244006CurrentTaxYear
Total432660831Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99670PublicSupportPercentage509
Prior Year Support Percentage0.99470PriorYearSupportPercentage
Investment Income Percentage0.00210InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00290PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc1AgentTrusteeEtc
Beginning Balance441413BeginningBalance
Additions During Year46790AdditionsDuringYear
Ending Balance488203EndingBalance
Included On FS0IncludedOnFS

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6617122OtherCostOrOtherBasis
Depreciation1648392Depreciation
Book Value4968730BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2716027OtherCostOrOtherBasis
Depreciation1000143Depreciation
Book Value1715884BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6684614TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
INVESTMENT IN CAPTIVE2445000
AMOUNTS HELD BY LENDER UNDER REVOLVING LINE OF CREDIT766185
REAL ESTATE TAX ESCROW3629389
REPLACEMENT RESERVE2623803
RENT RESERVE650000
CAPITAL IMPROVEMENTS5500000
RESTRICTED CASH6000000
FieldValueIRS element (for citing)
Total Book Value Other Assets21614377TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionESTIMATED THIRD PARTY PAYOR SETTLEMENTSDescription
Amount$849,036Amount
FieldValueIRS element (for citing)
Total Of Amounts849036TotalOfAmounts
Total Revenue95237871TotalRevenue
Total Expenses92957626TotalExpenses
Excess Or Deficit For Year2280245ExcessOrDeficitForYear
Excess Or Deficit Per FS2280245ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt97817936TotRevenueEtcAuditedFinclStmt
Other Revenues2580065OtherRevenues
Revenue Not Rptd F9902580065RevenueNotRptdF990
Revenue Subtotal95237871RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99095237871TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt95537691TotExpensesEtcAuditedFinclStmt
Other Expenses Included2580065OtherExpensesIncluded
Expenses Not Rptd F9902580065ExpensesNotRptdF990
Expenses Subtotal92957626ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99092957626TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 1B:THE ORGANIZATION OFFERS CASH MANAGEMENT SERVICES TO ITS RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF THE RESIDENTS AND ARE DISBURSED AS REQUESTED. THE ORGANIZATION HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS AND REMAINS ONLY A CUSTODIAN.
REVENUE ON FINANCIALS REPORTED AS EXPENSE ON 990 2,580,065.PART XII, LINE 2D - OTHER ADJUSTMENTS:
REVENUE ON FINANCIALS REPORTED AS EXPENSE ON 990 2,580,065.PART XIII, LINE 2D - OTHER ADJUSTMENTS:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
FLORIDA HEALTH CARE ASSOCIATION
307 WEST PARK AVENUETALLAHASSEEFL32301591229583501(C)(6)30000GENERAL SUPPORT
FRONTLINE SENIOR CARE INC
1313 N MARKET STREET STE 5100WILMINGTONDE19801274202010501(C)(3)6000000GENERAL SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE CONSULTING COMPANY OF THE ORGANIZATION IS ON THE STEERING COMMITTEE OF THE FLORIDA HEALTHCARE ASSOCIATION (FHCA). THE ORGANIZATION HAS ASKED FHCA TO NOTIFY THEM AS TO WHAT THE GRANT MONEY IS BEING USED FOR BEFORE THE FUNDS ARE SPENT. DISBURSEMENTS FROM THE FUNDS ARE REVIEWED AND APPROVED BY A PAC ATTORNEY WHO VERIFIES THE EXPENDITURE IS ONE PERMITTED UNDER IRS REGULATIONS GOVERNING 501(C)(3) TAX EXEMPT ENTITIES.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 8BTHERE ARE NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS REVIEWED BY THE BOARD PRESIDENT AND THE CONSULTING COMPANY. THE RETURN IS PROVIDED TO ALL VOTING BOARD MEMBERS BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATIONS CONFLICT OF INTEREST POLICY IS CONTAINED IN THE EMPLOYEE HANDBOOK. THE POLICY EXTENDS TO THE ORGANIZATION'S OFFICERS AND DIRECTORS. THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH ITS ANNUAL DISCLOSURE PROCESS. THE BOARD REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED AND PROHIBITS OFFICERS AND DIRECTORS FROM VOTING ON MATTERS WHERE ACTUAL CONFLICTS EXIST.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS HAS THE AUTHORITY TO FIX THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR AS WELL AS OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION LEVELS ARE SET BASED ON CONSULTATION WITH THE CONSULTING COMPANY. ALL PARTIES ARE INDEPENDENT WITH RESPECT TO THE COMPENSATION DECISIONS. COMPENSATION LEVELS ARE SET BASED ON CURRENT MARKET CONDITIONS, THE ECONOMY AND FUNDING SOURCES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 2CTHE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT IS ASSUMED BY THE GOVERNING BODY. THIS PROCESS HAS NOT CHANGED IN ANY WAY FROM THE PRIOR YEAR.OVERSIGHT OF AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
BARTOW REHABILITATION CENTER LLC
2055 EAST GEORGIA STREETBARTOWFL33830263410674NURSINGFL86760552775220HEARTHSTONE SENIOR COMMUNITIES INC
BAY CENTER REHABILITATION CENTER LLC
1336 ST ANDREWS BLVDPANAMA CITYFL32405263411018NURSINGFL116520963903419HEARTHSTONE SENIOR COMMUNITIES INC
BOCA CIEGA REHABILITATION CENTER LLC
1414 59TH STREET SOUTHGULFPORTFL33707263411147NURSINGFL88312362049824HEARTHSTONE SENIOR COMMUNITIES INC
CLEARWATER REHABILITATION CENTER LLC
1270 TURNER STREETCLEARWATERFL33756263419520NURSINGFL93656362280006HEARTHSTONE SENIOR COMMUNITIES INC
EGRET COVE REHABILITATION CENTER LLC
550 62ND STREET SOUTHST PETERSBURGFL33707263411425NURSINGFL99965442632704HEARTHSTONE SENIOR COMMUNITIES INC
EMERALD COAST REHABILITATION CENTER LLC
114 3RD STREET SOUTH EASTFT WALTON BEACHFL32548263411532NURSINGFL93747811993600HEARTHSTONE SENIOR COMMUNITIES INC
GROVES REHABILITATION CENTER LLC
512 SOUTH 11TH STREETLAKE WALESFL33853263411666NURSINGFL104469972424194HEARTHSTONE SENIOR COMMUNITIES INC
LAKELAND HILLS REHABILITATION CENTER LLC
610 EAST BELLA VISTA DRIVELAKELANDFL33805263411839NURSINGFL88226872192543HEARTHSTONE SENIOR COMMUNITIES INC
TARPON REHABILITATION CENTER LLC
515 CHESAPEAKE DRIVETARPON SPRINGSFL34689263411945NURSINGFL92720232138693HEARTHSTONE SENIOR COMMUNITIES INC
UNIVERSITY EAST REHABILITATION CENTER LLC
991 EAST NEW YORK AVENUEDELANDFL33274263412167NURSINGFL44028641069404HEARTHSTONE SENIOR COMMUNITIES INC
UNIVERSITY WEST REHABILITATION CENTER LLC
545 WEST EUCLID AVENUEDELANDFL32720263412294NURSINGFL4396951949702HEARTHSTONE SENIOR COMMUNITIES INC

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MATURE CARE INSURANCE COBusinessNameLine1

Address Foreign AddressForeign

FieldValueIRS element (for citing)
Address Line1PO BOX 64 SUITE C12AddressLine1
CityMARKET PLACECity
Province Or StatePROVIDENCIALESProvinceOrState
CountryTKCountry
Postal CodeBWIPostalCode
FieldValueIRS element (for citing)
EIN251900526EIN
Primary ActivityINSURANCEPrimaryActivity
Legal Domicile Foreign CountryTKLegalDomicileForeignCountry
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income245935ShareOfTotalIncome
Share Of EOY Assets11621563ShareOfEOYAssets
Percentage Ownership0.28910PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg