2012-03-07T08:32:02-06:00 2011-03-31 CLIFTONLARSONALLEN LLP 610 WGERMANTOWN PIKESTE 400 PLYMOUTH MTG PA 19462 990 2010-04-01 521281156 COLLINGTON EPISCOPAL LIFE CARE COMMUNITY INC COLL 3018834764 10450 LOTTSFORD ROAD MITCHELLVILLE MD 20721 MARVELL ADAMS 3018834764 2012-03-05 1 BERNADETTE O'TOOLECPA 2156433900 2010 2016-02-24 21:20:13Z MARVELL ADAMS 10450 LOTTSFORD ROAD MITCHELLVILLE MD 20721 23979544 0 X WWW.COLLINGTON.COM X 1982 MD PROVISION OF CARE TO THE ELDERLY 15 15 327 0 0 0 162291 126409 21504124 22876728 250303 840994 191006 135413 22107724 23979544 0 0 0 0 8352097 8552971 0 0 0 14282054 14796157 22634151 23349128 -526427 630416 70373305 68719632 99420906 96630656 -29047601 -27911024 PROVISION OF CARE TO THE ELDERLY 0 0 19900068 22671443 TO DEVELOP, CONSTRUCT & OPERATE A CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES FOR THE PRIMARY NEEDS(HOUSING & FOOD) AS WELL AS THE PHYSICAL, RECREATIONAL, AND EMOTIONAL NEEDS OF THE ELDERLY. 19900068 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 1 45 0 1 327 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 0 0 MD X X AMY HARRISON CFO 3018834768 10450 LOTTSFORD ROAD MITCHELLVILLE MD 20721 X PAUL E COONEY 1.00 X X 0 0 0 PAUL BATTIN 1.00 X 0 0 0 SALLI HARTMAN 1.00 X 0 0 0 SUSAN DOVELL 1.00 X 0 0 0 LANCE ELLIOTT 1.00 X X 0 0 0 NORMAN PRINCE 1.00 X 0 0 0 FRAN VOLEL-STECH 1.00 X 0 0 0 JOE HOWELL 1.00 X 0 0 0 ANNETHA HALL 1.00 X 0 0 0 ROANNE HARTFIELD 1.00 X X 0 0 0 NEIL GRAMMER 1.00 X X 0 0 0 MARY KIRKEBY 1.00 X 0 0 0 AGNES HATFIELD 1.00 X 0 0 0 MICHELE HAGANS 1.00 X 0 0 0 DAVID WALBRIGHT 40.00 X 90279 0 120 OLADE ALADE 40.00 X 110195 0 10301 LINDA CHAPLIN 40.00 X 93727 0 5376 THOMAS CONNELLY 40.00 X 91447 0 11212 FELICIA SAULS-JONES 40.00 X 88425 0 6846 110195 0 10301 1 0 0 0 IGOR OSTER 109 CHURCH LANE PIKESVILLE MD 21208 PAINTING/REMODELING 543055 LIFE CARE SERVICES LLC 400 LOCUST STREET STE 820 DES MOINES IA 50309 MANAGEMENT COMPANY 510873 HAMLIN SENIOR MARKETING LLC 1415 ROUTE 70 EAST CHERRY HILL NJ 08034 MARKETING COMPANY 401868 REHABCARE GROUP INC PO BOX 503534 ST LOUIS MO 631503534 THERAPY SERVICES 401384 AJ GALLGHER RISK MANAGEMENT SERVICES 5229 PAYSHPERE CIRCLE CHICAGO IL 60674 INSURANCE BROKERS 326452 12 126409 126409 RES CARE SVCS 623000 11479721 11321683 158038 HEALTH CARE REVENUE 623000 5659096 5659096 AMORTIZATION OF DEFERR 623000 4715882 4715882 ANCILLARY INCOME 623000 1022029 974782 47247 22876728 234206 234206 606788 606788 606788 606788 MISCELLANEOUS INCOME 900099 135413 135413 135413 23979544 22671443 0 1181692 110195 110195 7040349 6235678 804671 49460 38961 10499 734641 696614 38027 618326 555001 63325 443508 443508 130281 130281 113875 113875 503674 351364 152310 745226 745226 131213 84463 46750 1450974 1300952 150022 1005146 946731 58415 308095 235865 72230 3020679 2688404 332275 3842699 3842699 339060 301763 37297 OTHER MEDICAL EXPENSES 983271 983271 FOOD 948166 948166 MEDICAL SUPPLIES 456804 436395 20409 BAD DEBT EXPENSE 222798 222798 OTHE EMPLOYEE EXPENSES 140686 29044 111642 10002 1899 8103 23349128 19900068 3449060 0 3744197 2162615 977220 1089372 923600 920495 267457 485527 98345644 51246239 48960217 47099405 2883987 2993055 6471878 7811041 6144749 6158122 70373305 68719632 1874335 2172672 36372434 34138076 55670000 54775000 143808 126968 1300000 1300000 4060329 4117940 99420906 96630656 X -33311286 -32356810 4263685 4445786 -29047601 -27911024 70373305 68719632 X 630416 506161 X X 0 1 1 X 0 X 95958 370626 181677 162291 390559 1201111 21326864 21982425 21767451 21495930 22876728 109449398 21422822 22353051 21949128 21658221 23267287 110650509 0 0 0 110650509 641475 448373 232705 239763 234206 1796522 641475 448373 232705 239763 234206 1796522 125619 139066 240260 191006 135413 831364 22189916 22940490 22422093 22088990 23636906 113278395 0.97680 0.97200 0.01590 0.02080 X 0 143808 126968 1 892186 892186 50487520 46686357 3801163 40732641 573617 40159024 4407464 3986265 421199 1825833 1825833 47099405 CASH & EQUIVALENTS 3931462 F MARKETABLE EQUITY SECURITIES 3871094 F ACCRUED INTEREST 8485 F 7811041 DEFERRED FINANCING COSTS (NET OF AMORTIZATION) 1433228 DUE FROM AFFILIATE 56852 DEFERRED MARKETING COSTS 222256 INTEREST IN NET ASSETS OF COLLINGTON FOUNDATION 4445786 6158122 DUE TO AFFILIATE 141334 OBLIGATION UNDER INTEREST RATE SWAP AGREEMENT 3976606 4117940 23979544 23349128 630416 117571 388590 506161 1136577 24485705 117571 388590 506161 23979544 0 23979544 23349128 0 23349128 0 23349128 PART IV, LINE 2B: DEPOSITS FROM PROSPECTIVE RESIDENTS CONSIST OF ENTRANCE FEE DEPOSITS. ENTRANCE FEE DEPOSITS ARE RECEIVED FROM PROSPECTIVE RESIDENTS WHO INTEND TO MOVE INTO THE ORGANIZATION. ENTRANCE FEE DEPOSITS GENERALLY REPRESENT TEN PERCENT OF THE TOTAL ENTRANCE FEE FOR THE UNIT SELECTED. THE DEPOSIT FUNDS ARE APPLIED AGAINST THE TOTAL ENTRANCE FEE UPON OCCUPANCY OR ARE REFUNDED TO THE PROSPECTIVE RESIDENTS IF THEY DECIDE NOT TO MOVE INTO THE ORGANIZATION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: COLLINGTON EPISCOPAL LIFE CARE COMMUNITY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REQUIRED. COLLINGTON EPISCOPAL LIFE CARE COMMUNITY FOLLOWS THE PROVISIONS OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THESE PROVISIONS HAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. COLLINGTON EPISCOPAL LIFE CARE COMMUNITY'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE TAX RETURNS FOR THE TAX YEARS 2008 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST SWAP AGREEMENTS -57,661. INVESTMENT RETURN IN ASSETS HELD BY COLLINGTON FOUNDATION, INC. 446,251. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS -57,661. INCREASE IN INTEREST IN COLLINGTON FOUNDATION, INC. 446,251. 1 RESIDENT FINANCIAL ASSISTANCE 20 126783 0 FMV X 1 1 X 0 0 0 0 0 0 0 0 0 PART I, LINE 1A PROVIDING FIRST CLASS OR CHARTER TRAVEL TO THE ORGANIZATIONS OFFICER, DIRECTOR, TRUSTEE, KEY EMPLOYEE OR HIGHEST COMPENSATED EMPLOYEE WAS PAID BY LIFE CARE SERVICES (LCS) AND NOT BY COLLINGTON EPISCOPAL LIFE CARE COMMUNITY. PRINCE GEORGE'S COUNTY 526000998 741724BH0 2006-07-28 26350000 TO REFINANCE BOTH THE SERIES 1994 AND SERIES 2001 BONDS. 0 0 0 PRINCE GEORGE'S COUNTY 526000998 741724BJ6 2006-07-28 24310000 TO REFINANCE BOTH THE SERIES 1994 AND SERIES 2001 BONDS. 0 0 0 26350000 25600914 527000 222086 1 0 1 1 24310000 23602034 486200 221766 0 1 1 1 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 0 0 0 1 1 1 BANK OF AMERICA 78.000000000000 0 0 0 0 0 CHRIS FRANCIS EXECUTIVE DIRECTOR OF ORGANIZATION 112188 LCS EMPLOYEE. MANAGEMENT FEES OF $510,873.31 PAID BY COLLINGTON EPISCOPAL LIFE CARE COMMUNITY TO LIFE CARE SERVICES, LLC (LCS). THIS INCLUDED SALARY OF $112,188.39 PAID TO CHRIS FRANCIS. 0 ANGELA LAYFIELD ADMINISTRATOR FOR ORGANIZATION 181601 LCS EMPLOYEE. SALARY OF $144,218.09 AND BENEFITS OF $37,382.46 PAID BY LIFE CARE SERVICES, LLC 0 ROBERT PERRY ADMINISTRATOR FOR ORGANIZATION 29556 LCS EMPLOYEE. SALARY OF $27,158.33 AND BENEFITS OF $2,397.74 PAID BY LIFE CARE SERVICES, LLC. 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION ENTERED INTO AN AGREEMENT WITH LIFE CARE SERVICES LLC DATED OCTOBER 2, 2008 TO MANAGE, OPERATE AND MAINTAIN COLLINGTON EPISCOPAL LIFE CARE COMMUNITY, INC. FORM 990, PART VI, SECTION A, LINE 7B THE KENDAL CORPORATION SHALL HAVE THE RIGHT TO REVIEW COLLINGTON'S OPERATIONS, STRATEGIC AND OTHER PLANS, AND FINANCIAL PROJECTIONS AND PERFORMANCE. IF, IN THE JUDGMENT OF THE KENDAL CORPORATION, COLLINGTON IS NOT IN ACCORD WITH THE VALUES AND PRACTICES AND AFFILIATION AGREEMENT OF KENDAL AFFILIATES AS ESTABLISHED FROM TIME TO TIME BY THE KENDAL CORPORATION, TO THE EXTENT NOT PROHIBITED BY THE LAWS OF MARYLAND, THE KENDAL CORPORATION MAY REQUEST, AND REQUIRE IF NECESSARY, THE AFFILIATE TO TAKE APPROPRIATE ACTION TO ADDRESS THE SITUATION. WITH REGARDS TO VACANCIES, IF THE OFFICE OF ANY DIRECTOR BECOMES VACANT FOR ANY REASON, THEN THE REMAINING DIRECTORS MAY SELECT A PERSON TO HOLD OFFICE FOR THE REMAINING TERM SUBJECT TO THE APPROVAL OF THE KENDAL CORPORATION. SUBJECT TO THE APPROVAL OF THE KENDAL CORPORATION AS PROVIDED ABOVE, THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION MAY BE AMENDED BY AFFIRMATION OF THREE-FOURTHS OF THE DIRECTORS IN OFFICE AT ANY ANNUAL, REGULAR OR SPECIAL MEETING DULY CONVENED AFTER NOTICE OF SUCH PURPOSE. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING THE FORM 990 THE BOARD OF TRUSTEES WILL RECEIVE A COPY OF THE 990, THEY WILL REVIEW AND APPROVE IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST IS DEFINED AS A PERSON WHO HAS AN "INTEREST" IN A CONTRACT OR OTHER TRANSACTION IF HE OR SHE IS THE PARTY (OR ONE OF THE PARTIES) CONTRACTING OR DEALING WITH THE CORPORATION, OR IS A DIRECTOR, TRUSTEE OR OFFICER OF, OR HAS A SIGNIFICANT FINANCIAL OR INFLUENTIAL INTEREST IN, THE ENTITY CONTRACTING OR DEALING WITH THE CORPORATION OTHER THAN CORPORATIONS, PARTNERSHIPS, JOINT VENTURES, OR OTHER ENTITIES OWNED, CONTROLLED, OR MANAGED BY THE CORPORATION. THE ORGANIZATION ENFORCES THE WRITTEN CONFLICT OF INTEREST POLICY BY ANNUALLY BEING REVIEWED AND EXECUTED BY THE BOARD MEMBERS AND SENIOR STAFF MEMBERS. THE INDIVIDUALS THAT ARE COVERED BY THIS POLICY ARE DIRECTORS, OFFICERS, KEY EMPLOYEES AND COMMITTEE MEMBERS. ANY DIRECTOR, OFFICER, KEY EMPLOYEE OR COMMITTEE MEMBER HAVING A INTEREST IN A CONTRACT OR OTHER TRANSACTION WITH THE CORPORATION SHALL DISCLOSE SUCH INTEREST TO THE BOARD OR A COMMITTEE THEREOF FOR CONSIDERATION, AUTHORIZATION, APPROVAL, OR RATIFICATION AND SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF HIS OR HER INTEREST TO THE BOARD OR COMMITTEE PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. SUCH DISCLOSURE SHALL INCLUDE ANY RELEVANT AND MATERIAL FACTS, KNOWN TO SUCH PERSON, ABOUT THE CONTRACT OR TRANSACTION, WHICH MIGHT REASONABLY BE CONSTRUED TO BE ADVERSE OR POTENTIALLY ADVERSE TO THE CORPORATION'S INTEREST. THE BODY TO WHICH SUCH DISCLOSURE IS MADE SHALL THEREUPON DETERMINE, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT OF INTEREST EXISTS OR CAN REASONABLY BE CONSTRUED TO EXIST. IF A CONFLICT IS DEEMED TO EXIST, SUCH PERSON SHALL NOT VOTE ON, NOR USE HIS OR PER PERSONAL INFLUENCE ON, NOR PARTICIPATE (OTHER THAN TO PRESENT FACTUAL INFORMATION OR TO RESPOND TO QUESTIONS) IN THE DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO, SUCH CONTRACT OR TRANSACTION. SUCH PERSON MAY BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT ANY MEETING WHERE THE CONTRACT OR TRANSACTION IS UNDER DISCUSSION OR IS BEING VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE THEREON AND, WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATION, AND THAT A QUORUM WAS PRESENT. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION ENTERED INTO AN AGREEMENT WITH LIFE CARE SERVICES LLC TO MANAGE, OPERATE AND AND MAINTAIN COLLINGTON EPISCOPAL LIFE CARE COMMUNITY, INC. THE ORGANIZATION'S CEO AND HCA ARE LIFE CARE SERVICES EMPLOYEES. THEIR COMPENSATION IS PAID DIRECTLY BY LIFE CARE SERVICES AND NOT BY THE ORGANIZATION. LCS IS PAID A MANAGEMENT FEE BY CELCC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 117,571. CHANGE IN FAIR VALUE OF INTEREST SWAP AGREEMENTS -57,661. INVESTMENT RETURN IN ASSETS HELD BY COLLINGTON FOUNDATION, INC. 446,251. TOTAL TO FORM 990, PART XI, LINE 5: 506,161. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COLLINGTON CARE SERVICES INC 10450 LOTTSFORD ROAD MITCHELLVILLE MD 20721 522011248 TO PROVIDE MANAGEMENT SERVICES TO COLLINGTON EPISCOPAL LIFE CARE COMMUNITY. MD 501(C)(3) 11 0 COLLINGTON FOUNDATION INC 10450 LOTTSFORD ROAD MITCHELLVILLE MD 20721 522011239 TO PROVIDE SUPPORT TO CELCC MD 501(C)(3) 11 COLLINGTON CARE SERVICES 1 COLLINGTON MANAGEMENT AND CONSULTING SERVICES 10450 LOTTSFORD RD MITCHELLVILLE MD 207212734 522011248 CONSULTING SERVICES MD C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COLLINGTON FOUNDATION- RESIDENT ASSISTANCE C 264150