2011-01-11T15:22:47-06:00 2010-06-30 LARSONALLEN LLP 18 SENTRY PARK WEST SUITE 300 BLUE BELL PA 194222240 990 2009-07-01 232613942 Riddle Village RIDD 6108913777 1048 W Baltimore Pike Media PA 19063 ROBERT BERTOLETTE CEO 6108913777 2011-01-11 1 2156433900 2009 2016-02-24 21:20:13Z ROBERT BERTOLETTE 1048 WEST BALTIMORE PIKE MEDIA PA 19063 24670234 0 X WWW.RIDDLeVILLAGE.COM X 1993 PA To enrich the value of retirement living for residents & lives of those who support them. 9 9 468 45 0 0 105972 50526 23164757 24321791 608646 297917 0 23879375 24670234 0 0 9787264 10469854 0 0 14719893 13886768 24507157 24356622 -627782 313612 57010808 54044482 98028294 95487117 -41017486 -41442635 To enrich the value of retirement living for our residents and the lives of those who support them. 0 0 13086336 16590953 INDEPENDENT LIVING-independent living facility, consisting of 365 units, is designed to allow each resident to live their life to the fullest without the concerns associated with possible future healthcare needs. the organization provides meals, housekeeping, activities, wellness, 24 hour nurse availability and a fitness center that encourages residents to remain as active as possible. As a CCRC, Riddle Village provides subsidies to any resident who is unable to meet their financial obligations to the community. The organization currently has at least two residents who are in need of this subsidy with others requesting assistance recently due to the downturn in the economy. Riddle Village hosts many community events, is a voting center during elections and supports the overall community by participating in the payment of local, county and school taxes. 3826077 4535448 Personal Care Unit-consists of 49 apartments both studio and one-bedrooms. There was a recent expansion and refurbishing project for both personal care unit and skilled nursing facility to allow for a more home like environment, more gathering places for residents, family and friends and kitchen facilities to better serve our residents. It is our philosophy that each residents care, physical and emotional health is equally important. This unit consists of both lifecare residents and private pay residents. All lifecare residents are guaranteed care regardless of their ability to pay for such services. 3803491 3195390 Skilled nursing facility-consists of 86 skilled beds. The facility is designed to provide a home like atmosphere to ensure that residents are comfortable in all stages of their life. This facility also cares for lifecare residents and private pay residents. We also provide for Medicare and other third party billing residents. All lifecare residents are guaranteed care regardless of their ability to pay for such services. 20715904 1 0 0 0 0 0 0 0 1 1 1 0 0 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 0 1 0 0 0 0 1 26 0 1 468 1 0 0 0 0 0 0 0 0 0 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X KIMBERLY ROGUSZEWSKI 6108913777 1048 WEST BALTIMORE PIKE MEDIA PA 19063 Arthur A Bernardon 1.00 X X 0 0 0 Lorraine Bradshaw 1.00 X X 0 0 0 Daniel Butler 1.00 X 0 0 0 William F Chaveas 1.00 X 0 0 0 Robert F Fischer 1.00 X X 0 0 0 Jon D Helms 1.00 X X 0 0 0 Daniel E Kennedy 1.00 X X 0 0 0 Robert Sutton 1.00 X 0 0 0 Sophia T Wisniewska 1.00 X 0 0 0 Robert G Bertolette 40.00 X 242001 0 15588 Kimberly Roguszewski 40.00 X 165002 0 20133 Ronald Waterman 40.00 X 159051 0 20133 566054 0 55854 21 0 1 0 Keystone Health Plan East PO Box 70250 Philadelphia PA 191760250 Healthcare Insurance 844512 REHAB CARE GROUP INC PO BOX 503534 ST LOUIS MO 63150 THERAPY 784654 Elwyn Pharmacy & Medical Equipment 194 S New Middletown Rd Media PA 19063 Pharmacy 524353 Sysco Food Services PO Box 6499 Philadelphia PA 19145 Rawfood Supplies 420817 AmeriHealth Casualty Services Lockbox 8271 PO Box 8500 Philadelphia PA 191788271 Healthcare Insurance 320237 5 50526 50526 NET PATIENt SERVICE RE 623000 11394019 11394019 RESIDENT CARE 623000 7855016 7855016 EARNED ENTRANCE FEE 623000 5008906 5008906 PROCESSING FEE 623000 5550 5550 58300 58300 24321791 297917 297917 24670234 24321791 0 297917 554578 499120 55458 8132202 6865476 1266726 1123454 1011109 112345 659620 593658 65962 1196889 1196889 3353406 3018065 335341 1705000 1534500 170500 3738797 3364917 373880 Nursing 1659365 1659365 Dining Services 1349362 1349362 Plant and Maintenance 652513 588896 63617 Activities and Social S 134815 134815 Housekeeping Services 96621 96621 24356622 20715904 3640718 0 898953 1046730 871212 922445 3743504 3327722 144722 154450 1636672 1517168 88177322 52839850 37949345 35337472 11766400 11738495 57010808 54044482 1268131 1263697 43193671 40983258 51210000 50300000 857143 714286 1499349 2225876 98028294 95487117 X -41896447 -42372740 199209 199827 679752 730278 -41017486 -41442635 57010808 54044482 X 0 1 1 X 0 X 4715323 5469488 105972 50526 10341309 15189692 15651519 22569566 23164757 24321791 100897325 19905015 21121007 22569566 23270729 24372317 111238634 0 0 0 111238634 293154 827351 907507 608646 297917 2934575 293154 827351 907507 608646 297917 2934575 20198169 21948358 23477073 23879375 24670234 114173209 0.97430 0.97080 0.02570 0.02920 X 679752 50526 730278 578173 101579 679752 0 0 52313812 26750537 25563275 5892148 4719789 1172359 29594630 20997830 8596800 376732 371694 5038 35337472 DEFERRED Marketing and Development 1284092 BOND FUNDS 10454403 11738495 INTEREST RATE SWAP AGREEMENTS 2225876 2225876 24670234 24356622 313612 -12233 -726528 -738761 -425149 24670234 0 24670234 0 24670234 25095383 738761 738761 24356622 0 24356622 Part XI, Line 8 - Other Adjustments: CHANGE IN FAIR VALUE OF SWAP AGREEMENT: -726528. Part XIII, Line 2d - Other Adjustments: Unrealized Loss on Investments: 12233. Change In Fair Value of Interest Rate Swap Agreements: 726528. FIN 48 Footnote: Riddle Village is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code; accordingly, no provision for income taxes is required. The Village follows the provisions of the income tax standard regarding the recognition and measurement of uncertain tax positions. The Village believes that there is no uncertainty in the tax positions taken by the organization and these provisions have no impact on the Village's financial statements. The Village's income tax returns are subject to review and examination by federal, state, and local authorities. The Village is not aware of any activities that would jeopardize its tax-exempt status. The Village is not aware of any activities that are subject to tax on unrelated business income or excise or other taxes. The tax returns for the years 2006 to 2009 are open to examination by federal, local, and state authorities. X X X 0 0 0 0 0 0 0 0 0 Robert G Bertolette 210026 0 23200 0 8775 0 0 0 15588 0 257589 0 0 0 Kimberly Roguszewski 145409 0 16893 0 2700 0 0 0 20133 0 185135 0 0 0 Ronald Waterman 142672 0 16379 0 0 0 0 0 20133 0 179184 0 0 0 Delaware County Authority 231973437 245913HF8 2005-06-15 8230000 To provide funds to make the loan for purposes of paying construction costs 0 0 Delaware County Authority 231973437 245913HK7 2006-10-01 45270000 To provide funds to make the loan for purposes of paying construction costs 0 0 8230000 7942678 234836 52486 2036 0 1 1 1 45270000 36496917 602374 8170709 2037 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 Sovereign 10.000000000000 0 0 0 0 1 1 Sovereign 10.000000000000 0 0 0 Form 990, Part VI, Section B, line 11 All members of the board review the form prior to the filing thereof. Form 990, Part VI, Section B, line 12c Currently, all members of the Board review the conflict of interest statement on an annual basis. They confirm that they have no such conflict if appropriate. If conflict were to exist, the board as a whole would review each potential conflict and determine the appropriateness of the action. Any board member involved in a conflict would be unable to vote on any action, purchase or decision being made. In addition, each senior management representative signs a similar statement. Directors with a potential conflict are excluded from decision making in that area. Form 990, Part VI, Section B, line 15 Compensation is mainly determined based on external salary surveys. Work performance and expanded job responsiblities are also considered. The President/CEO uses the tools mentioned above to determine the salaries of key employees. The information is then shared with the Compensation Committee for discussion. Form 990, Part VI, Section C, line 19 The Organization does not make its governing documents, conflict of interest policy available to the public. The Organizations financial statements are distributed to residents & filed with the PA insurance department. They are also made available to the public upon request. Form 990, Part XI, Line 2c This process has not changed from the prior year. Related Party Explanation Riddle Village leases the land on which their facility is situated from Riddle Healthcare Foundation. These entities also have a board member in common. Riddle Healthcare foundation does not have control or an ability to elect a majority of the board members of Riddle Village. Therefore, these two parties are not considered related. Riddle Village Development LLC 1048 West Baltimore Pike Media PA 19063 262397145 Implementing development of additional facilities PA 0 0 Riddle Village