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John Knox Village of Tampa Bay Inc: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
John Knox Village of Tampa Bay Inc (EIN 58-1377711)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-11
IRS object ID
201123159349303712
Schema version
2010v3.4
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)
Timestamp2011-11-11T15:40:57-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line155 IVAN ALLEN BOULEVARD SUITE 1000AddressLine1
CityATLANTACity
StateGAState
ZIP Code30308ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN581377711EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1John Knox Village of Tampa Bay IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlJOHNNameControl
Phone8136322398Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14100 East Fletcher AvenueAddressLine1
CityTampaCity
StateFLState
ZIP Code33613ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMary ArghittuName
TitlePresidentTitle
Phone9888898989Phone
Date Signed2011-11-11DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone4048748300Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCathy YoderNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14100 East Fletcher AveAddressLine1
CityTampaCity
StateFLState
ZIP Code33613ZIPCode
FieldValueIRS element (for citing)
Gross Receipts31171320GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1979YearFormation
State Legal DomicileFLStateLegalDomicile
Activity Or Mission DescriptionJohn Knox Village will improve the health of all we serve through community-owned health care services that set the standard for high-quality, compassionate care.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees602TotalNbrEmployees
Total Nbr Volunteers89TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year7477ContributionsGrantsPriorYear
Contributions Grants Current Year1240ContributionsGrantsCurrentYear
Program Service Revenue Prior Year27937489ProgramServiceRevenuePriorYear
Program Service Revenue CY30656436ProgramServiceRevenueCY
Investment Income Prior Year836309InvestmentIncomePriorYear
Investment Income Current Year655781InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year-420427OtherRevenueCurrentYear
Total Revenue Prior Year28781275TotalRevenuePriorYear
Total Revenue Current Year30893030TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year15598957SalariesEtcPriorYear
Salaries Etc Current Year16295805SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year13385511OtherExpensePriorYear
Other Expenses Current Year14693804OtherExpensesCurrentYear
Total Expenses Prior Year28984468TotalExpensesPriorYear
Total Expenses Current Year30989609TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-203193RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-96579RevenuesLessExpensesCY
Total Assets BOY39818160TotalAssetsBOY
Total Assets EOY38496858TotalAssetsEOY
Total Liabilities BOY35938556TotalLiabilitiesBOY
Total Liabilities EOY34663759TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3879604NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3833099NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionJohn Knox Village of Tampa Bay, Inc. will improve the health of all we serve through community-owned health care services that set the standard for high-quality, compassionate care.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense29201714Expense
Revenue30236009Revenue
DescriptionRefer to Schedule O for description of program services.Description
Total Program Service Expense29201714TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109691NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees602NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonELLEN KOBERLEINNamePerson
Telephone Number8136322428TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14100 East Fletcher AveAddressLine1
CityTampaCity
StateFLState
ZIP Code33613ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (10 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Gary West
Director, Executive Director45.0XX14947209167
Mary Arghittu
Director, President1.0XX000
George Wallace
Director1.0X000
Patricia Donnelly
Director, Secretary/Treasurer1.0XX031378562754
Isaac Mallah
Director1.0X01094130146782
Cathy Yoder
Director, CFO-SJB1.0XX033941050870
Michele Hall
DIRECTOR NURSING SERVICES45.0111551017135X
Chandra Karan
REGISTERED NURSE III45.010167109308X
Lisa Lyons
CONTROLLER - JKV45.0111039015157X
Christina Johnson
DIR, HLTH SVCS/MEDICAL CENTER45.010438707924X
FieldValueIRS element (for citing)
Total Reportable Comp From Org578120TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1747325TotalReportableCompFrmRltdOrgs
Total Other Compensation319097TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
NANAKS LANDSCAPING GROUNDS MAINTENA
PO BOX 521085LONGWOODFL327521085Landscape maint.112219
FMR MGMT SVCS
PO BOX 13712TAMPAFL336813712laundry services293067
MCKESSON MEDICAL SURGICAL
PO BOX 933027ATLANTAGA311933027software maintenance298466
QUALITY CARE REHAB INC
8477 S SUNCOAST BLVDHOMOSASSAFL34446rehabilitation serv.363962
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
All Other Contributions1240AllOtherContributions
Total Contributions1240TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
APARTMENT SERVICE FEES6231101108219111082191
ENTRANCE FEES62139916539741653974
FOOD SERVICES722210215917215917
MEDICARE/MEDICAID PAYMENTS62311099359829935982
SKILLED NURSING62311075953527595352

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column173020TotalRevenueColumn
Related Or Exempt Function Income173020RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue30656436TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column794926TotalRevenueColumn
Exclusion$794,926ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other139145Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other278290Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-139145Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-139145TotalRevenueColumn
Exclusion-$139,145ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionNET LOSS ON BOND RESTRUCTURINGDescription
Business Code523999BusinessCode
Total Revenue Column-420427TotalRevenueColumn
Related Or Exempt Function Income-420427RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue-420427TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column30893030TotalRevenueColumn
Related Or Exempt Function Income30236009RelatedOrExemptFunctionIncome
Exclusion$655,781ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total158638Total
Program Services158638ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total12692169Total
Program Services12559390ProgramServices
Management And General132779ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total342150Total
Program Services338571ProgramServices
Management And General3579ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2188743Total
Program Services2165845ProgramServices
Management And General22898ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total914105Total
Program Services904717ProgramServices
Management And General9388ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total11831Total
Management And General11831ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total6253Total
Management And General6253ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3143272Total
Program Services3137434ProgramServices
Management And General5838ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total170672Total
Program Services170672ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2611474Total
Program Services1755075ProgramServices
Management And General856399ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total43054Total
Program Services43054ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1374678Total
Program Services1374678ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total39309Total
Management And General39309ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total888224Total
Program Services888224ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2851606Total
Program Services2851606ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total466009Total
Management And General466009ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
CORPORATE ALLOCATIONS212244212244
DIETARY20775172077517
MISCELLANEOUS41137021368390002
BAD DEBT EXPENSE386291386291

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total30989609Total
Program Services29201714ProgramServices
Management And General1787895ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2144BOY
EOY3053EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1764295BOY
EOY2070521EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY28900BOY
EOY788EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY112264BOY
EOY130916EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY98923BOY
EOY33952EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis68159159LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec40826944LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY29006558BOY
EOY27332215EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY8457693BOY
EOY8706354EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY235633BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY111750BOY
EOY219059EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY39818160BOY
EOY38496858EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1395129BOY
EOY1306915EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY8860278BOY
EOY8681644EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY25683149BOY
EOY24675200EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY35938556BOY
EOY34663759EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2897952BOY
EOY2787812EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY981652BOY
EOY1045287EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3879604BOY
EOY3833099EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39818160BOY
EOY38496858EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-96579ReconcilationRevenueExpenses
Reconcilation Other Changes50074ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years44522CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2607CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years70575CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7477CurrentTaxYearMinus1Year
Current Tax Year1240CurrentTaxYear
Total126421Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years23083564CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years24197312CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years25458069CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year27937489CurrentTaxYearMinus1Year
Current Tax Year30236009CurrentTaxYear
Total130912443Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years23128086CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years24199919CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years25528644CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year27944966CurrentTaxYearMinus1Year
Current Tax Year30237249CurrentTaxYear
Total131038864Total
FieldValueIRS element (for citing)
Public Support Total509131038864PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1001410CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years927835CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years418282CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year836779CurrentTaxYearMinus1Year
Current Tax Year794926CurrentTaxYear
Total3979232Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1001410CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years927835CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years418282CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year836779CurrentTaxYearMinus1Year
Current Tax Year794926CurrentTaxYear
Total3979232Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24129496CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years25127754CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years25946926CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year28781745CurrentTaxYearMinus1Year
Current Tax Year31032175CurrentTaxYear
Total135018096Total
FieldValueIRS element (for citing)
Public Support Percentage5090.97053PublicSupportPercentage509
Prior Year Support Percentage0.96926PriorYearSupportPercentage
Investment Income Percentage0.02947InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.03074PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3100000OtherCostOrOtherBasis
Book Value3100000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis54372700OtherCostOrOtherBasis
Depreciation31467875Depreciation
Book Value22904825BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis10550740OtherCostOrOtherBasis
Depreciation9359069Depreciation
Book Value1191672BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis135719OtherCostOrOtherBasis
Book Value135718BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings27332215TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$24,062,843
Deposits$598,357
Endowment Deposits$14,000
FieldValueIRS element (for citing)
Total Of Amounts24675200TotalOfAmounts
Total Revenue30893030TotalRevenue
Total Expenses30989609TotalExpenses
Excess Or Deficit For Year-96579ExcessOrDeficitForYear
Net Unrealized GL On Investments-13561NetUnrealizedGLOnInvestments
Other$63,635OtherAmount
Total Adjustments50074TotalAdjustments
Excess Or Deficit Per FS-46505ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt30893030TotRevenueEtcAuditedFinclStmt
Revenue Subtotal30893030RevenueSubtotal
Total Revenue Per Form99030893030TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt30989609TotExpensesEtcAuditedFinclStmt
Expenses Subtotal30989609ExpensesSubtotal
Total Expenses Per Form99030989609TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8Identifier
ExplanationIncrease in temporarily restricted net assets $63,635Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Gary West
1362480114660175805304038630158639000
Patricia Donnelly
0238250064539010996051020011734037653900
Isaac Mallah
0725099031533605369501300880166940124091200
Cathy Yoder
023936207581202423604227808592039028000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental Compensation InformationSchedule J, Line 3The filing organization does not use any of the options listed in Schedule J, Line 3 to establish the compensation of the CEO/Executive Director. However, the related organization, BayCare Health System Inc, uses Compensation committee, Independent compensation consultant, Written employment contract, Compensation survey or study and Approval by the board or compensation committee as a means to establish the CEO's compensation of the filing organization.
Supplemental Compensation InformationSchedule J, Line 4bPatricia Donnelly - Participated in a supplemental nonqualified deferred compensation plan. She had $0 in benefits vest in 2010. She had $40,890 of nonvested benefits accrue during 2010. This amount is included in Part II Column C. Isaac Mallah - Participated in a supplemental nonqualified deferred compensation plan. He had $0 in benefits vest in 2010. He had $130,088 of nonvested benefits accrue during 2010. This amount is included in Part II Column C. Cathy Yoder - Participated in a supplemental nonqualified deferred compensation plan. She had $15,790 in benefits vest in 2010. This amount is included in Part II (B)(iii) other compensation. She had $30,357 of nonvested benefits accrue during 2010. This amount is included in Part II Column C. The plan made cash distribution of $5,755 in 2010.
Supplemental Compensation InformationSchedule J, Line 780 percent of the incentive compensation for which an individual is eligible would be considered fixed based on the instructions. 20 percent would be considered non-fixed and is based on the discretion of the employee's immediate supervisor.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierExplanationExplanation
Part III and Part VIForm 990, Part III, Program Services We serve the elderly population through a continuum of care including independent living with home health assistance, assisted living and skilled nursing care. This includes a secured level of care of Alzheimer's patients in the assisted and skilled levels. All services and amenities to improve the quality of daily living are provided. These services include health care, housing, home health, dietary, security, maintenance, social services, activities and related services to over 540 residents/patients. Medicaid patients are served in our skilled care facility and assisted living through the diversion plan as well as assistance from veteran's aid and attendance program. We educate the community regarding senior living services as well as current elder population programs. Form 990, Part VI, Question 2 - Description of Family and Business Relationships Cathy Yoder and Isaac Mallah are both Board members of the Organization, as well as Board members of a taxable entity, which is an affiliate of the filing Organization. Form 990, Part VI, Question 6 - Description of Classes of Members or Stockholders The sole member of John Knox Village, Inc. is St. Joseph's Health Care Center, Inc. Form 990, Part VI, Question 7a - Description of Classes of Persons and the Nature of Their Rights Designation and Election of Directors. (a) The President of the Corporation shall serve as a permanent Director. (b) All Directors shall be elected by the Member. Form 990, Part VI, Question 7b - Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights The taxpayer is a Participant, as defined in the Second Restated Joint Operating Agreement dated as of May 23, 2006, as amended (the "JOA"). Under the JOA, BayCare health System, Inc. is responsible for the operations of the Participants. The JOA Participants include the taxpayer and other hospitals and non-hospital organizations. Notice of the JOA was previously provided to the Internal Revenue Service by letter dated July 1, 1997. The Member shall reserve to itself in its capacity as the Corporate Member of the Corporation the following two categories of actions: Class I Member Reserved Rights and Class II Member Reserved Rights. A. Class I Member Reserved Rights. 1. Addition, deletion or reconfiguration of services of the Corporation. 2. Establishment of overall capital and operating budgets and strategic plans applicable to the Corporation, including the use of the funds of the Corporation. 3. Exclusive authority to enter into managed care contracts on behalf of the Corporation. 4. Approval of contracts on behalf of the Corporation (but the Class I Member may establish policies from time to time providing that only specific types of contracts or contracts involving obligations in excess of specified levels need to be approved by the Class I Member). 5. Authority to establish fees and charges on behalf of the Corporation. 6. Determination of whether the Corporation should join any networks or alternative or integrated delivery systems. 7. Establishment of employment and other policies applicable to all personnel employed by the Corporation. 8. Approval of the philosophy, mission statement and purposes of the Corporation. 9. Approval of changes in the Articles of Incorporation or in the Bylaws of the Corporation. 10. Approval of the merger, consolidation, dissolution, sale or other transfer of substantially all assets of the Corporation, or other change in corporate form, causing a fundamental reorganization of the Corporation. 11. Approval of the incurrence of indebtedness by the Corporation above certain limits established by the Class I Member. 12. Approval of the establishment of additional affiliates or subsidiaries of the Corporation. 13. Adoption of strategic plans or major changes in programs or services of the Corporation. 14. Approval of the purchase, sale, transfer, or other encumbrance of assets of the Corporation above specified levels established by the Class I Member. B. Class II Member Reserved Rights. 1. Approval of the philosophy, mission statement and purposes of the Corporation. 2. Approval of the merger, consolidation, dissolution, sale or other transfer of substantially all assets of the Corporation, or other change in corporate form, causing a fundamental reorganization of the Corporation. 3. Approval of any sale, long term lease, mortgage, encumbrance or disposition of property of the Corporation constituting an 'alienation' under principles of canon law. 4. Approval of matters relating to the implementation of and compliance with the Ethical and Religious Directives. 5. Approval of substantive changes in the Articles of Incorporation of the Corporation and these Bylaws (provided that prior notice of any change in the Articles of Incorporation of the Corporation or these Bylaws shall be provided to CHE and, if such change, as a result of CHE being a Catholic entity, must be approved by CHE, such change, regardless of whether it is substantive as a matter of civil law, shall be subject to the approval of CHE). 6. With regard to any assets of the Corporation no longer required in the operations of the Corporation, approval of any sale or other disposition of any assets not in the ordinary course which have a value in excess of $3 million, and with regard to all other assets of the Corporation used in the operations of the Corporation, approval of any sale or other disposition of such assets not in the ordinary course (but the foregoing is not intended to limit any transfer of the location of the assets from the Corporation to another entity in connection with a duly authorized reconfiguration of services). 7. The determination of the distribution of assets upon dissolution or liquidation of the Corporation. Form 990, Part VI, Question 11b - Describe the Process used by Management &/or Governing Body to Review 990 The Form 990 is prepared by the organization and reviewed by the CFO, as well as the organization's paid preparer. A final copy of the Form 990 was reviewed by a subcommittee of the Board of Directors. Prior to filing with the IRS, a final copy of the Form 990 will be made available to the entire Board.
Part VI and Part VIIForm 990, Part VI, Question 12c - Description of Process to Monitor Transactions for Conflicts of Interest John Knox Village, Inc. has two separate conflict of interest procedures; one that relates to Board members and another that relates to non-board member employees. Both groups are required on an annual basis to complete, sign and file an annual disclosure statement detailing existing or potential conflicts of interests. For Board members, the review of conflicts or potential conflicts occurs at the Board or committee level. After disclosure of the Board Member's or Committee Member's actual or potential conflict, the following procedures for addressing the conflict of interest will be adhered to by each Board and all Committees with Board delegated powers, without exception: 1. The interested Director or Committee member shall leave the Board or Committee meeting while the conflict of interest issue is discussed. 2. The remaining Board or Committee Members shall decide if a conflict of interest exists. 3. If a conflict of interest is deemed to exist: a. The Chairperson of the Board or Committee shall, if appropriate, appoint a disinterested individual or committee to investigate the proposed transaction or arrangement. b. The Board or Committee shall determine whether the BayCare entity can obtain a more advantageous transaction or arrangement with reasonable efforts from an individual or entity that would not give rise to a conflict of interest. c. If a more advantageous transaction or arrangement is not reasonably available, the Board or Committee shall determine whether the transaction or arrangement is in the BayCare entity's best interest, and whether the transaction is fair and reasonable to BayCare. An interested Director or Committee Member shall not vote, participate in, influence or attempt to influence any determination or proceedings. The Director or Committee Member may, however, respond to questions posed by the Board or Committee regarding the contract or transaction. Any such contract or transaction must be authorized by a vote of at least two-thirds (2/3) of the Directors or Committee Members entitled to vote at a meeting at which a quorum was present. Any interested Director or Committee Member may not be counted in determining the existence of a quorum. For employees, the review of conflicts of interest or potential conflicts goes to the Conflict of Interest Determination Committee. This committee consists of BayCare Chief Compliance Officer, the Corporate Responsibility Officers, and the BayCare Vice President of Team Resources. This committee shall determine if an actual conflict exists and any action required to address the conflict of interest situation. Form 990, Part VI, Question 15a & 15b - Process used for Compensation Review and Approval The organization uses an independent compensation committee, appointed by the Board of Directors. The Compensation Committee's purpose is to provide oversight for the organization's executive compensation program, review and approve compensation and benefits for all "disqualified persons" subject to the Intermediate Sanctions regulations issued under Section 4958 of the Internal Revenue Code (including the Chief Executive Officer, Chief Administrative Officer & CFO, other system and entity executives, and other disqualified persons as defined in the Intermediate Sanctions regulations (i.e., voting members of the governing body, family members, former officers)), and establish the compensation philosophy for all other executives. This committee engages nationally recognized compensation consultants to assist them in review of executive compensation. The compensation consultants provide a review of each vice president and above in the system to determine if that employee's compensation is reasonable when compared against market standards. The data reviewed comes from compensation studies that include comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated organizations. The organization keeps contemporaneous minutes of the compensation committees meetings and decisions. External consultants review compensation every other year the last review occurring in 2009, but the compensation committee regularly monitors compensation and all other procedures are followed annually. Form 990, Part VI, Question 19 - How and If the Governing Documents, Conflict of Interest Policy and Financial Statements are Made Available to the Public John Knox Village, Inc. does not make its governing documents, conflict of interest policy or financial statements available to the public. Form 990, Part VII, Section A, Column B - Estimated hours worked by officers, directors, trustees, key employees, and highest compensated employees at related entities: Cathy Yoder - Franciscan Properties, Inc. - 1 Cathy Yoder - San Damiano Enterprises, Inc. - 1 Cathy Yoder - South Florida Baptist Hospital, Inc. - 1 Cathy Yoder - St. Joseph's Ancillary Services, Inc. - 1 Cathy Yoder - St. Joseph's Community Care, Inc. - 1 Cathy Yoder - St. Joseph's Enterprises, Inc. - 1 Cathy Yoder - St. Joseph's Health Care Center, Inc. - 45 Cathy Yoder - St. Joseph's Hospital, Inc. - 1 Isaac Mallah - Franciscan Properties, Inc. - 1 Isaac Mallah - San Damiano Enterprises, Inc. - 1 Isaac Mallah - South Florida Baptist Hospital, Inc. - 1 Isaac Mallah - St. Joseph's Ancillary Services, Inc. - 1 Isaac Mallah - St. Joseph's Community Care, Inc. - 1 Isaac Mallah - St. Joseph's Enterprises, Inc. - 1 Isaac Mallah - St. Joseph's Health Care Center, Inc. - 45 Isaac Mallah - St. Joseph's Hospital Foundation, Inc. - 1 Isaac Mallah - St. Joseph's Hospital, Inc. - 1 Mary Arghittu - BayCare Health System, Inc. - 1 Mary Arghittu - South Florida Baptist Hospital, Inc. - 1 Mary Arghittu - St. Joseph's Health Care Center, Inc. - 1 Mary Arghittu - St. Joseph's Hospital, Inc. - 1 Patricia Donnelly - St. Joseph's Ancillary Services, Inc. - 1
Part XI Line 5Unrealized (loss) on investments ($13,561) Increase in temporarily restricted net assets $63,635 Total $50,074

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
BayCare Health System Inc
16255 Bay Vista DriveClearwaterFL33760592796965Support srvcsFL501(C)(3)11ANA
St Joseph's Health Care Center Inc
3001 W Dr Martin Luther King Jr BTampaFL33607592593686Support srvcsFL501(C)(3)11BNA
St Joseph's Ancillary Services Inc
3001 W Dr Martin Luther King Jr BlTampaFL33607592795925Health promoFL501(C)(3)11BSJHCC
Franciscan Properties Inc
3001 W Dr Martin Luther King Jr BlTampaFL33607592822519Supports SJHFL501(C)(3)11BSJHCC
San Damiano Enterprises Inc
3001 W Dr Martin Luther King Jr BlTampaFL33607592822514Health investFL501(C)(3)11BSJHCC
St Joseph's Community Care Inc
3001 W Dr Martin Luther King JrTampaFL33607593152608Medical asstFL501(C)(3)11BSJHCC
St Joseph's Enterprises Inc
3001 W Dr Martin Luther King Jr BlTampaFL33607592822516Health investFL501(C)(3)11BSJHCC
St Joseph's Hospital of Tampa Found Inc
3003 W Dr Martin Luther King Jr BlTampaFL33607591100828FundraisingFL501(C)(3)11CSJHCC
St Joseph's Hospital Inc
3001 W Dr Martin Luther King Jr BlTampaFL33607590774199Health srvcsFL501(C)(3)3NA
SOUTH FLORIDA BAPTIST HOSPITAL
301 NORTH ALEXANDER STREETPLANT CITYFL33563590594631MEDICAL SRVCSFL501(C)(3)3NA

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Healthpoint Management Services Inc
4902 Eisenhower Blvd Suite 300TampaFL33634650645457Billing/MgmtFLnaC corp000.00000
Healthpoint Medical Group Inc
4902 Eisenhower Blvd Suite 300TampaFL33634593244268Phys GroupFLnaC corp000.00000
St Joseph's Physicians-Healthcenter Org
3001 W Dr Martin Luther King Jr BlvTampaFL33607592820509Holding companyFLnaC corp000.00000
St Joseph's Preferred Inc
3001 W Dr Martin Luther King Jr BlvTampaFL33607593055643Provider networkFLnaC corp000.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg