2011-11-11T15:40:57-05:00 2010-12-31 ERNST & YOUNG US LLP 55 IVAN ALLEN BOULEVARD SUITE 1000 ATLANTA GA 30308 990 2010-01-01 581377711 John Knox Village of Tampa Bay Inc JOHN 8136322398 4100 East Fletcher Avenue Tampa FL 33613 Mary Arghittu 9888898989 2011-11-11 4048748300 2010 2016-02-24 21:20:13Z Cathy Yoder 4100 East Fletcher Ave Tampa FL 33613 31171320 false X N/A X 1979 FL John 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. 6 2 602 89 0 0 7477 1240 27937489 30656436 836309 655781 0 -420427 28781275 30893030 0 0 0 0 15598957 16295805 0 0 0 13385511 14693804 28984468 30989609 -203193 -96579 39818160 38496858 35938556 34663759 3879604 3833099 X John 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. false false 29201714 30236009 Refer to Schedule O for description of program services. 29201714 true false false false false false false false false true false false false true false true true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 91 0 602 true false false false false false false false false false false X 6 2 true false false false true true true true true false false true true true true true true true true false X ELLEN KOBERLEIN 8136322428 4100 East Fletcher Ave Tampa FL 33613 X Gary West 45.0 X X 149472 0 9167 Mary Arghittu 1.0 X X 0 0 0 George Wallace 1.0 X 0 0 0 Patricia Donnelly 1.0 X X 0 313785 62754 Isaac Mallah 1.0 X 0 1094130 146782 Cathy Yoder 1.0 X X 0 339410 50870 Michele Hall 45.0 X 111551 0 17135 Chandra Karan 45.0 X 101671 0 9308 Lisa Lyons 45.0 X 111039 0 15157 Christina Johnson 45.0 X 104387 0 7924 578120 1747325 319097 5 false true false NANAKS LANDSCAPING GROUNDS MAINTENA PO BOX 521085 LONGWOOD FL 327521085 Landscape maint. 112219 FMR MGMT SVCS PO BOX 13712 TAMPA FL 336813712 laundry services 293067 MCKESSON MEDICAL SURGICAL PO BOX 933027 ATLANTA GA 311933027 software maintenance 298466 QUALITY CARE REHAB INC 8477 S SUNCOAST BLVD HOMOSASSA FL 34446 rehabilitation serv. 363962 4 1240 1240 APARTMENT SERVICE FEES 623110 11082191 11082191 ENTRANCE FEES 621399 1653974 1653974 FOOD SERVICES 722210 215917 215917 MEDICARE/MEDICAID PAYMENTS 623110 9935982 9935982 SKILLED NURSING 623110 7595352 7595352 173020 173020 30656436 794926 794926 0 0 139145 278290 -139145 -139145 -139145 0 0 0 NET LOSS ON BOND RESTRUCTURING 523999 -420427 -420427 -420427 30893030 30236009 655781 0 0 0 0 158638 158638 0 12692169 12559390 132779 0 342150 338571 3579 2188743 2165845 22898 914105 904717 9388 0 11831 11831 6253 6253 0 0 0 3143272 3137434 5838 170672 170672 2611474 1755075 856399 43054 43054 0 1374678 1374678 39309 39309 0 0 888224 888224 0 2851606 2851606 466009 466009 CORPORATE ALLOCATIONS 212244 212244 DIETARY 2077517 2077517 MISCELLANEOUS 411370 390002 21368 BAD DEBT EXPENSE 386291 386291 30989609 29201714 1787895 0 2144 3053 1764295 2070521 28900 788 112264 130916 98923 33952 68159159 40826944 29006558 27332215 8457693 8706354 235633 0 111750 219059 39818160 38496858 1395129 1306915 8860278 8681644 25683149 24675200 35938556 34663759 X 2897952 2787812 981652 1045287 3879604 3833099 39818160 38496858 X -96579 50074 X false true true X false X 44522 2607 70575 7477 1240 126421 23083564 24197312 25458069 27937489 30236009 130912443 23128086 24199919 25528644 27944966 30237249 131038864 131038864 1001410 927835 418282 836779 794926 3979232 1001410 927835 418282 836779 794926 3979232 24129496 25127754 25946926 28781745 31032175 135018096 0.97053 0.96926 0.02947 0.03074 X 3100000 3100000 54372700 31467875 22904825 10550740 9359069 1191672 135719 135718 27332215 0 DUE TO AFFILIATES 24062843 Deposits 598357 Endowment Deposits 14000 24675200 30893030 30989609 -96579 -13561 63635 50074 -46505 30893030 30893030 30893030 30989609 30989609 30989609 Part XI, Line 8 Increase in temporarily restricted net assets $63,635 false true false false false false false true false Gary West 136248 0 11466 0 1758 0 5304 0 3863 0 158639 0 0 0 Patricia Donnelly 0 238250 0 64539 0 10996 0 51020 0 11734 0 376539 0 0 Isaac Mallah 0 725099 0 315336 0 53695 0 130088 0 16694 0 1240912 0 0 Cathy Yoder 0 239362 0 75812 0 24236 0 42278 0 8592 0 390280 0 0 Supplemental Compensation Information Schedule J, Line 3 The 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 Information Schedule J, Line 4b Patricia 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 Information Schedule J, Line 7 80 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. Part III and Part VI Form 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 VII Form 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 5 Unrealized (loss) on investments ($13,561) Increase in temporarily restricted net assets $63,635 Total $50,074 BayCare Health System Inc 16255 Bay Vista Drive Clearwater FL 33760 592796965 Support srvcs FL 501(C)(3) 11A NA St Joseph's Health Care Center Inc 3001 W Dr Martin Luther King Jr B Tampa FL 33607 592593686 Support srvcs FL 501(C)(3) 11B NA St Joseph's Ancillary Services Inc 3001 W Dr Martin Luther King Jr Bl Tampa FL 33607 592795925 Health promo FL 501(C)(3) 11B SJHCC Franciscan Properties Inc 3001 W Dr Martin Luther King Jr Bl Tampa FL 33607 592822519 Supports SJH FL 501(C)(3) 11B SJHCC San Damiano Enterprises Inc 3001 W Dr Martin Luther King Jr Bl Tampa FL 33607 592822514 Health invest FL 501(C)(3) 11B SJHCC St Joseph's Community Care Inc 3001 W Dr Martin Luther King Jr Tampa FL 33607 593152608 Medical asst FL 501(C)(3) 11B SJHCC St Joseph's Enterprises Inc 3001 W Dr Martin Luther King Jr Bl Tampa FL 33607 592822516 Health invest FL 501(C)(3) 11B SJHCC St Joseph's Hospital of Tampa Found Inc 3003 W Dr Martin Luther King Jr Bl Tampa FL 33607 591100828 Fundraising FL 501(C)(3) 11C SJHCC St Joseph's Hospital Inc 3001 W Dr Martin Luther King Jr Bl Tampa FL 33607 590774199 Health srvcs FL 501(C)(3) 3 NA SOUTH FLORIDA BAPTIST HOSPITAL 301 NORTH ALEXANDER STREET PLANT CITY FL 33563 590594631 MEDICAL SRVCS FL 501(C)(3) 3 NA Healthpoint Management Services Inc 4902 Eisenhower Blvd Suite 300 Tampa FL 33634 650645457 Billing/Mgmt FL na C corp 0 0 0.00000 Healthpoint Medical Group Inc 4902 Eisenhower Blvd Suite 300 Tampa FL 33634 593244268 Phys Group FL na C corp 0 0 0.00000 St Joseph's Physicians-Healthcenter Org 3001 W Dr Martin Luther King Jr Blv Tampa FL 33607 592820509 Holding company FL na C corp 0 0 0.00000 St Joseph's Preferred Inc 3001 W Dr Martin Luther King Jr Blv Tampa FL 33607 593055643 Provider network FL na C corp 0 0 0.00000 false false false false false false false false false false false true false true false false true true