2011-05-13T15:36:17-05:00 2010-12-31 LARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2010-01-01 621827185 THE VILLAGE AT GERMANTOWN INC VILL 9017374242 7820 WALKING HORSE CIRCLE GERMANTOWN TN 38138 EDDY HERBERT 9107374242 2011-05-13 1 3149254300 2010 2016-03-07 17:11:31Z EDDY HERBERT 7820 WALKING HORSE CIRCLE GERMANTOWN TN 38138 20135424 0 X WWW.VILLAGE-GERMANTOWN.COM X 2000 TN TO OPERATE AS A CONTINUING CARE RETIREMENT COMMUNITY 5 5 256 130 0 0 0 0 13456419 14708911 3618 448 22465 5426065 13482502 20135424 0 0 0 0 4712826 5245559 0 0 0 10975439 11123723 15688265 16369282 -2205763 3766142 75594372 71549521 94881428 87801011 -19287056 -16251490 X THE MISSION OF THE VILLAGE AT GERMANTOWN IS TO PROVIDE A QUALITY, STIMULATING, AND SAFE COMMUNITY THAT PROMOTES INDEPENDENCE AND WELLNESS THROUGH INNOVATIVE PROGRAMS, SUPPORTIVE SERVICES, AND AN EXCEPTIONAL STAFF. WE RESPECT AND VALUE THE DIGNITY OF EACH PERSON THROUGH OUR AFFILIATION WITH METHODIST HEALTHCARE. WE SERVE THE COMMUNITY AS A RESOURCE FOR SENIOR WELLNESS PROGRAMS AND INFORMATION. 0 0 14446155 14708911 THE VILLAGE AT GERMANTOWN, INC. (THE COMPANY) WAS FORMED ON JULY 25, 2000 AS A NOT-FOR-PROFIT CORPORATION UNDER THE LAWS AND REGULATIONS OF THE STATE OF TENNESSEE. THE COMPANY'S PURPOSE IS TO ACQUIRE REAL PROPERTY AND TO DEVELOP, MARKET AND OPERATE THE PROPERTY AS A CONTINUING CARE RETIREMENT COMMUNITY IN SHELBY COUNTY, TENNESSEE, KNOWN AS THE VILLAGE AT GERMANTOWN, INC. (THE PROJECT). THE PROJECT CONSISTS OF 199 INDEPENDENT LIVING UNITS (INCLUDING 171 APARTMENTS AND 28 PATIO HOMES), AND A HEALTHCARE FACILITY CONSISTING OF APPROXIMATELY 10 ASSISTED LIVING UNITS, 8 SPECIAL CARE DEMENTIA UNITS, AND 30 SKILLED NURSING BEDS. PERMANENT FINANCING OF THE PROJECT OCCURRED IN DECEMBER OF 2003 WITH CONSTRUCTION BEGINNING THAT SAME MONTH. THE PROJECT WAS SUBSTANTIALLY AVAILABLE FOR OCCUPANCY BEGINNING ON OCTOBER 2005. DURING 2010, THE VILLAGE AT GERMANTOWN RECEIVED THE CIRCLE OF EXCELLENCE DESIGNATION FROM CRSA FOR HAVING THE HIGHEST RESIDENT SATISFACTION SURVEY RESULTS OF 99%. WE BILLED 15,935 HEALTHCARE DAYS- 2,256 FOR DEMENTIA, 3,647 FOR ASSISTED LIVING, AND 10,032 SKILLED. OF THESE DAYS, 6,072 WERE MEDICARE DAYS, 3,841 PRIVATE PAY DAYS, AND 119 OTHER INSURANCE BILLABLE DAYS. OUR INDEPENDENT LIVING OCCUPANCY 191 OUT OF 199. 14446155 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 19 0 1 256 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 1 1 1 0 TN X X JUANITA LAVY 9016844977 3350 PLAYERS CLUB PARKWAY SUITE 300 MEMPHIS TN 38125 MAURICE ELLIOTT 1.00 X X 0 0 0 DAVID PECK 1.00 X 0 0 0 DR JOHN DOBSON 1.00 X 0 0 0 DONNA ABNEY 1.00 X 0 0 0 CAMERON WELTON 1.00 X 0 0 0 EDDY HERBERT 40.00 X 0 172570 0 PAM LEET 40.00 X 136758 0 0 SALLY OSTHEIMER 40.00 X 116981 0 0 LESLIE REED 40.00 X 104829 0 0 358568 172570 0 3 0 1 0 REHABCARE PO BOX 503534 ST LOUIS MO 63105 CONTRACT THERAPY 653825 CRSA 3350 PLAYERS CLUB PARKWAY SUITE 30 GERMANTOWN TN 38125 MANAGEMENT SERVICES 211102 CRSALCS 3350 PLAYERS CLUB PARKWAY SUITE 30 GERMANTOWN TN 38125 MANAGEMENT SERVICES 176534 GREENSCAPE PO BOX 18 ELLENDALE TN 38133 LANDSCAPING SERVICES 146604 4 PROGRAM SERVICE REVENU 623000 14708911 14708911 14708911 448 448 GAIN ON FORGIVENESS OF 900099 5426065 5426065 5426065 20135424 14708911 0 5426513 4345719 3634228 711491 510197 446223 63974 389643 340785 48858 182549 182549 141877 141877 667902 459338 208564 225299 97442 127857 2299181 2245596 53585 76235 76235 1390201 1390201 26302 12062 14240 22714 10088 12626 2564336 2465155 99181 3370881 3240505 130376 LETTER OF CREDIT AND BA 104532 104532 MISCELLANEOUS 51714 51714 16369282 14446155 1923127 0 84078 1237995 234328 192575 1174882 768794 37356 27745 84868 135159 72760754 12887532 58382853 59873222 15596007 9314031 75594372 71549521 2252099 3238740 53016162 45895674 37350641 35363287 500000 206727 1762526 3096583 94881428 87801011 X -19287056 -16251490 -19287056 -16251490 75594372 71549521 X 3766142 -730576 X X 0 1 1 X 0 X 33360877 11121905 12536558 13419939 14708911 85148190 33360877 11121905 12536558 13419939 14708911 85148190 0 845807 845807 845807 845807 84302383 384641 281149 196609 3618 448 866465 384641 281149 196609 3618 448 866465 45417 9750 51301 58945 5426065 5591478 33790935 11412804 12784468 13482502 20135424 91606133 0.92030 0.89600 0.00950 0.01090 X 5349049 5349049 64259880 12328011 51931869 198350 38053 160297 2718158 521468 2196690 235317 235317 59873222 DEFERRED PRE-OPENING COSTS 3071185 DEFERRED FINANCING COSTS 2854781 HELD BY TRUSTEE UNDER BOND INDENTURE 3388065 9314031 LONG-TERM ACCRUED INTEREST PAYABLE 1433000 ENTRANCE FEE DEPOSITS PAYABLE 236583 FEES PAYABLE 1427000 3096583 20135424 16369282 3766142 -730576 -730576 3035566 20135424 0 20135424 0 20135424 16369282 0 16369282 0 16369282 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND 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 2007 TO 2010 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. X 0 0 0 0 0 0 0 0 0 EDDY HERBERT 0 172570 0 0 0 0 0 0 0 0 0 172570 0 0 HEALTH EDUCATION & HOUSING FACILITIES BOARD OF THE COUNTY OF SHELBY TN 511283414 82169JAB9 2003-12-18 75620946 CONSTRUCTION AND OPERATIONS 0 0 0 HEALTH EDUCATION & HOUSING FACILITIES BOARD OF THE COUNTY OF SHELBY TN 521283414 82169JAG8 2006-07-01 2400000 CONSTRUCTION AND OPERATIONS 0 0 0 77880848 3291868 3058550 3648000 57816000 355374 2006 1 0 1 1 2404431 48000 2149247 10309 2006 0 0 1 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS AN AGREEMENT WITH LCS TO PROVIDE MANAGEMENT SERVICES THROUGH FISCAL YEAR ENDED 2015. THE AGREEMENT INCLUDE THE SUPERVISION OF ALL ASPECTS OF NORMAL OPERATIONS INCLUDING BUDGETING, HIRING OF EMPLOYEES, BILLING, PAYROLL, ACCOUNTING, ACCOUNTS PAYABLE AND OTHER MANAGEMENT RESPONSIBILITIES. THE ORGANIZATION INCURRED EXPENSE OF APPROXIMATELY $178,000 UNDER THE TERMS OF THIS AGREEMENT FOR THE YEAR ENDED DECEMBER 31, 2010. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR OF THE ORGANIZATION PRIOR TO FILING WITH THE IRS. EACH BOARD MEMBER RECEIVES A COPY OF THE FORM 990 FOR THEIR REVIEW. THE FORM 990 IS REVIEWED BY THE BOARD AT A BOARD MEETING PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LIFE CARE SERVICES (LCS), AND LCS DETERMINES HIS ACTUAL COMPENSATION. CRSA BILLS THE VILLAGE AT GERMANTOWN FOR THE EXECUTIVE DIRECTOR'S SERVICE PER A WRITTEN EMPLOYMENT CONTRACT. THE CONTRACT WITH CRSA IS APPROVED BY THE BOARD OF DIRECTORS. THE EXECUTIVE DIRECTOR DETERMINES COMPENSATION FOR DEPARTMENT DIRECTORS WITH INPUT FROM THE HR DIRECTOR. THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION FOR THE KEY EMPLOYEES. HOWEVER, THE KEY EMPLOYEES DID NOT HAVE AN INCREASE FOR ONE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONLICT OF INTEREST POLICY AVAILABLE UPON REQUEST DIRECTED TO ITS HOME OFFICE AT 3350 PLAYERS CLUB PKWY, SUITE 300, MEMPHIS, TN 38125. THE ORGANIZATION MAKES ITS AUDITED FINANCIAL STATMENTS AVAILABLE ON THE INTERNET AT HTTP://EMMA.MSRB.ORG/. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PRIOR PERIOD ADJUSTMENTS: -730,576. FORM 990, PART XI, LINE 2C THE ORGANIZATION'S POLICY REGARDING OVERSIGHT OF AUDIT IS CONSISTENT WITH THE PRIOR YEAR. LIFE CARE SERVICES 400 LOCUST SUITE 820 DES MOINES IA 50309 MANAGEMENT OF COMMUNITY IA N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 CRSALIFE CARE SERVICES L 215066 CRSALIFE CARE SERVICES N 172570