2011-10-17T12:54:30-05:00 2010-12-31 MOORE STEPHENS LOVELACE PA 14400 NW 77TH COURT SUITE 306 MIAMI LAKES FL 330161507 990 2010-01-01 263411635 SILVER LAKE CENTER INC SILV 5618017600 1675 PALM BEACH LAKES BLVD NO 900 WEST PALM BEACH FL 33401 HARRY DILLON MADONNA 5618017600 2011-10-19 1 KARIN E VICKERS 3058199555 2010 2016-03-07 17:11:31Z HARRY DILLON MADONNA TWO BALA CYNWYD PLAZA SUITE 300 BALA CYNWYD PA 19004 15861447 0 X N/A X 2008 PA THE ENTITY IS ORGANIZED AND OPERATED FOR THE PROVISION OF SHORT AND LONG-TERM STAYS OFFERING POST ACUTE AND REHABILITATION SERVICES. THE ORGANIZATION PROVIDES THESE SERVICES BY PROVIDING ROOM AND BOARD, NURSING SERVICES, HEALTHCARE, THERAPY, RESIDENT SERVICES, AND SECURITY AT AN AFFORABLE COST. THE ORGANIZATION STRIVES TO PROVIDE OPEN, DIVERSE AND CARING ENVIRONMENTS FOR RESIDENTS, FAMILY MEMBERS AND STAFF. 5 4 191 4 0 0 4021000 0 15279741 15856469 131 9 6925 4969 19307797 15861447 0 0 0 0 3908961 3940316 0 0 0 11117653 11032847 15026614 14973163 4281183 888284 8667648 8490710 4386465 3848903 4281183 4641807 X THE ENTITY IS ORGANIZED AND OPERATED FOR THE PROVISION OF SHORT AND LONG-TERM STAYS OFFERING POST ACUTE AND REHABILITATION SERVICES. THE ORGANIZATION PROVIDES THESE SERVICES BY PROVIDING ROOM AND BOARD, NURSING SERVICES, HEALTHCARE, THERAPY, RESIDENT SERVICES, AND SECURITY AT AN AFFORABLE COST. THE ORGANIZATION STRIVES TO PROVIDE OPEN, DIVERSE AND CARING ENVIRONMENTS FOR RESIDENTS, FAMILY MEMBERS AND STAFF. 0 0 12061041 15861438 THE ORGANIZATION OPERATES A 174-BED SKILLED NURSING FACILITY AND PROVIDES NUMEROUS ACTIVITIES AND PROGRAMS, WHICH INCORPORATE AND PROMOTE FAMILY ACTIVITIES AND INVOLVEMENT WITH RESIDENTS AND STAFF. THESE ACTIVITIES PROMOTE A NORMALIZED CARE ENVIRONMENT. 12061041 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 65 0 1 191 1 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X FISCAL SERVICES GROUP LLC CO JOHN BRANNAN 4149088000 111 WEST MICHIGAN STREET 9TH FLOOR MILWAUKEE WI 53203 HARRY DILLON MADONNA 40.00 X X 310000 0 0 CHARLES DILLON 2.00 X 10000 0 0 NATE DUDLEY 2.00 X 10000 0 0 VIRGINIA OWENS 2.00 X 10000 0 0 LOUISE SEIFERT 2.00 X 8000 0 0 BRETT N SHIBLEY 45.00 X 113150 0 0 461150 0 0 2 0 1 0 DELAWARE VALLEY CONVELESCENT HOMES INC 905 TOWER ROAD BRISTAL PA 90073 NURSING 2980000 ARTEMIS HEALTH MANAGEMENT LLC 1675 PALM BEACH LAKES BLVD SUITE WEST PALM BEACH FL 33401 MANAGEMENT 757842 RELIANT PRO REHAB 5212 VILLAGE CREEK PKWY PLANO TX 75093 REHABILITATION 620312 HEALTHCARE SERVICES GROUP INC 3220 TILLMAN DRIVE STE 300 BENSALEM PA 19020 HOUSEKEEPING & LAUNDRY 568025 GENESIS REHAB SERVICES PO BOX 7247-6524 PHILADELPHIA PA 19170 REHABILITATION 430030 8 NET RESIDENT SERVICE R 623000 15856469 15856469 15856469 9 9 OTHER INCOME 623000 4969 4969 4969 15861447 15861438 0 9 348000 348000 3006092 2907202 98890 303971 261422 42549 282253 263039 19214 775635 775635 33102 33102 38295 38295 5627 1998 3629 1610309 1610309 10899 189 10710 988 988 76873 76873 272869 272869 224759 16740 208019 CONTRACTED SERVICES 5952852 4540937 1411915 BAD DEBTS 520065 520065 PHARMACY 492771 492771 EQUIPMENT RENTAL 310192 285273 24919 FOOD 298204 285130 13074 409407 270654 138753 14973163 12061041 2912122 0 642799 1920434 1417208 1433936 329564 392154 1636745 162983 612702 1473762 3573333 2893347 2092042 377077 8667648 8490710 2098533 1526460 2287932 2322443 4386465 3848903 X 4281183 4641807 4281183 4641807 8667648 8490710 X 888284 -527660 X X 0 1 1 X 0 X 4021000 4021000 15279741 15856469 31136210 19300741 15856469 35157210 0 0 0 35157210 131 9 140 131 9 140 6925 4969 11894 19307797 15861447 35169244 0.99970 0.99960 0.00000 X 1 168626 14232 182858 0 1165906 99291 1066615 470839 63692 407147 1473762 OTHER LIABILITY 2293376 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS, NET 11000 DUE TO OTHER ENTITIES, NET 18067 2322443 15861447 14973163 888284 0 888284 15861447 0 15861447 0 15861447 14973163 0 14973163 0 14973163 PART IV, LINE 1B: THE ORGANIZATION OFFERS CASH MANAGEMENT SERVICES TO ITS RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF THE RESIDENTS AND ARE DISBURSED AS REQUESTED. THE ORGANIZATION ACTS ONLY AS A CUSTODIAN. 1 X X X 0 0 0 0 0 0 0 0 0 HARRY DILLON MADONNA 310000 0 0 0 0 0 0 0 0 0 310000 0 0 0 DELAWARE VALLEY CONVALESCENT HOMES INC THE PRESIDENT OF THE ORGANIZATION IS THE CEO OF DVCH, INC. 2980000 HEALTHCARE SERVICES 0 FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE BOARD PRESIDENT AND THE MANAGEMENT COMPANY. THE RETURN IS PROVIDED TO ALL VOTING BOARD MEMBERS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATIONS CONFLICT OF INTEREST POLICY IS CONTAINED IN THE EMPLOYEE HANDBOOK. THE POLICY EXTENDS TO THE ORGANIZATION'S OFFICERS AND DIRECTORS. THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH ITS ANNUAL DISCLOSURE PROCESS. THE BOARD REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED AND PROHIBITS OFFICERS AND DIRECTORS FROM VOTING ON MATTERS WHERE ACTUAL CONFLICTS EXIST. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS THE AUTHORITY TO FIX THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVE DIRECTOR AS WELL AS OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION LEVELS ARE SET BASED ON CONSULTATION WITH THE MANAGEMENT COMPANY. ALL PARTIES ARE INDEPENDENT WITH RESPECT TO THE COMPENSATION DECISIONS. COMPENSATION LEVELS ARE SET BASED ON CURRENT MARKET CONDITIONS, THE ECONOMY AND FUNDING SOURCES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: BEGINNING NET ASSETS ADJUSTMENT -527,660. TOTAL TO FORM 990, PART XI, LINE 5: -527,660. OVERSIGHT OF AUDIT AND SELECTION OF INDEPENDENT ACCOUNTANT: FORM 990, PART XI, LINE 2C THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT IS ASSUMED BY THE GOVERNING BODY. THIS PROCESS HAS NOT CHANGED IN ANY WAY FROM THE PRIOR YEAR.