2011-02-14T15:52:46-06:00 2010-06-30 PARENTEBEARD LLC 400 MARKET STREET WILLIAMSPORT PA 17701 990 2009-07-01 232640814 Garden Spot Village GARD 7173556000 433 South Kinzer Avenue New Holland PA 17557 DALE L BEILER 7173556000 2011-02-14 1 5703236023 2009 2016-02-24 21:20:13Z STEVE LINDSEY 433 South Kinzer Avenue New Holland PA 17557 35541959 0 X www.gardenspotvillage.org X 1996 PA Operate a skilled nursing, independent & assisted living facility. Provide at-home health svcs. 9 9 553 463 32197 -194054 313151 292647 21068097 23578322 288041 319056 1565232 1638075 23234521 25828100 30000 25750 0 10363517 10377347 0 125302 12057932 13333561 22451449 23736658 783072 2091442 140975464 136609490 135006077 127867362 5969387 8742128 To enrich the lives of older adults as an expression of Christ's love. Garden Spot Village is a CCRC which provides services to independent living, skilled nursing, assisted living residents and at home resident services. 0 0 21468664 25750 23578322 Provided residential cottage and apartment living facilities for an average population of 767. Provided skilled nursing care in a 73 bed, Medicare certified facility for an average of 71 residents. Garden Spot Village is not Medicaid certified and provided care for over 15 indigent residents. The cost for this unreimbursed care exceeded $1,083,000 for the fiscal year.The assisted living unit operated with an average daily census of 57. Over $73,000 of unreimbursed care was provided during the fiscal year to residents that did not have sufficient resources to pay the full cost of their care. 21468664 1 1 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 29 0 1 553 1 1 1 0 0 0 0 1 1 0 0 0 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 PA X X Dale Beiler CFO 7173556038 433 South Kinzer Avenue New Holland PA 17557 mike cormany 5.00 X 0 0 0 PHILIP HESS 5.00 X 0 0 0 MarlIN GROFF 5.00 X 0 0 0 JudY WEAVER 5.00 X 0 0 0 DaLE BEILER 5.00 X 28552 0 7320 John E SMUCKER II 5.00 X 0 0 0 AmY WEAVER 5.00 X 0 0 0 HOPE WITMER 5.00 X 0 0 0 HENRY CORNELL 5.00 X 0 0 0 BRIAN MARTIN 5.00 X 0 0 0 STEPHEN D LINDSEY 40.00 X 160550 0 41165 John W FARBER 40.00 X 100376 0 25781 MARK R SMITH 40.00 X 102237 0 26259 391715 0 100525 3 0 1 0 RehabCare PO Box 503534 St Louis MO 63150 physical, occupational and speech therap 419074 1 51624 241023 292647 Net resident service r 623000 23578322 23578322 23578322 556735 556735 1193697 692059 501638 501638 501638 8686672 8924351 -237679 -237679 -237679 60254 51624 24745 35509 35509 77695 72704 4991 4991 Meals 722210 366396 366396 Miscellaneous 900099 218657 218657 adult daycare 624100 140768 140768 370116 32197 337919 1095937 25828100 23578322 32197 1924934 25750 25750 456368 456368 8122896 7579857 457636 85403 242085 213986 25430 2669 933524 913293 10292 9939 622474 548489 65556 8429 26595 26595 69325 69325 692975 455505 237470 204781 204781 2541747 2506962 29500 5285 126190 16078 109852 260 2535837 2433480 102357 69027 43008 23923 2096 6246 5871 375 2010072 2010072 4110375 4110375 250733 250733 MiSCELLANEOUS EXPENSE 407969 121271 276127 10571 DeFERRED FINANCING 90757 90757 Events 82237 81998 239 Nursing Facility Assess 80940 80940 LAB SERVICES 16349 16349 11406 9842 914 650 23736658 21468664 2142692 125302 5295 6563 9233594 1651026 430077 449477 4274886 2288178 105864 81507 376828 379843 135204208 31261086 106890039 103943122 17427102 22101298 2231779 5708476 140975464 136609490 2377487 2360050 66551596 64311655 63082413 56887304 2816053 3693323 178528 615030 135006077 127867362 X 5819836 8729382 149551 12746 5969387 8742128 140975464 136609490 X 0 1 1 X 0 X 305817 576726 433589 298178 241023 1855333 15795074 17377121 19513038 21068097 23578322 97331652 16100891 17953847 19946627 21366275 23819345 99186985 50000 50000 100000 0 50000 50000 100000 99086985 798920 1829622 1971697 1738067 1750432 8088738 798920 1829622 1971697 1738067 1750432 8088738 2314044 1945406 1120858 1047408 1173632 7601348 19213855 21728875 23039182 24151750 26743409 114877071 0.86250 0.85910 0.07040 0.06690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 6246118 6246118 111566691 22963620 88603071 9968989 5332132 4636857 7422410 2965334 4457076 103943122 DEPOSITS FROM PROSPECTIVE RESIDENTS 183278 Derivative financial instrument 431752 615030 25828100 23736658 2091442 1197920 -516621 681299 2772741 27298907 1197920 -516621 681299 26617608 -789508 -789508 25828100 24526166 789508 789508 23736658 0 23736658 Part IV, Line 2b: Resident escrow funds - This represents entrance fee refunds of those residents vacating their independent unit and admitted to one of the care areas such as skilled care or assisted living. The money is held in a joint account with GSV and the resident as cosigners and is available to pay monthly services charges after all other resident resources are exhausted. Part X: Description of Uncertain Tax Positions Under FIN 48: The organization accounts for uncertainty in income taxes using a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. Management has determined that there were no tax uncertainties that met the recognition threshold in 2010 or 2009. The organization's federal Exempt Organization Business Income Tax Returns for the years ended June 30, 2009, 2008, and 2007 remain subject to examination by the IRS. Part XI, Line 8 - Other Adjustments: CHANGE IN UNREALIZED LOSS ON DERIVATIVE FINANCIAL INSTRUMENTS: -516621. Part XII, Line 2d - Other Adjustments: CHANGE IN UNREALIZED LOSS ON DERIVATIVE FINANCIAL INSTRUMENTS: -516621. Part XII, Line 4b - Other Adjustments: COST OF GOODS SOLD: -72704. RENTAL EXPENSE: -692059. FUNDRAISING EVENT EXPENSES: -24745. Part XIII, Line 2d - Other Adjustments: COST OF GOODS SOLD: 72704. RENTAL EXPENSE: 692059. Fundraising event expenses: 24745. Golf Tournament 28194 15624 12570 11313 1257 Fall Festival 83684 36000 47684 3425 8750 111878 51624 60254 14738 10007 24745 35509 0 Liberty Fire Company 339 E Main St New Holland PA 17557 236281983 501(c) 3 25750 0 CASH N/A PURCHASE OF THERMAL IMAGING CAMERA AND TRUCK 1 0 X X X 0 0 0 0 0 0 0 0 0 STEPHEN D LINDSEY 160550 0 0 0 0 0 0 0 41165 0 201715 0 0 0 Lancaster Municipal Authority (A & B SERIES) 237334160 514351AY1 2006-06-07 37872042 CONSTRUCT RETIREMENT FACILITIES AND REFUND PRIOR BONDS 0 0 Lancaster Municipal Authority 237334160 2009-09-16 22820000 REFUNDING OF 2006 SERIES C BOND 0 0 39092439 372194 572622 11602273 2008 0 1 1 1 22820000 85070 2009 1 0 1 1 0 1 0 0 1 0.00400 0.00100 0.00500 0 0 1 0 0 1 0.00400 0.00100 0.00500 0 0 1 0 1 AIG DEBT SERVICE RESERVE FUNDS 1 0 0 0 1 1 MORGAN STANLEY CAPITAL SERVICES 26.400000000000 0 0 1 Form 990, Part VI, Section B, line 11 The CFO will review the return for consistency with the information provided to ParenteBeard and their audit report. A copy of the return will be e-mailed to members of the Finance Committee for their review before filing. Form 990, Part VI, Section B, line 12c Conflict of interest policy is reviewed annually. Board members are required to complete and sign a conflict of interest statement each year which are maintained by management. The CEO & Chairman of the board ensure that everyone has completed a statement and review for any potential conflicts. Any conflicts are dealt with on an as-needed basis. Conflicts would be documented and the board member would refrain from any vote for which there is a conflict of interest. No conflicts were noted for the current year. Form 990, Part VI, Section B, line 15 Executive committee approves all salaries for officers and top management. Salaries are determined based on review of an annual survey provided by trade association to ensure compensation does not exceed fair market value. Compensation review is documented in the minutes of the executive committee meeting. Form 990, Part VI, Section C, line 19 Financial statements, policies and governing documents are available upon request and through an annual disclosure statement filing with state. FORM 990, PART VII DALE BEILER WAS A BOARD MEMBER UNTIL 7/31/09. AT THAT TIME, HE RESIGNED FROM THE BOARD AND BECAME THE DIRECTOR OF AT HOME SERVICES FOR GARDEN SPOT VILLAGE. COMPENSATION REPORTED ON PART VII FOR MR. BEILER REPRESENTS HIS SALARY FROM 8/1/09 TO 12/31/09 PER HIS 2009 W-2 AS DIRECTOR OF AT HOME SERVICES. HE RECEIVED NO COMPENSATION AS TREASURER OF THE BOARD. At Home Services LLC 433 SOUTH KINZER AVENUE NEW HOLLAND PA 17557 203413595 PROVIDE HOME CARE SERVICES PA -41503 83330 N/A GSV LLC 433 SOUTH KINZER AVENUE NEW HOLLAND PA 17557 232640814 LEASE A BUILDING FOR USE AS MEDICAL OFFICES PA 704054 6478943 N/A GARDEN SPOT VILLAGE OF AKRON NURSING HOME FACILITY PA 501(C)3 9 N/A 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 GARDEN SPOT VILLAGE OF AKRON D 3662142 GARDEN SPOT VILLAGE OF AKRON A 80552