2023-05-15T16:12:32-05:00 2022-06-30 390859910 BAKER TILLY US LLP 1570 FRUITVILLE PIKE STE 400 LANCASTER PA 17601 990 2021-07-01 480987497 LARKSFIELD PLACE RETIREMENT COMMUNITIES INC LARK 3163631000 7373 EAST 29TH STREET NORTH WITCHITA KS 67226 MICHAEL GRIFFIN CFO 3163631000 2023-05-12 1 MICHAEL GRIFFIN 999009999 KERRI N BOGDA CPA P00760402 7177404863 2023-05-12 X 0 AAL1 IAL1 2021 2023-04-26 12:10:37Z MICHAEL HAMBLEY 7373 EAST 29TH STREET NORTH WITCHITA KS 67226 24114363 0 X WWW.LAKESFIELD.ORG X 1984 KS OPERATE AND MAINTAIN RESIDENT FACILITIES FOR THE ELDERLY INCLUDING NON-ACUTE HEALTH CARE. 16 16 373 172 0 0 3005243 200869 23726750 22639088 965113 -125095 0 394042 27697106 23108904 0 0 0 0 13372809 12779084 0 0 0 18621294 12543971 31994103 25323055 -4296997 -2214151 52859205 52616618 79259779 78946711 -26400574 -26330093 TO OPERATE AND MAINTAN SUITABLE RESIDENT FACILITIES AND SERVICES FOR THE CARE, TREATMENT AND REHABILITATION OF ELDERLY PERSONS, INCLUDING NON-ACUTE HEALTH CARE, IN WHICH QUALITY OF LIFE CAN BE MAINTAINED AT THE LOWEST FEASIBLE COST. 0 0 21195134 22639088 PROVIDING RESIDENTIAL AND LONG-TERM CARE HEALTH SERVICES, WELLNESS SERVICES AND DISTINCTIVE LIFESTYLE THAT ENRICHES THE LIVES OF ELDERLY PERSONS IN WICHITA, KANSAS AND SURROUDING AREAS. 21195134 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 23 0 373 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 KS X MICHAEL GRIFFIN CFO 3163631000 7373 EAST 29TH STREET NORTH WITCHITA KS 67226 CONNIE DIETZ CHAIR 1.00 1.00 X X 0 0 0 JILL CASADO VICE CHAIR 1.00 1.00 X X 0 0 0 ETAF AWAR DIRECTOR 1.00 X 0 0 0 STEVE DILLARD DIRECTOR 1.00 X 0 0 0 VIRDENA GILKEY DIRECTOR 1.00 X 0 0 0 ERIK HATTEN DIRECTOR 1.00 X 0 0 0 MARY HERRIN DIRECTOR 1.00 X 0 0 0 PAT O'SULLIVAN DIRECTOR 1.00 X 0 0 0 STEPHEN BENSON DIRECTOR 1.00 X 0 0 0 JOAQUIN SANTOS DIRECTOR 1.00 X 0 0 0 LOU MEDVENE DIRECTOR 1.00 X 0 0 0 SHEREE UTASH DIRECTOR 1.00 X 0 0 0 SHANNON BRAUN DIRECTOR 1.00 1.00 X 0 0 0 WADE BRUENDL CHAIR (UNTIL 12/31/21) 2.00 X X 0 0 0 CHAD CLARK DIRECTOR (UNTIL 12/31/21) 1.00 1.00 X 0 0 0 JUM GUSTAVSON RESIDENT MEMBER 1.00 X 0 0 0 DICK PEEL RESIDENT MEMBER 1.00 X 0 0 0 KEN ADAMEK RESIDENT MEMBER 1.00 X 0 0 0 MARTIN EBY RESIDENT REP (UNTIL 12/31/21) 1.00 X 0 0 0 MICHAEL HAMBLEY PRESIDENT/CEO 40.00 4.00 X 239341 0 14519 TIM NIKKEL TREASURER/CFO (UNTIL 2/22/22) 40.00 4.00 X 212802 0 37849 LYNN CRACRAFT SECRETARY (UNTIL 10/18/21) 38.00 2.00 X 66152 0 2429 DENA HOLTZ SECRETARY (AS OF 11/8/21) 38.00 2.00 X 6865 0 0 KAREN NELSON SVP OPS & CLINICAL SVCS 40.00 X 115115 0 5146 LARRY NANNY EX DIRECTOR OF ASST LIVING 40.00 X 129107 0 16125 769382 0 76068 4 0 1 0 SUMMIT CARE INC 6830 W 121ST CT OVERLAND PARK KS 66209 THERAPY SERVICES 995031 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 60694 THERAPY SERVICES 250287 MILL CREEK CARPET & TILE PO BOX 4770 TULSA OK 74159 CONSTRUCTION 224844 DEAN E NORRIS PO BOX 47719 WICHITA KS 67201 CONSTRUCTION 221043 CASCADE HEALTH SERVICES 1001 NW BARRY RD KANSAS CITY MO 64155 STAFFING SERVICES 170373 10 136676 64193 200869 NET RESIDENT SERVICE REVENUE 623000 22639088 22639088 22639088 190935 190935 631820 640618 307232 -8798 -307232 -316030 -316030 42279 57609 -15330 -15330 CAFETERIA 999999 388551 388551 MISCELLANEOUS 999999 17643 17643 BEAUTY SHOP 999999 3178 3178 409372 23108904 22639088 0 268947 293008 293008 10084489 8485953 1598536 186191 156940 29251 1568924 1382128 186796 646472 493484 152988 175000 175000 35101 35101 64215 64215 2500 2500 2301751 1938483 363268 144337 142302 2035 520998 466207 54791 366512 365216 1296 1023803 1023803 21667 10927 10740 57508 19039 38469 1097456 1093746 3710 2643933 2643933 742011 742011 FOOD & FOOD SERVICES 1282518 1282518 PROGRAM COSTS 889638 882234 7404 MEDICAL SUPPLIES 365864 365864 EQUIPMENT RENTAL 168447 168001 446 640712 274356 366356 25323055 21195134 4127921 0 29734 85975 3156193 1444139 1147711 1459084 130064 82408 269483 380668 76952369 37337068 40306049 39615301 7653672 6654675 166299 2894368 52859205 52616618 1394034 1091134 2086154 35705157 35690837 350000 40074434 41814740 79259779 78946711 X -26414594 -26340539 14020 10446 -26400574 -26330093 52859205 52616618 X -2214151 -1134766 3419398 X 0 1 X 1 0 X 23534 97685 586016 2910715 200869 3818819 22476749 23348204 24417872 23726750 22639088 116608663 391729 391729 22500283 23445889 25003888 26637465 23231686 120819211 137891 150682 156062 104006 84115 632756 57560 47343 104903 195451 198025 156062 104006 84115 737659 120081552 228758 246618 205407 150611 190935 1022329 228758 246618 205407 150611 190935 1022329 17643 17643 22729041 23692507 25209295 26788076 23440264 121859183 0.98540 0.97840 0.00840 0.00930 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS INCOME - 2021 AMOUNT: $ 17,643. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2500 2500 0 PART II-B, LINE 1: LARKSFIELD PLACE RETIREMENT COMMUNITY PAID DUES TO LEADING AGE IN FISCAL YEAR 2021-2022, THE AMOUNT OF DUES USED FOR LOBBYING WAS $2,500. 1531650 358503 13208 122179 1754766 1499034 182494 12033 137845 1531650 1531017 51120 10861 72242 1499034 1611026 156657 17261 219405 1531017 1660398 111571 15545 145398 1611026 0.03700 0.96300 0 1 1 2215032 2215032 67826488 32907176 34919312 3509406 2513536 995870 3401443 1916356 1485087 39615301 ENTRANCE FEES 134100 DUE FROM AFFILIATE 165229 INTEREST RATE SWAP 2595039 2894368 REFUNDABLE DEPOSITS 39808489 NON-REFUNDABLE ENTRANCE FEES 2006251 41814740 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD BY LARKSFIELD PLACE FOUNDATION, INC. FOR THE BENEFIT OF LARKSFIELD PLACE RETIREMENT COMMUNITIES, INC. THE ENDOWMENT FUNDS ARE INTENDED TO: 1. PROVIDE FINANCIAL ASSITANCE TO RESIDENTS THAT EXHAUST RESOURCES. 2. PROVIDE ON-GOING MAINTENANCE OF REFLECTION GARDEN ON CAMPUS. PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. X X X X X 0 0 0 0 0 0 0 0 0 MICHAEL HAMBLEY PRESIDENT/CEO 187341 0 52000 0 0 0 8392 0 6127 0 253860 0 0 0 TIM NIKKEL TREASURER/CFO (UNTIL 2/22/22) 166802 0 46000 0 0 0 15889 0 21960 0 250651 0 0 0 A CITY OF WICHITA HCF REVENUE BOND SERIES 1 2021A 486000653 2021-06-10 28774885 SEE PART VI 0 0 0 B CITY OF WICHITA HCF REVENUE BOND SERIES 1 2021B 486000653 2021-06-10 7964281 SEE PART VI 0 0 0 C CITY OF WICHITA HCF REVENUE BOND SERIES 1 2021C 486000653 2021-06-10 3260833 SEE PART VI 0 0 0 A 793128 28774885 27925508 849378 2021 0 1 1 1 B 192248 7964281 159286 7804995 2021 1 0 1 1 C 3260833 65217 934312 2261304 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 1 FIRST MIDWEST BANK 9.000000000000 0 0 0 0 1 B 0 0 1 0 0 1 FIRST MIDWEST BANK 9.000000000000 0 0 0 0 1 C 0 1 0 0 0 1 FIRST MIDWEST BANK 9.000000000000 0 0 0 0 1 A 1 B 1 C 1 SCHEDULE K, PART I, COLUMN F - DESCRIPTION OF PURPOSE: PROCEEDS OF THE SERIES I, 2021A BONDS WERE USED TO REFUND THE OUTSTANDING PRINCIPAL ON THE SERIES III, 2013 REVENUE BONDS. PROCEEDS OF THE SERIES I, 2021B BONDS WERE USED TO REFUND THE OUTSTANDING PRINCIPAL ON THE SERIES III, 2010 REVENUE BONDS. PROCEEDS OF THE SERIES I, 2021C BOND ARE TO BE USED BY LARKSFIELD PLACE FOR IMPROVEMENTS TO ITS RETIREMENT COMMUNITY FACILITIES. THE REMAINING PROCEEDS OF THE SERIES I, 2021A, 2021B, AND 2021C BONDS WERE USED TO COVER ISSUANCE AND UNDERWRITING COSTS OF THE BOND ISSUES. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR, VICE-CHAIR, FINANCE CHAIR AND QUALITY AND COMPLIANCE CHAIR. UNLESS THE BOARD SPECIFICALLY DIRECTS OTHERWISE, DURING THE INTERVALS BETWEEN MEETINGS OF THE BOARD, THE EXECUTIVE COMMITTEE SHALL HAVE, AND MAY EXERCISE, ALL THE POWERS OF THE BOARD AND THE MANAGEMENT OF THE BUSINESS AND AFFAIRS OF THE CORPORATION AS PROVIDED IN THESE BYLAWS IN SUCH MANNER AS SUCH COMMITTEE SHALL DEEM IN THE BEST INTEREST OF THE CORPORATION, EXCEPT THAT IT MAY NOT AMEND THE ARTICLES OF INCORPORATION OR BYLAWS; APPROVE MERGER, CONSOLIDATION OR DISSOLUTION; OR SELL, LEASE, ENCUMBER OR OTHERWISE TRANSFER ALL OR SUBSTANTIALLY ALL OF THE ASSETS WITHOUT SUBMITTING SUCH ACTIONS FOR APPROVAL OF THE ENTIRE BOARD. FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE RETURN IS THEN REVIEWED BY THE PRESIDENT/CEO AND THE TREASURER/CFO. ANY QUESTIONS OR CONCERNS ARE ADDRESSED WITH THE PREPARES AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C LARKSFIELD PLACE HAS DEFINED A CONFLICT OF INTEREST WITHIN THE BYLAWS OF THE CORPORATION AS ANY ACTON OR STATEMENT INTENDED TO INFLUENCE THE ACTIONS OF THE CORPORATION IN SUCH A WAY AS TO CONFER ANY FINANCIAL BENEFIT ON SUCH DIRECTORS OR ON ANY FIRM OR CORPORATION IN WHICH THE DIRECTOR HAS A MATERIAL INTEREST IN ANY WAY, INCLUDING A PERSONAL INTEREST OR AS AN EMPLOYEE, DIRECTOR, OR OFFICER. THE BYLAWS OF THE CORPORATION ALSO PROVIDE FOR DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST BY REQUIRING ANY DIRECTOR WHO IS AWARE OF A POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO ANY MATTER WHICH MAY COME BEFORE THE DIRECTOR OR COMMITTEES TO DISCLOSE IMMEDIATELY TO THE DIRECTOR OR COMMITTEES, AS THE CASE MAY BE, THE POTENTIAL CONFLICT OF INTEREST AND TO REFRAIN FROM VOTING ON SUCH MATTER. OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY AS AN ITEM OF BUSINESS DURING THE ANNUAL BOARD MEETING, AND THE STATEMENTS ARE MAINTAINED WITH THE CORPORATION'S RECORDS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ENGAGED AN INDEPENDENT CONSULTING FIRM TO ASSIST IN THE HIRING OF THE CEO, AND TO ESTABLISH CEO COMPENSATION WITHIN THE COMPARATIVE RANGE FOR SIMILAR ORGANIZATIONS. THE VICE-PRESIDENT OF HUMAN RESOURCES PROVIDES COMPARATIVE SALARY AND BENEFITS DATA FROM THE HOSPITAL AND HEALTHCARE COMPENSATION SERVICE, THE BUREAU OF LABOR STATISTICS, THE WICHITA METROPOLITAN SERVICE AREA, AND OTHER ON-LINE SOURCES TO THE PRESIDENT/CEO. THIS DATA IS REVIEWED AND USED TO DETERMINE THE COMPARATIVE COMPENSATION LEVELS FOR OFFICERS AND KEY EMPLOYEES IN THE ORGANIZATION. THIS REVIEW AND APPROVAL IS DOCUMENTED AS IT OCCURS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ANNUAL AUDITED FINANCIAL STATEMENTS, FORM 990 RETURNS, AND QUARTERLY FINANCIAL SUMMARIES ARE MAINTAINED WITH THE CFO AND ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND MINUTES OF THE BOARD OF DIRECTORS ARE MAINTAINED BY THE SECRETARY OF THE CORPORATION AND ARE ALSO AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST RATE SWAP 3,419,398. LARKSFIELD PLACE FOUNDATION INC 7373 EAST 29TH STREET NORTH WICHITA KS 67226 263384821 SUPPORT ORG KS 501(C)(3) LINE 12A, I LARKSFIELD PLACE RETIREMENT COMMUNITY 1 PROGRESSIVE HEALTHCARE ALLIANCE INC 3120 NORTH PLUM STREET HUTCHINSON KS 67502 481194308 PURCHASING KS 501(C)(3) LINE 12A, I N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 LAKESFIELD PLACE FOUNDATION INC C 136676 CASH