2022-05-11T16:39:26-05:00 2021-06-30 593070669 MSL PA 500 E BROWARD BLVD SUITE 1550 FORT LAUDERDALE FL 33394 990 2020-07-01 161676095 ALDERSGATE RETIREMENT INC ALDE 3055565654 5300 W 16TH AVENUE HIALEAH FL 33012 NICK ANTONACCI DIRECTOR OF OPERATIONS 3055565654 2022-05-11 1 NICK ANTONACCI 999009999 YASMIN CHEHAYEB CPA P02428781 9548478910 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z EPWORTH VILLAGE RETIREMENT COMMUNITY MADELYN SIMON LOZANO 5300 W 16TH AVENUE HIALEAH FL 33012 6541744 0 X HTTPS://EPWORTHVILLAGERC.COM/ X 2003 FL OPERATION OF A RETIREMENT LIVING FACILITY DESIGNED TO MEET NEEDS OF ELDERLY AND HANDICAPPED PERSONS. 13 13 153 13 0 0 47615 760430 6315064 5781314 0 0 12214 0 6374893 6541744 0 0 0 0 3797007 4245363 0 0 0 2974178 2919677 6771185 7165040 -396292 -623296 4412095 3351583 6378618 5941402 -1966523 -2589819 THE ORGANIZATION'S GOAL IS TO MAKE A DIFFERENCE IN EVERY LIFE IT TOUCHES BY PROVIDING ONLY THE HIGHEST QUALITY CARE AND SERVICE, MEETING THE NEEDS OF ITS RESIDENTS, FAMILIES, PHYSICIANS, AND EMPLOYEES WITH COMPASSION, DIGNITY AND LOVE. 0 0 6153881 5781314 THE ORGANIZATION OPERATES A 290-UNIT ASSISTED LIVING AND INDEPENDENT LIVING FACILITY IN MIAMI-DADE COUNTY, FLORIDA THAT PROVIDES RETIREMENT HOUSING, AS WELL AS LIMITED NURSING CARE. IN THE CURRENT YEAR, THERE WERE 79,755 RESIDENT DAYS. 6153881 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 24 0 1 153 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X BILL CONOL 3055565654 5300 W 16TH AVENUE HIALEAH FL 33012 JUDITH PIERRE-OKERSON CHAIR/PRESIDENT 1.00 1.00 X X 0 0 0 GERTRUDE STEWART VICE CHAIR (ENDING 02/2021) 1.00 1.00 X X 0 0 0 RUTH MCNAUGHTON SECRETARY 1.00 1.00 X X 0 0 0 ELVIRA MOUNTAIN VICE CHAIR (BEG. 02/2021) 1.00 1.00 X X 0 0 0 KENNETH VICTOR TREASURER 1.00 1.00 X X 0 0 0 ROBERT LADNER TREASURER 1.00 0.00 X X 0 0 0 REV RENE RAMIREZ DIRECTOR/CHAPLAIN 1.00 1.00 X 0 0 0 REV CARLOS SALABARIA DIRECTOR 1.00 1.00 X 0 0 0 JESSICA RODRIGUEZ DIRECTOR 1.00 1.00 X 0 0 0 REV CYNTHIA WEEMS DIRECTOR 1.00 1.00 X 0 0 0 BELINDA BACON DIRECTOR 1.00 1.00 X 0 0 0 BERYL LOUGACHI DIRECTOR 1.00 1.00 X 0 0 0 AVIS BROWN DIRECTOR 1.00 1.00 X 0 0 0 LINDA LOM DIRECTOR (BEG. 02/2021) 1.00 0.00 X 0 0 0 BARBARA DEPPMAN PEREZ DIRECTOR 1.00 1.00 X 0 0 0 ANA DURAN ADMINISTRATOR 40.00 0.00 X 104486 0 24758 MADELYN SIMON LOZANO EXECUTIVE DIRECTOR 20.00 20.00 X 0 0 0 104486 0 24758 1 0 0 0 DOS HEALTH MANAGEMENT INC 7735 NW 146TH STREET STE 204 MIAM MIAMI LAKES FL 33016 MANAGEMENT SERVICES 211659 1 760430 760430 RESIDENT SERVICE REVENUE 623000 5776144 5776144 OTHER REVENUE 623000 5170 5170 5781314 6541744 5781314 0 0 129244 25849 103395 3050690 2778844 271846 64552 43888 20664 727771 664441 63330 273106 232447 40659 157640 157640 3475 3475 27000 27000 70440 26280 44160 66351 66351 205824 64047 141777 1532914 1496144 36770 905 905 102653 101626 1027 32160 32160 NUTRITION SUPPLIES 538201 538201 MEDICAL SUPPLIES 138222 138222 PROVISION FOR DOUBTFUL 32489 32489 PERSONAL CARE COSTS 11403 11403 7165040 6153881 1011159 0 2892737 2086833 45277 45257 4530 4530 66873 87278 1436720 921128 618247 515592 784431 612093 4412095 3351583 548548 395140 42580 57481 670440 0 5117050 5488781 6378618 5941402 X -1966523 -2589819 -1966523 -2589819 4412095 3351583 -623296 0 X X 0 1 X 1 0 X 3350 28150 2750 47615 760430 842295 5996453 6298007 6311131 6315064 5781314 30701969 5999803 6326157 6313881 6362679 6541744 31544264 0 0 0 31544264 6111 13437 23412 31236 74196 6005914 6339594 6337293 6393915 6541744 31618460 0.99770 0.99700 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 7906 343 8249 0 1124206 629051 495155 312514 292077 20437 515592 OTHER ASSETS 67094 DUE FROM LANDLORD 82003 SECURITY DEPOSITS 462996 612093 DUE TO RELATED PARTIES 5025785 SECURITY DEPOSITS 462996 5488781 X 6541744 0 6541744 0 6541744 7165040 0 7165040 0 7165040 PART IV, LINE 1B: THE COMPANY OFFERS A CASH MANAGEMENT SERVICE TO ITS RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF EACH RESPECTIVE RESIDENT, TO BE DISBURSED ONLY AS REQUESTED AND, ACCORDINGLY, THESE FUNDS ARE EXCLUDED FROM THE ACCOMPANYING FINANCIAL STATEMENTS. THE COMPANY HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. AT JUNE 30, 2021 AND 2020, THE FUND BALANCES APPROXIMATED $8,000. PART X, LINE 2: THE COMPANY IS ORGANIZED AS A NONPROFIT CORPORATION UNDER THE LAWS OF THE STATE OF FLORIDA AND HAS BEEN GRANTED RECOGNITION OF ITS TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO INCOME TAX LIABILITY OR PROVISION FOR INCOME TAXES IS REFLECTED IN THE FINANCIAL STATEMENTS. MSL PUBLIC RELATIONS LLC ENTITY MORE THAN 35% OWNED BY MADELYN SIMON LOZANO, EXECUTIVE DIRECTOR 12000 INDEPENDENT CONTRACTOR COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED MANAGEMENT DUTIES TO DOS HEALTH MANAGEMENT, INC. THROUGH A BOARD-APPROVED CONTRACT. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DIRECTOR CONDUCTS A COMPREHENSIVE REVIEW OF THE FORM 990 BEFORE IT IS FILED WITH THE IRS. A COPY OF THE FORM 990 IS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS BEFORE ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT-OF-INTEREST POLICY COVERS ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS. IT IS THE RESPONSIBILITY OF ALL PERSONS COVERED TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES WHEN DETERMINED. THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD OF DIRECTORS REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE DISCLOSURE PROCESS AND DETERMINES WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO THE ORGANIZATION. THE PERSON WITH THE CONFLICT OF INTEREST WILL BE EXCLUDED FROM DISCUSSION AND APPROVAL OF SUCH TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE DIRECTOR OF THE FILING ORGANIZATION IS COMPENSATED AS AN INDEPENDENT CONTRACTOR AS APPROVED BY THE BOARD OF DIRECTORS. SEE SCHEDULE L, PART IV FOR FURTHER INFORMATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT AUDIT FIRM AND OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. ALDERSGATE HEALTHCARE INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 161676092 OPERATES SKILLED NURSING FACILITY FL 501(C)(3) LINE 10 N/A 0 EPWORTH VILLAGE INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 590589990 FUND RAISING FOR RELATED TAX-EXEMPT ORGANIZATIONS FL 501(C)(3) LINE 12B, II N/A 0 EPWORTH VILLAGE WEST INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 591920293 LEASE OF RETIREMENT LIVING FACILITY TO RELATED ORGANIZATION FL 501(C)(3) LINE 12C, III-FI N/A 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0