2022-05-06T09:01:46-05:00 2021-06-30 410746749 CLIFTONLARSONALLEN LLP 610 W GERMANTOWN PIKE SUITE 400 PLYMOUTH MEETING PA 19462 990 2020-07-01 232613942 RIDDLE VILLAGE RIDD 6108913777 1048 W BALTIMORE PIKE MEDIA PA 19063 KIMBERLY ROGUSZEWSKI EVP/CFO 6108913777 2022-05-05 1 KIMBERLY ROGUSZEWSKI 999009999 SETH BRODY P01586423 2156433900 2022-05-05 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROBERT BERTOLETTE 1048 W BALTIMORE PIKE MEDIA PA 19063 29758956 0 X WWW.RIDDLEVILLAGE.COM X 1993 PA TO ENRICH THE VALUE OF RETIREMENT LIVING FOR RESIDENTS & LIVES OF THOSE WHO SUPPORT THEM. 9 9 402 30 0 0 715332 500268 30795770 28919676 398182 339012 0 0 31909284 29758956 0 0 0 0 14217694 15322782 0 0 0 15906770 14257069 30124464 29579851 1784820 179105 64868963 66630390 101887070 98732948 -37018107 -32102558 X TO ENRICH THE VALUE OF RETIREMENT LIVING FOR OUR RESIDENTS AND THE LIVES OF THOSE WHO SUPPORT THEM. 0 0 14334114 0 20701329 INDEPENDENT LIVING FACILITY, CONSISTING OF 359 UNITS, IS DESIGNED TO ALLOW EACH RESIDENT TO LIVE THEIR LIFE TO THE FULLEST WITHOUT THE CONCERNS ASSOCIATED WITH POSSIBLE FUTURE HEALTHCARE NEEDS. THE ORGANIZATION PROVIDES MEALS, HOUSEKEEPING, ACTIVITIES, WELLNESS, 24 HOUR NURSE AVAILABILITY AND A FITNESS CENTER THAT ENCOURAGES RESIDENTS TO REMAIN AS ACTIVE AS POSSIBLE. AS A CCRC, RIDDLE VILLAGE PROVIDES SUBSIDIES TO ANY RESIDENT WHO IS UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS TO THE COMMUNITY. THE ORGANIZATION CURRENTLY HAS AT LEAST FOUR RESIDENTS WHO ARE IN NEED OF THIS SUBSIDY WITH OTHERS REQUESTING ASSISTANCE RECENTLY DUE TO THE DOWNTURN IN THE ECONOMY. (CONTINUED ON SCHEDULE O)RIDDLE VILLAGE HOSTS MANY COMMUNITY EVENTS, IS A VOTING CENTER DURING ELECTIONS AND SUPPORTS THE OVERALL COMMUNITY BY PARTICIPATING IN THE PAYMENT OF LOCAL, COUNTY AND SCHOOL TAXES.COVID-19 HAS IMPACTED THE FACILITY, CAUSING ADDITIONAL COSTS FOR EMERGENCY PREPARDNESS, DISEASE CONTROL AND CONTAINMENT, POTENTIAL SHORTAGES OF HEALTH CARE AND OTHER PERSONNEL, AND LOSS OF REVENUE DUE TO REDUCTIONS IN CERTAIN REVENUE STREAMS. PROVIDER RELIEF FUNDING WAS UTILIZED FOR PAYROLL AND NONPAYROLL RELATED EXPENDITURES AS WELL AS TO HELP WITH LOST REVENUES. 3602859 0 4310228 PERSONAL CARE UNIT - CONSISTS OF 49 APARTMENTS BOTH STUDIO AND ONE-BEDROOMS. THERE WAS A RECENT EXPANSION AND REFURBISHING PROJECT FOR BOTH PERSONAL CARE UNIT AND SKILLED NURSING FACILITY TO ALLOW FOR A MORE HOME LIKE ENVIRONMENT, MORE GATHERING PLACES FOR RESIDENTS, FAMILY AND FRIENDS AND KITCHEN FACILITIES TO BETTER SERVE OUR RESIDENTS. IT IS OUR PHILOSOPHY THAT EACH RESIDENTS' CARE, PHYSICAL AND EMOTIONAL HEALTH IS EQUALLY IMPORTANT. THIS UNIT CONSISTS OF BOTH LIFECARE RESIDENTS AND PRIVATE PAY RESIDENTS. ALL LIFECARE RESIDENTS ARE GUARANTEED CARE REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. 7413223 0 3908119 SKILLED NURSING FACILITY - CONSISTS OF 86 SKILLED BEDS. THE FACILITY IS DESIGNED TO PROVIDE A HOME LIKE ATMOSPHERE TO ENSURE THAT RESIDENTS ARE COMFORTABLE IN ALL STAGES OF THEIR LIFE. THIS FACILITY ALSO CARES FOR LIFECARE RESIDENTS AND PRIVATE PAY RESIDENTS. WE ALSO PROVIDE FOR MEDICARE AND OTHER THIRD PARTY BILLING RESIDENTS. ALL LIFECARE RESIDENTS ARE GUARANTEED CARE REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. 25350196 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 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 1 0 0 0 0 1 17 0 1 402 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X KIMBERLY ROGUSZEWSKI 6108913777 1048 WEST BALTIMORE PIKE MEDIA PA 19063 ROBERT G BERTOLETTE PRESIDENT/CEO 40.00 X 289896 0 33761 KIMBERLY FOSTER-ROGUSZEWSKI EVP/CFO 40.00 X 248245 0 35850 RONALD WATERMAN VP OF OPERATIONS 40.00 X 235069 0 46721 KRISTEN LAMANNA DIRECTOR OF MARKETING 40.00 X 136433 0 3808 LISA PATTERSON DIRECTOR OF ACCOUNTING 40.00 X 123534 0 3781 CHRISTINA MCGEE DIRECTOR OF NURSING 40.00 X 126800 0 39297 KISHA LESTER- DENNIS DIRECTOR OF PCU/WELLNESS 40.00 X 126139 0 35756 ROB PHILIPS DIRECTOR OF FACILITIES OPERATIONS 40.00 X 118741 0 28547 DANIEL E KENNEDY CHAIR 0.00 X X 0 0 0 EDWARD MCKILLIP VICE CHAIR 0.00 X X 0 0 0 ROBERT F FISCHER TREASURER 0.00 X 0 0 0 JON D HELMS SECRETARY LEFT OCT 2020 0.00 X X 0 0 0 THOMAS A GOLDSMITH JR SECRETARY 0.00 X 0 0 0 MARIA C BUCCO DIRECTOR 0.00 X 0 0 0 ELIZAEBTH J CRAIG DIRECTOR 0.00 X 0 0 0 JOSEPH LUNDY ESQ DIRECTOR 0.00 X 0 0 0 ROSEMARY MORSE DIRECTOR 0.00 X 0 0 0 ROBERT L SUMNER DIRECTOR 0.00 X 0 0 0 1404857 0 227521 8 0 1 0 CONSTRUCTION SERVICES GROUP LLC 1630 WEST CHESTER PIKE WEST CHESTER PA 19382 REFURBISHMENTS AND RENOVATIONS 3686714 RC MARLAND ASSOCIATES 406 WARD STREET CHESTER PA 19013 ROOFING CONTRACTOR 849468 US FOOD SERVICE - PHILADELPHIA PO BOX 820050 PHILADELPHIA PA 19182 FOOD SERVICE DISTRIBUTION 576480 SELECT REHABILITATION LLC PO BOX 71985 CHICAGO IL 60694 REHAB SERVICES 426753 REHAB CARE GROUP PO BOX 5053534 ST LOUIS MO 63150 REHAB SERVICES 412864 15 299648 200620 500268 RESIDENT CARE 623000 15263793 15263793 NET PATIENT SERVICE REVENUE 623000 8351224 8351224 EARNED ENTRANCE FEE 623000 5303622 5303622 MEAL INCOME 623000 1037 1037 28919676 339012 339012 29758956 28919676 0 339012 889540 444770 444770 11124496 9270360 1854136 420430 312873 107557 2104154 1696546 407608 784162 768479 15683 56401 56401 -10008 -10008 78000 78000 19646 19646 128819 128819 313712 313712 46871 8308 38563 295158 295158 749335 749335 43594 17614 25980 1898883 1708995 189888 4045900 3641311 404589 915534 823981 91553 RAW FOOD 1402679 1402679 DRUG AND THERAPY COSTS 1214049 1214049 OUTSIDE SERVICE FEE 1020894 955643 65251 PLANT AND MAINTENANCE 167412 150671 16741 1870190 1742051 128139 29579851 25350196 4229655 0 1095486 789568 176285 170160 3843630 3995288 111830 132594 628643 652557 134631018 98848508 33906023 35782510 24811655 25107713 295411 0 64868963 66630390 1904390 2996885 46423057 46504097 48065461 45879845 5494162 3352121 101887070 98732948 X -39400979 -34557449 2382872 2454891 -37018107 -32102558 64868963 66630390 X 179105 2889815 1846629 X 0 1 X 1 0 X 367226 187469 150989 715332 500268 1921284 29467284 30443811 30334231 30795770 28919676 149960772 29834510 30631280 30485220 31511102 29419944 151882056 17700 13000 17000 17000 64700 0 17700 13000 17000 17000 64700 151817356 138642 291838 597572 398182 339012 1765246 138642 291838 597572 398182 339012 1765246 29973152 30923118 31082792 31909284 29758956 153647302 0.98810 0.98940 0.01150 0.01000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2394753 67037 472910 -97771 3032471 2529028 24065 -3486 154854 2394753 2455287 67143 85231 78633 2529028 2386818 74355 104875 110761 2455287 2030162 270953 174150 88447 2386818 1.00000 0.00000 0.00000 0 0 96988340 57345558 39642782 5897402 5595556 301846 31745276 35907394 -4162118 35782510 INTEREST RATE SWAP 3352121 3352121 X 34790812 2889815 2142041 5031856 29758956 0 29758956 29579851 0 29579851 0 29579851 PART V, LINE 4: THE VILLAGE HAS ESTABLISHED AN ENDOWMENT FUND TO PROVIDE A SOURCE FOR FINANCIAL ASSISTANCE TO RESIDENTS OF THE COMMUNITY WHO ARE ABLE TO DEMONSTRATE FINANCIAL NEED FOR THE COST OF CARE. PART X, LINE 2: THE VILLAGE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 509(A)(2) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REQUIRED. THE VILLAGE FOLLOWS THE PROVISIONS OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE VILLAGE BELIEVES THAT THERE IS NO UNCERTAINTY IN THE TAX POSITIONS TAKEN BY THE VILLAGE AND THESE PROVISIONS HAVE NO IMPACT ON THE VILLAGE'S FINANCIAL STATEMENTS. THE VILLAGE'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE INTEREST RATE SWAP AGREEMENTS 2,142,041. X X X X 0 0 0 0 0 0 0 0 0 ROBERT G BERTOLETTE PRESIDENT/CEO 272709 0 0 0 17187 0 8593 0 25168 0 323657 0 0 0 KIMBERLY FOSTER-ROGUSZEWSKI EVP/CFO 207101 0 41144 0 0 0 0 0 35850 0 284095 0 0 0 RONALD WATERMAN VP OF OPERATIONS 170446 0 40064 0 24559 0 10871 0 35850 0 281790 0 0 0 CHRISTINA MCGEE DIRECTOR OF NURSING 110530 0 6843 0 9427 0 3539 0 35758 0 166097 0 0 0 KISHA LESTER- DENNIS DIRECTOR OF PCU/WELLNESS 114589 0 11550 0 0 0 0 0 35756 0 161895 0 0 0 A DELAWARE COUNTY AUTHORITY 231973437 2017-12-27 53765000 TO REFUND THE SERIES 2011 AND 2013 BONDS 0 0 0 A 7335000 53765000 687693 8061219 43146500 1869588 1 0 1 1 A 0 0 0 0 0.00090 0.00090 0 0 1 A 0 1 0 0 1 1 BRANCH BANKING AND TRUST COMPANY 6.500000000000 0 0 0 0 1 A 1 (F) DESCRIPTION OF PURPOSE (CONTINUED): AS WELL AS FINANCE RENOVATIONS AND IMPROVEMENTS TO THE VILLAGE'S FACILITIES. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD, TO THE EXTENT PERMITTED BY APPLICABLE LAW, BETWEEN MEETINGS OF THE BOARD. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED AT ANY TIME BY THE CHAIR OF THE COMMITTEE, BY THE CHAIR OF THE BOARD OR BY ANY TWO MEMBERS OF THE COMMITTEE. NOTICE OF SPECIAL MEETINGS OF THE EXECUTIVE COMMITTEE SHALL BE GIVEN AT LEAST TWO DAYS BEFORE SUCH MEETING, BUT WRITTEN NOTICE SHALL NOT BE REQUIRED. NO STANDING COMMITTEE, SHALL HAVE ANY POWER OR AUTHORITY AS TO THE FOLLOWING: (A) THE FILLING OF VACANCIES ON THE BOARD; (B) THE ADOPTION, AMENDMENT OR REPEAL OF THE BYLAWS OR THE ARTICLES OF INCORPORATION; (C) THE AMENDMENT OR REPEAL OF ANY RESOLUTION OF THE BOARD; OR (D) ACTION ON MATTERS COMMITTED BY THE BYLAWS OR BY RESOLUTION OF THE BOARD TO ANOTHER COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 RIDDLE HEALTH CARE FOUNDATION, AN UNRELATED 501(C)(3) PUBLIC CHARITY, MEETS THE INTERNAL REVENUE SERVICE DEFINITION OF MEMBER. FORM 990, PART VI, SECTION A, LINE 7A ONE DIRECTOR SHALL BE NOMINATED BY THE RIDDLE HEALTH CARE FOUNDATION, AND PROVIDED THAT SUCH NOMINEE IS OTHERWISE QUALIFIED UNDER THESE BYLAWS AND APPLICABLE LAW, SUCH NOMINEE SHALL BE ELECTED BY THE BOARD TO SERVE FOR A TERM OF ONE YEAR, AND SHALL BE ELIGIBLE FOR SUCCEEDING ONE-YEAR TERMS WITHOUT LIMIT. AT ALL TIMES, A MAJORITY OF ALL OF THE DIRECTORS SHALL BE NON-RESIDENTS OF RIDDLE VILLAGE. NO DIRECTOR, EXCEPT THE DIRECTOR NOMINATED BY THE RIDDLE HEALTH CARE FOUNDATION, MAY SERVE MORE THAN TWO CONSECUTIVE FULL TERMS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM AND THEN ALL MEMBERS OF THE BOARD REVIEW THE FORM 990 PRIOR TO THE FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CURRENTLY, ALL MEMBERS OF THE BOARD REVIEW THE CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. IF CONFLICTS ARISE BETWEEN THE ANNUAL MEETING THEY WOULD BE BROUGHT TO THE ATTENTION OF THE BOARD AT THAT TIME. THEY CONFIRM THAT THEY HAVE NO SUCH CONFLICT IF APPROPRIATE. IF CONFLICT WERE TO EXIST, THE BOARD AS A WHOLE WOULD REVIEW EACH POTENTIAL CONFLICT AND DETERMINE THE APPROPRIATENESS OF THE ACTION. ANY BOARD MEMBER INVOLVED IN A CONFLICT WOULD BE UNABLE TO VOTE ON ANY ACTION, PURCHASE OR DECISION BEING MADE. IN ADDITION, EACH SENIOR MANAGEMENT REPRESENTATIVE SIGNS A SIMILAR STATEMENT. DIRECTORS WITH A POTENTIAL CONFLICT ARE EXCLUDED FROM DECISION MAKING IN THAT AREA. FORM 990, PART VI, SECTION B, LINE 15 RIDDLE VILLAGE HAS A COMPENSATION COMMITTEE AS PART OF THE RIDDLE VILLAGE BOARD OF DIRECTORS. THE COMMITTEE IS MADE UP OF SEVERAL INDEPENDENT MEMBERS OF THE BOARD WHO REVIEW SALARY SURVEYS, WORK PERFORMANCE, COMPLETION OF ANNUAL GOALS AND JOB DESCRIPTIONS IN DETERMINING A FAIR WAGE FOR THE CEO. THEY ALSO REVIEW COO AND CFO POSITIONS RELATED TO THE SAME AREAS TO GIVE FINAL APPROVAL OF THE CEO'S RECOMMENDATION OF THEIR SALARIES. THIS PROCESS WAS LAST PERFORMED IN OCTOBER 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE DISTRIBUTED TO RESIDENTS AND FILED WITH THE PA INSURANCE DEPARTMENT. THE FINANCIAL STATEMENTS ARE ALSO MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 2,142,041. CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE -295,412. RIDDLE VILLAGE DEVELOPMENT LLC 1048 WEST BALTIMORE PIKE MEDIA PA 19063 262397145 IMPLEMENTING DEVELOPMENT OF ADDITIONAL FACILITIES PA 0 0 RIDDLE VILLAGE