2020-05-11T15:21:18-05:00 2019-12-31 593070669 MSL PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2019-01-01 591031820 PLYMOUTH HARBOR INC PLYM 9413652600 700 JOHN RINGLING BLVD SARASOTA FL 34236 HARRY E HOBSON PRESIDENT/CEO 9413652600 2020-05-11 1 NORMAN B NEAL CPA P00071411 4077405400 73.179.45.151 2020-05-11 15:17:36 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D82DAE13932C41878502CF208E25BB5BC26ECAE2 2019 2020-09-23 17:36:50Z HARRY E HOBSON 700 JOHN RINGLING BLVD SARASOTA FL 34236 38966634 0 X WWW.PLYMOUTHHARBOR.ORG X 1961 FL PLYMOUTH HARBOR IS A CHURCH-SPONSORED, NOT-FOR-PROFIT COMMUNITY OF DISTINCTION FOR OLDER ADULTS COMMITTED TO PROVIDING THE MOST POSITIVE AGING EXPERIENCE POSSIBLE FOR ITS RESIDENTS. 18 18 434 24 0 0 475204 455207 29834076 32204908 1044809 773815 433594 234885 31787683 33668815 31305 44789 0 0 15439519 15900037 0 0 105642 16053691 16580827 31524515 32525653 263168 1143162 125230459 131043992 97131299 99537255 28099160 31506737 PLYMOUTH HARBOR IS A CHURCH-SPONSORED NOT-FOR-PROFIT COMMUNITY OF DISTINCTION FOR OLDER ADULTS COMMITTED TO PROVIDING THE MOST POSITIVE AGING EXPERIENCE POSSIBLE FOR ITS RESIDENTS. 0 0 29002545 32439793 CARING FOR SENIOR ADULTS THROUGH THE OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF 214 INDEPENDENT APARTMENT UNITS, 60 ASSISTED LIVING APARTMENT UNITS, A LICENSED HOME HEALTH AGENCY AND 56 BED SKILLED NURSING CENTER. 135197 44789 THE PLYMOUTH HARBOR FOUNDATION - ENSURING THE APPROPRIATE STEWARDSHIP OF CONTRIBUTED FUNDS, DEVELOPING FUNDRAISING STRATEGIES THAT SUPPORT THE MOST POSITIVE AGING EXPERIENCE POSSIBLE, AND PROVIDING FUNDING FOR INNOVATIVE PROGRAMS AND SERVICES IN THE REGION. 342542 THE LEGACY FUND PROVIDES SUPPORT FOR OPERATING AND MAINTAINING A LIFE CARE FACILITY AIDING NEEDY RESIDENTS OF THE CORPORATION. 29480284 1 1 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 82 0 1 434 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X NATALLIA DZIATSEL CPA 9413652600 700 RINGLING BLVD SARASOTA FL 34236 JOHN M CRANOR III CHAIRMAN 1.00 X X 0 0 0 BRUCE BERG VICE CHAIRMAN 1.00 X X 0 0 0 NORA PATTERSON SECRETARY 1.00 X X 0 0 0 WILLIAM WOELTJEN TREASURER 1.00 X X 0 0 0 JAY PRICE FOUNDATION CHAIR 1.00 X X 0 0 0 BRIAN D HALL IMMEDIATE PAST CHAIR 1.00 X 0 0 0 TOM BELCHER TRUSTEE 1.00 X 0 0 0 ERIC BLEDSOE TRUSTEE 1.00 X 0 0 0 KATHRYN ANGELL CARR TRUSTEE 1.00 X 0 0 0 JEFF CHARLOTTE TRUSTEE 1.00 X 0 0 0 LEE DELIETO JR TRUSTEE 1.00 X 0 0 0 WILLIAM R JOHNSTON TRUSTEE 1.00 X 0 0 0 GUY PETERSON TRUSTEE 1.00 X 0 0 0 MYRON ROBINSON TRUSTEE 1.00 X 0 0 0 CONNIE SANDERS TRUSTEE 1.00 X 0 0 0 CHRIS SFORZO TRUSTEE 1.00 X 0 0 0 CADE SIBLEY TRUSTEE 1.00 X 0 0 0 JENNIFER WALKER TRUSTEE 1.00 X 0 0 0 HARRY E HOBSON PRESIDENT/CEO 40.00 X 349948 0 31167 NATALLIA DZIATSEL VICE PRESIDENT/CFO 40.00 X 159238 0 14256 JOSEPH J DEVORE SENIOR VICE PRESIDENT OF HEALTH SERVICES 40.00 X 170036 0 13931 GEORGE W MCGONAGILL VP OF FACILITIES 40.00 X 160546 0 12718 GORDON OKAWA VP OF MARKETING 40.00 X 126178 0 28901 RENE H WEDER DIRECTOR OF DINING SERVICES/EXECUTIVE CHEF 40.00 X 117541 0 27043 TENA WILSON VP OF RESIDENT AND EMPLOYEE RELATIONS 40.00 X 128924 0 25472 KAREN E NOVAK DIRECTOR OF NURSING 40.00 X 103141 0 11858 1315552 0 165346 9 0 1 0 WILLIS A SMITH CONSTRUCTION 5001 LAKEWOOD RANCH BLVD N SARASOTA FL 34240 CONSTRUCTION 3424290 REHABCARE PO BOX 503534 ST LOUIS MO 63150 REHABILITATION AND THERAPY 621397 OTIS ELEVATOR COMPANY PO BOX 73579 CHICAGO IL 60673 ELEVATOR UPGRADE AND MAINTENANCE 518266 AAPAIR INC 6222 TOWER LANE SARASOTA FL 34240 A/C AND DUCT WORK 412099 SOFTRIM LLC 9210 ESTERO PARK COMMONS BLVD SUI ESTERO FL 33928 NURSE CALL SYSTEM 407272 23 455207 455207 MONTHLY SERVICE FEES 623000 23395228 23395228 ENTRANCE FEES 623000 8809680 8809680 32204908 879477 879477 5192157 5008917 288902 183240 -288902 -105662 -105662 CAPITAL REIMBURSEMENTS 623000 234885 234885 234885 33668815 32439793 0 773815 44789 44789 738577 190558 548019 11559430 10475733 1002999 80698 245695 200253 44775 667 2424022 2266812 151688 5522 932313 822866 102343 7104 53273 7956 45317 31107 31107 115376 115376 1700171 1275450 424721 132564 17636 110220 4708 319565 183262 134378 1925 8387 8387 2812130 2784654 27476 48674 27582 19496 1596 771494 771494 7221659 7060749 160910 209270 202846 6424 FOOD 963227 963227 MEDICAL, OXYGEN, AND DR 804555 804555 SUPPLIES 415933 383805 31548 580 LINENS AND UNIFORMS 328579 328579 644863 552102 89919 2842 32525653 29480284 2939727 105642 3084929 1827603 64685 145812 592560 426869 1279887 1351597 103650 130783 641145 653163 151220719 59483773 89845997 91736946 29617606 34199169 572050 125230459 131043992 1958764 3142772 42083602 45582843 25902076 23950269 27186857 26861371 97131299 99537255 X 24743291 28167725 3355869 3339012 28099160 31506737 125230459 131043992 X 1143162 2618676 625444 -979705 X X 0 1 X 1 0 X 922308 2461095 1385852 475204 455207 5699666 23813539 23993495 25305768 29834076 32204908 135151786 24735847 26454590 26691620 30309280 32660115 140851452 0 0 0 140851452 115907 149637 220485 901153 879477 2266659 115907 149637 220485 901153 879477 2266659 154625 397379 812020 433594 234885 2032503 25006379 27001606 27724125 31644027 33774477 145150614 0.97040 0.97530 0.01560 0.01130 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 88 240 328 0 11962931 2293159 1820049 12436041 13906717 55000 -742855 1255931 11962931 12161627 90530 1654560 13906717 11477104 547064 233621 96162 12161627 11630413 262873 374487 41695 11477104 0.98790 0.00000 0.01210 0 1 1 273228 273228 132950435 54173710 78776725 9294925 3716314 5578611 8702131 1593749 7108382 91736946 CASH AND CASH EQUIVALENTS 6960049 F ACCRUED INTEREST 54083 F CORPORATE BONDS 3704675 F U.S. GOVERNMENT OBLIGATIONS 3077325 F MUTUAL FUNDS 16651501 F CERTIFICATE OF DEPOSITS 1026900 F CORPORATE STOCK 2724636 F 34199169 DEFERRED ENTRANCE FEES 25620399 INTEREST RATE SWAP 1240972 26861371 35192412 2618676 -979703 1638973 33553439 115376 115376 33668815 32410277 0 32410277 115376 115376 32525653 PART IV, LINE 1B: PLYMOUTH HARBOR, INC. OFFERS A CASH MANAGEMENT SERVICE TO ITS HEALTHCARE RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF EACH RESPECTIVE RESIDENT. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET UNREALIZED GAIN (LOSS) ON CHARITABLE REMAINDER TRUST CHANGE IN VALUE OF SWAP INTEREST AGREEMENT 0 SCHOLARSHIPS 16 44789 FAIR MARKET VALUE SCHOLARSHIPS TO INDIVIDUALS X 1 1 X X X X 0 1 0 0 0 0 0 0 0 HARRY E HOBSON PRESIDENT/CEO 349948 0 0 0 0 0 8322 0 22845 0 381115 0 0 0 NATALLIA DZIATSEL VICE PRESIDENT/CFO 159238 0 0 0 0 0 5989 0 8267 0 173494 0 0 0 JOSEPH J DEVORE SENIOR VICE PRESIDENT OF HEALTH SERV 170036 0 0 0 0 0 5664 0 8267 0 183967 0 0 0 GEORGE W MCGONAGILL VP OF FACILITIES 160546 0 0 0 0 0 5130 0 7588 0 173264 0 0 0 GORDON OKAWA VP OF MARKETING 126178 0 0 0 0 0 4519 0 24382 0 155079 0 0 0 TENA WILSON VP OF RESIDENT AND EMPLOYEE RELATION 128924 0 0 0 0 0 4492 0 20980 0 154396 0 0 0 A SARASOTA COUNTY HEALTH FACILITIES AUTHORITY 596000848 2015-12-10 26000000 SEE SUPPLEMENTAL INFORMATION BELOW 0 0 0 A 1962688 26000000 203740 25796260 2015 0 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 THE NORTHERN TRUST COMPANY 12.000000000000 0 0 0 0 1 A 0 SCHEDULE K, ROW A, PART I(F) THE PROCEEDS OF THE SERIES 2015 NOTES WERE USED TO (A) FINANCE THE CONSTRUCTION COSTS FOR THE EXPANSION OF AN EXISTING CONTINUING CARE RETIREMENT COMMUNITY, (B) REFUND ALL OF THE THEN OUTSTANDING MORTGAGE NOTE PAYABLE, AND (C) PAY THE COST OF ISSUANCE OF THE SERIES 2015 NOTES. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS REVIEWED IN ITS ENTIRETY BY THE CHIEF FINANCIAL OFFICER. ANY QUESTIONS ARE RESOLVED WITH THE INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE RETURN. IN ADDITION, A COPY IS PROVIDED TO EACH INDEPENDENT VOTING MEMBER OF THE BOARD FOR REVIEW BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY COVERS ALL BOARD MEMBERS AND EMPLOYEES. NEW BOARD MEMBERS COMPLETE AND SUBMIT A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT AT ORIENTATION. ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE AND SUBMIT A SIGNED CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. THESE STATEMENTS ARE REVIEWED BY THE BOARD PRESIDENT AND CHIEF EXECUTIVE OFFICER. ANY BOARD MEMBER HAVING A POSSIBLE OR ACTUAL CONFLICT OF INTEREST IS PROHIBITED FROM VOTING OR USING HIS/HER PERSONAL INFLUENCE ON THE MATTER, AND SHOULD NOT BE COUNTED AS PART OF A QUORUM FOR THE MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION COMMITTEE, WHICH IS INDEPENDENT WITH RESPECT TO ALL COMPENSATION DECISIONS AND CONSISTS OF SEVERAL INDEPENDENT BOARD MEMBERS, AND AN INDEPENDENT CONSULTANT EVALUATES THE PERFORMANCE OF THE CHIEF EXECUTIVE OFFICER. THE CEO PERFORMS ANNUAL EVALUATIONS OF OTHER TOP MANAGEMENT OFFICIALS. THE ORGANIZATION UTILIZES COMPARABILITY SURVEYS, CONDUCTED BY THE HUMAN RESOURCES DIRECTOR, TO DETERMINE THE COMPENSATION OF THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE PRESIDENT OF THE BOARD OF DIRECTORS REVIEWS THE EVALUATIONS AND PROVIDES WRITTEN APPROVAL OF COMPENSATION DECISIONS. 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 AT THE FACILITY. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -982,429. NET UNREALIZED GAIN (LOSS) OF CHAIRTABLE REMAINDER TRUST 2,724. FORM 990, PART XII, LINE 2C OVERSIGHT OF FINANCIAL STATEMENT AUDIT: THE ORGANIZATION'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE PLYMOUTH HARBOR FOUNDATION LLC 700 JOHN RINGING BLVD SARASOTA FL 34236 000000000 TO SUPPORT THE PLYMOUTH HARBOR FACILITY. FL 1153385 4656011 PLYMOUTH HARBOR INC