2020-10-08T22:45:22-05:00 2019-12-31 381357951 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2019-01-01 271953892 COLORADO SENIOR RESIDENCES INC COLO 9708798855 2855 OWL HOOT TRAIL STEAMBOAT SPRINGS CO 80487 CHARLES PARSONS PRESIDENT 9708798855 2020-10-08 1 RYAN C HARRIS P00614618 3037409400 2020-10-08 174.245.195.180 2020-10-08 11:02:05 MD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F832CEB9E7E923DCBD1A270062A5B56359EC80EF 2019 2021-01-29 14:40:06Z CASEY'S POND SENIOR LIVING BRAD BOATRIGHT 2855 OWL HOOT TRAIL STEAMBOAT SPRINGS CO 80487 11845530 0 X WWW.CASEYSPOND.ORG X 2010 CO TO PROVIDE HOUSING, HEALTHCARE, & OTHER SERVICES TO SENIOR CITIZENS THROUGH A RETIREMENT COMMUNITY. 12 12 214 30 0 0 2000 0 11818804 11665302 51284 85190 73539 95038 11945627 11845530 0 5750 0 0 6526792 5422170 0 0 0 8389478 9484676 14916270 14912596 -2970643 -3067066 42276320 40882003 59436756 61109505 -17160436 -20227502 TO BE VIEWED AS A LEADER IN THE SENIOR LIVING CONTINUUM OF SERVICES WITH WARM AND INVITING RESIDENCES, DEDICATED AND VISIONARY LEADERSHIP, PROFESSIONAL MANAGEMENT AND AN ENGAGED STAFF WHO ARE COMMITTED TO AN ENVIRONMENT OF GROWTH AND INDEPENDENCE. 0 0 12507343 5750 11665302 CASEY'S POND WAS FORMED TO DEVELOP, OWN, AND OPERATE A SENIOR LIVING AND LONG-TERM CARE COMMUNITY IN STEAMBOAT SPRINGS, COLORADO. CASEY'S POND CONSISTS OF APPROXIMATELY 66 SKILLED NURSING BEDS; 53 ASSISTED LIVING UNITS; 15 MEMORY CARE UNITS; 22 INDEPENDENT LIVING UNITS; AND RELATED COMMON AREAS, AMENITIES, AND OTHER IMPROVEMENTS ALL HOUSED WITHIN ONE BUILDING. 12507343 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 X 40 0 1 214 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X DEBBIE WILLIAMS 9708798855 2855 OWL HOOT TRAIL STEAMBOAT SPRINGS CO 80487 X X LOUI ANTONUCCI DIRECTOR 1.00 X 0 0 0 KAREN BOMBERG DIRECTOR 1.00 X 0 0 0 CONNIE BRINKMAN DIRECTOR 1.00 X 0 0 0 RENEE GILBERSON DIRECTOR 1.00 X 0 0 0 KARL GILLS TREASURER 1.00 X X 0 0 0 BJ HEUBERGER SECRETARY 1.00 X X 0 0 0 MARY JENKINS VICE PRESIDENT 1.00 X X 0 0 0 MICHAEL LOMAS DIRECTOR 1.00 X 0 0 0 MARILYN MCCAULLEY DIRECTOR 1.00 X 0 0 0 TRISH O'CONNELL DIRECTOR 1.00 X 0 0 0 CHARLES PARSONS PRESIDENT 1.00 X X 0 0 0 BRAD BOATRIGHT EXECUTIVE DIRECTOR 40.00 X 0 0 0 0 0 0 0 0 0 0 MORRISON COMMUNITY LIVING PO BOX 102289 ATLANTA GA 303682289 CULINARY SERVICES 865737 CAPPELLA LIVING SOLUTIONS 9570 S KINGSTON CT STE 300 ENGLEWOOD CO 80112 MANAGEMENT 406513 RTG MEDICAL 1005 E 23RD STREET FREMONT NE 68025 AGENCY STAFF 201837 PREMERE REHAB LLC 25117 SW PARKWAY STE D WILSONVILLE OR 97070 THERAPY 162726 4 RESIDENT/PATIENT SERV. 623000 11665302 11665302 11665302 85190 85190 TRANSPORT, MEALS & MIS 999999 81163 81163 MOVE-IN FEE & LEASE 532000 13875 13875 95038 11845530 11760340 0 85190 X 5750 5750 4567882 3885957 681925 12328 10488 1840 508750 447393 61357 333210 296951 36259 406513 406513 49586 49586 60994 60994 2931036 2357446 573590 60831 60831 79778 38550 41228 365642 360867 4775 25966 5522 20444 13324 2685 10639 3292475 3244635 47840 1023527 1008655 14872 81431 81431 FOOD & BEVERAGE 561230 568909 -7679 SUPPLIES 155549 154961 588 REPAIRS & MAINTENANCE 99856 99856 BAD DEBT EXPENSE 95614 95614 181324 18718 162606 14912596 12507343 2405253 0 630954 51968 632088 940099 613482 325931 18778 18778 26297 64041 42491804 7492047 35938854 34999757 4415867 4481429 42276320 40882003 893010 904573 206719 151562 42917289 42980200 10056 3500000 3500000 11909682 13573170 59436756 61109505 X -17160436 -20227502 -17160436 -20227502 42276320 40882003 -3067066 0 X 0 1 X 1 0 X 1170 1762 1983 2000 6915 10000615 10122387 11057718 11892343 11760340 54833403 10001785 10124149 11059701 11894343 11760340 54840318 0 0 0 54840318 56293 30027 8826 51284 85190 231620 56293 30027 8826 51284 85190 231620 10058078 10154176 11068527 11945627 11845530 55071938 0.99580 0.99570 0.00420 0.00430 X 3777121 3777121 36515471 5758059 30757412 1885617 1638315 247302 313595 95673 217922 34999757 DEPOSITS 60401 ASSETS LIMITED AS TO USE 4421028 4481429 DEPOSITS HELD IN ESCROW 49917 SECURITY DEPOSITS 40500 OTHER LONG TERM LIABILITIES 693358 BOND INTEREST PAYABLE 11749145 NOTE INTEREST PAYABLE 616350 REFUNDABLE LIFE CARE ENTRY FEES 423900 13573170 11845530 0 11845530 0 11845530 14912596 0 14912596 0 14912596 A COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648AYC3 2012-05-03 45110000 CONSTRUCTION OF FACILITY 0 0 0 A 43710632 3586747 892257 39231628 2013 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 PART IV, LINE 2C THE REBATE COMPUTATION WAS PERFORMED IN 2017. FORM 990, PART V, LINE 2B: CASEY'S POND USES A PEO, WHICH FILES FORMS W-2 ON BEHALF OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED CONTROL OF THE EXECUTIVE DIRECTOR POSITION TO CAPPELLA LIVING SOLUTIONS. BRAD BOATRIGHT IS THE EXECUTIVE DIRECTOR OF THE ORGANIZATION AND IS AN EMPLOYEE OF CAPPELLA LIVING SOLUTIONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE EXECUTIVE COMMITTEE AND THEN PROVIDED TO THE BOARD MEMBERS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C EACH RESPONSIBLE PERSON HAS A CONTINUING OBLIGATION TO (I) SCRUTINIZE HIS OR HER INTERESTS, RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES, BOTH DIRECT AND INDIRECT, TO IDENTIFY ANY APPARENT OR ACTUAL CONFLICTS OF INTEREST, AND (II) DISCLOSE THE CONFLICT OF INTEREST AS SOON AS IT IS KNOWN. DISCLOSURE IS REQUIRED ANNUALLY, AND WHENEVER A RESPONSIBLE PERSON BECOMES AWARE OF AN ACTUAL OR APPARENT CONFLICT OF INTEREST THAT HAS NOT PREVIOUSLY BEEN DISCLOSED. IN CASES WHERE A RESPONSIBLE PERSON FEELS A CONFLICT ARISES THAT IS NOT PART OF THE ANNUAL DISCLOSURE, HE/SHE SHALL REPORT THE CIRCUMSTANCE TO THE CHAIR OF THE BOARD. IF A CONFLICT OF INTEREST EXISTS, THE RESPONSIBLE PERSON MUST EXCUSE HIMSELF OR HERSELF FROM DISCUSSION, DELIBERATION AND DEBATE ON THE MATTER. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION B THE ORANIZATION PAID THE EXECUTIVE DIRECTOR THROUGH A MANAGEMENT COMPANY. THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF CAPPELLA LIVING SOLUTIONS, AN UNRELATED ENTITY. BRAD BOATRIGHT WAS PAID THROUGH CAPPELLA LIVING SOLUTIONS. BRAD'S WAGES WERE $164,007 AND HIS NONTAXABLE BENEFITS WERE $11,750. FORM 990, PART IX, LINE 11G THERAPY: PROGRAM SERVICE EXPENSES 255,915. MANAGEMENT AND GENERAL EXPENSES 126,863. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 382,778. NURSING: PROGRAM SERVICE EXPENSES 905,021. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 905,021. CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 32,278. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,278. PHARMACY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,188. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,188. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 202,458. MANAGEMENT AND GENERAL EXPENSES 410,261. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 612,719. CULINARY SERVICES: PROGRAM SERVICE EXPENSES 994,052. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 994,052.