2019-12-20T07:32:32-06:00 2019-06-30 721396621 CARR RIGGS & INGRAM LLC 111 VETERANS BLVD SUITE 350 METAIRIE LA 70005 990 2018-07-01 720996315 COMMCARE CORPORATION COMM 5043248950 950 WEST CAUSEWAY APPROACH MANDEVILLE LA 70471 DAWN HARVEY CORPORATE SECRETARY 5043248950 2019-12-19 1 RYAN KRUSE CPA P01323111 5048379116 2019-12-19 12.229.25.27 2019-12-19 15:23:29 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1E45F7A43F932160906BCDDB26186997CA6DEB39 2018 2020-03-31 21:24:44Z JOHN TUCKER 950 WEST CAUSEWAY APPROACH MANDEVILLE LA 70471 98604243 0 X WWW.COMMCARE.COM X 1984 LA TO PROVIDE THE HIGHEST QUALITY HEALTH & CUSTODIAL CARE TO ELDERLY & INFIRM PERSONS ON A NON-DISCRIMINATORY BASIS IN CONJUNCTION WITH A COMMITMENT TO SUPPORT THE CITIZENS OF THE COMMUNITY WE SERVE. 5 0 2437 10 129809 128809 0 0 89759716 97450330 283291 333311 1032562 617005 91075569 98400646 0 0 0 0 46580499 49525649 0 0 0 40752974 48290948 87333473 97816597 3742096 584049 116456611 139539324 54097791 73596455 62358820 65942869 X TO PROVIDE RESIDENTIAL/EXTENDED CARE, INCLUDING REHABILITATION AND OTHER NON-ACUTE SERVICES TO THE COMMUNITIES IN WHICH IT OPERATES NURSING HOMES, AND TO SERVE THE SPECIAL NEEDS OF THE ELDERLY BY PROVIDING PHYSICAL CARE, SAFE ENVIRONMENTS, PSYCHOLOGICAL CARE AND RECREATIONAL OPPORTUNITIES TO BOTH RESIDENTS OF THE FACILITIES AND THE ELDERLY WHO RESIDE IN THE COMMUNITIES THE ORGANIZATION SERVES. 0 0 64728484 97772525 PROVISION OF RESIDENTIAL/EXENDED CARE INCLUDING REHABILITATION AND OTHER NON-ACUTE SERVICES TO THE COMMUNITIES IN WHICH IT OPERATES NURSING HOME FACILITIES. 64728484 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 1 345 0 1 2437 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 5 0 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X MARY HUDSON 5043248950 950 WEST CAUSEWAY APPROACH MANDEVILLE LA 70471 HENRY MASSON TREASURER/DIRECTOR 1.00 1.00 X X 36000 0 0 JOHN STASSI II PRESIDENT/CEO/EMPLOYEE 45.00 5.00 X X 300000 0 0 ANTHONY MANGUM DIRECTOR 1.00 1.00 X X 36000 0 0 PATRICIA M PRECHTER DIRECTOR/ASSISTANT SECRETARY 1.00 1.00 X X 25000 0 0 DAWN HARVEY SECRETARY (NON-VOTING) 50.00 1.00 X X 161105 96962 16833 JON GOUX CFO 40.00 X 108481 69897 15624 JAMES TUCKER PRESIDENT/DIRECTOR/CEO 3.00 X 432413 236453 27029 GEORGE E GARDNER S. VICE PRESIDENT/COO 50.00 X 220809 147157 21653 DONNA L BEAUBOUEF MARKET MANAGER 50.00 X 107929 74900 23525 ROBERT BAUDER MARKET MANAGER 50.00 X 119108 51746 19438 JOHNNIE ECCLES QI NURSE 50.00 X 93210 61604 12670 MARY HUDSON CONTROLLER 50.00 X 116468 71468 13879 LISA GARDNER VICE PRESIDENT MARKETING 50.00 X 99522 59570 12415 REBECCA GUTHIER VICE PRESIDENT NURSING 50.00 X 105822 74761 23442 HOWARD SADLER ADMINISTRATOR 50.00 X 135763 0 15110 VANESSA HOUCK ADMINISTRATOR 50.00 X 139228 0 12174 DONISE BOSCARENO ADMINISTRATOR 40.00 X 149233 0 2181 JEROLD HINDSMAN DIRECTOR OF NURSING 40.00 X 126318 0 9739 DONNA COTTON DIRECTOR OF NURSING 40.00 X 123080 0 9984 L RENE' GOUX FORMER VICE-PRESIDENT/DIRECTOR 40.00 1.00 X 104140 0 277307 2739629 944518 513003 26 1 1 0 QUALITY CARE REHAB INC 8477 S SUNCOAST BLVD HOMOSASSA FL 34446 THERAPY SERVICES 5511934 THE THERAPY CENTER OF JEFFERSON DAVIS PA PO BOX 849 JENNINGS LA 70546 PHYSICAL THERAPY 3524426 DONAHUE FAVRET CONTRACTOR'S INC 3030 CAUSEWAY APPROACH MANDEVILLE LA 70448 BUILDING CONTRACTOR 3120989 FUSION CARE PHARMACY 8720 QUIMPER PLACE STE 200 SHREVEPORT LA 71105 PHARACEUTICAL DRUG/SUPPLIES 2876678 KTH ARCHITECTS INC 1741 KIWANIS TRAIL DUBOIS PA 15801 ARCHITECTURE SERVICES 1484514 46 PATIENT SERVICES REVENUE 623000 97450330 97450330 97450330 333311 333311 498407 203597 294810 294810 129809 165001 MANAGEMENT FEE INCOME 623000 462136 462136 MISCELLANEOUS 623000 142212 142212 MEALS INCOME 623000 91875 91875 -374028 -374028 322195 98400646 97772525 129809 498312 1365966 1365966 39203337 32231839 6971498 552359 365607 186752 5270749 3601703 1669046 3133238 2135013 998225 6524162 6524162 455932 455932 764402 764402 676897 676897 140409 140409 1279219 564060 715159 1326176 1326176 5002636 5002636 268170 4847 263323 111846 1655 110191 1566978 3015 1563963 3785184 2782191 1002993 1002268 1002268 UBT INCOME TAX 21331 21331 ANCILLARY PATIENT SERVI 14592643 13862603 730040 DUES, LICENSES & PROVID 4913160 4727443 185717 DIETARY & OTHER SUPPLIE 3040391 3040391 2819144 1408117 1411027 97816597 64728484 33088113 0 18646508 13464365 3042447 3060108 8787619 12445513 6166400 6966400 214 665 633829 558689 124782441 47544453 58114981 77237988 5076075 11710284 12417850 12734625 3570688 1360687 116456611 139539324 7712754 11495077 46385037 62101378 54097791 73596455 X 62358820 65942869 62358820 65942869 116456611 139539324 X 584049 3000000 X X 0 1 X 1 0 X 81053463 85513673 90602490 89761716 97450330 444381672 81053463 85513673 90602490 89761716 97450330 444381672 0 0 0 444381672 273610 59332 369064 281291 333311 1316608 116132 143636 91356 129808 480932 273610 175464 512700 372647 463119 1797540 285543 266644 369064 901586 322195 2145032 81612616 85955781 91484254 91035949 98235644 448324244 0.99120 0.99150 0.00400 0.00330 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 285,543. 2015 AMOUNT: $ 266,644. 2016 AMOUNT: $ 369,064. 2017 AMOUNT: $ 901,586. 2018 AMOUNT: $ 322,195. 8995292 8995292 91810557 28344430 63466127 9620453 8333371 1287082 14356139 10866652 3489487 77237988 INVESTMENT IN DIGNITY CARE 4000000 C INVESTMENT IN CAMELOT 2634209 C INVESTMENTS 5076075 C 11710284 X PART X, LINE 2: MANAGEMENT IS A C-CORPORATION FOR INCOME TAX PURPOSES AND INCOME TAX EXPENSE IS CALCULATED BASED ON THE LIABILITY METHOD. DURING THE YEAR ENDED JUNE 30, 2019 THERE WERE NO DIFFERENCES BETWEEN THE BOOK BASIS AND THE TAX BASIS OF MANAGEMENT'S ASSETS AND LIABILITIES, AND THEREFORE THERE WERE NO DEFERRED TAX ASSETS OR LIABILITIES RECORDED AT JUNE 30, 2019. INCOME TAX EXPENSE OF $221,900 WAS RECORDED IN MISCELLANEOUS (EXPENSE) INCOME ON THE CONSOLIDATED STATEMENTS OF REVENUES, EXPENSES AND CHANGES IN NET ASSETS DURING THE YEAR ENDED JUNE 30, 2019. NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS OTHER THAN FOR MANAGEMENT. THE INTERNAL REVENUE SERVICE HAS DETERMINED THAT COMMCARE CORPORATION AND ITS NONPROFIT SUBSIDIARIES QUALIFY AS 503(C)(3) ORGANIZATIONS AND ARE EXEMPT FROM INCOME TAXES. THE COMPANY'S FOR PROFIT SUBSIDIARIES, OTHER THAN MANAGEMENT, HAVE ELECTED TO BE TAXED AS PARTNERSHIPS AND ALL INCOME FLOWS THROUGH TO THE INDIVIDUAL MEMBERS. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE AN ORGANIZATION TO ACCOUNT FOR UNCERTAINTIES IN INCOME TAXES. THE INTERPRETATION REQUIRES RECOGNITION AND MEASUREMENT OF UNCERTAIN INCOME TAX POSITIONS USING A "MORE-LIKELY-THAN-NOT" APPROACH. THE COMPANY HAS REVIEWED ITS TAX POSITIONS AND DETERMINED THERE WERE NO OUTSTANDING OR RETROACTIVE TAX POSITIONS WITH LESS THAN A 50% LIKELIHOOD OF BEING SUSTAINED UPON EXAMINATION OF TAXING AUTHORITIES. X X X X X 1 0 0 0 0 0 0 1 0 JOHN STASSI II PRESIDENT/CEO/EMPLOYEE 0 0 0 0 300000 0 0 0 0 0 300000 0 0 0 DAWN HARVEY SECRETARY (NON-VOTING) 110416 96962 50689 0 0 0 0 0 16833 0 177938 96962 0 0 JON GOUX CFO 75481 69897 33000 0 0 0 0 0 15624 0 124105 69897 0 0 JAMES TUCKER PRESIDENT/DIRECTOR/CEO 252913 236453 164500 0 15000 0 0 0 27029 0 459442 236453 0 0 GEORGE E GARDNER S. VICE PRESIDENT/COO 153071 147157 67738 0 0 0 0 0 21653 0 242462 147157 0 0 DONNA L BEAUBOUEF MARKET MANAGER 82944 74900 24985 0 0 0 0 0 23525 0 131454 74900 0 0 ROBERT BAUDER MARKET MANAGER 119108 51746 0 0 0 0 0 0 19438 0 138546 51746 0 0 JOHNNIE ECCLES QI NURSE 70383 61604 22827 0 0 0 0 0 12670 0 105880 61604 0 0 MARY HUDSON CONTROLLER 78968 71468 37500 0 0 0 0 0 13879 0 130347 71468 0 0 LISA GARDNER VICE PRESIDENT MARKETING 67966 59520 31556 50 0 0 0 0 12415 0 111937 59570 0 0 REBECCA GUTHIER VICE PRESIDENT NURSING 70082 74761 35740 0 0 0 0 0 23442 0 129264 74761 0 0 HOWARD SADLER ADMINISTRATOR 116619 0 19144 0 0 0 0 0 15110 0 150873 0 0 0 VANESSA HOUCK ADMINISTRATOR 107521 0 31707 0 0 0 0 0 12174 0 151402 0 0 0 DONISE BOSCARENO ADMINISTRATOR 117554 0 31679 0 0 0 0 0 2181 0 151414 0 0 0 L RENE' GOUX FORMER VICE-PRESIDENT/DIRECTOR 47040 0 54600 0 2500 0 273750 0 3557 0 381447 0 0 0 PART I, LINE 3 SUBSCRIBE TO ANNUAL COMPENSATION SURVEYS BY HCCS. COMPENSATION IS REVIEWED ANNUALLY BY OUTSIDE DIRECTORS IN COMPARISON WITH INDUSTRY AVERAGES REPORTED BY HCCS. PART I, LINE 4A L. RENE GOUX'S NEGOTIATED SEVERANCE PACKAGE APPROVED BY THE BOARD OF DIRECTORS. PART I, LINE 7 MERIT BONUSES AT THE DISCRETION OF MANAGEMENT AND BOARD OF DIRECTORS. A LOUISIANA PUBLIC FACILITIES AUTHORITY 720895871 000000000 2016-06-01 41808729 REFUNDING OF BONDS ISSUED 07/29/2015 0 0 0 B LOUISIANA PUBLIC FACILITIES AUTHORITY 720895871 000000000 2016-06-30 1512000 ACQUISITION 0 0 0 A 4685796 41808729 41808729 2011 1 0 1 1 B 84000 1512000 1512000 2018 0 0 0 1 A 0 1 0 0 0.21000 0.21000 0 0 1 B 0 0 0 0 0 0 1 A 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 L RENE GOUX FORMER: DIRECTOR/VICE PRESIDENT/COO/EMPLOYEE 381447 SEVERANCE PACKAGE AS APPROVED BY THE BOARD OF DIRECTORS. 0 JON GOUX SON OF L. RENE GOUX 124064 EMPLOYEE WAGES 0 LISA GARDNER SPOUSE OF GEORGE GARDNER 111936 EMPLOYEE WAGES 0 GEORGE GARDNER SPOUSE OF LISA GARDER 242461 EMPLOYEE WAGES 0 FORM 990, PART VI, SECTION A, LINE 2 AN OFFICER HAS A FAMILY RELATIONSHIP WITH A FORMER OFFICER ON THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 3 DURING THE YEAR ENDED JUNE 30, 2019 THE COMPANY FORMED A WHOLLY OWNED SUBSIDIARY COMMCARE MANAGEMENT CORPORATION, MANAGEMENT IS FORMED TO MANAGE SKILLED NURSING FACILITIES BOTH OWNED BY THE COMPANY AND BY THIRD PARTY ENTITIES. ALL MANAGEMENT FEES ASSESSED TO ENTITIES WITH COMMON OWNERSHIP ARE ELIMINATED THROUGH CONSOLIDATION OF THE FINANCIAL STATEMENTS. MANAGEMENT FEE INCOME OF $649,184 FOR THE YEAR ENDED JUNE 30, 2019, REPRESENTS FEES EARNED THROUGH THE MANAGEMENT OF THIRD PARTY OWNED SKILLED HOMES. FORM 990, PART VI, SECTION B, LINE 11B REVIEWED BY MANAGEMENT, WHO ARE ALSO PART OF THE GOVERNING BOARD, THEN REVIEWED BY ALL OF THE GOVERNING BOARD AT AN OPEN MEETING. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, WHO ARE MEMBERS OF THE BOARD OF DIRECTORS, CERTIFY ANNUALLY THAT THEY HAVE READ, UNDERSTAND, AND WILL COMPLY WITH THE COMPLIANCE POLICY, WHICH CONTAINS CONFLICT OF INTEREST PROVISIONS AND A QUESTIONNAIRE REGARDING CONFLICTS OF INTEREST. ANY NOTED CONFLICTS WILL CAUSE A PERSON TO ABSTAIN FROM VOTE. FORM 990, PART VI, SECTION B, LINE 15 SUBSCRIBE TO ANNUAL COMPENSATION SURVEYS BY HCCS. COMPENSATION IS REVIEWED ANNUALLY BY OUTSIDE DIRECTORS IN COMPARISON WITH INDISTRY AVERAGES REPOTRED BY HCCS. FORM 990, PART VI, SECTION C, LINE 19 ALL INFORMATION IS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CONTRIBUTION FROM COMMCARE LOUISIANA, INC. 3,000,000. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE IT'S OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. 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