2019-04-15T14:48:27-05:00 2018-06-30 721396621 CARR RIGGS & INGRAM LLC 1601 2ND AVENUE EAST ONEONTA AL 35121 990 2017-07-01 630386404 EPISCOPAL FOUNDATION OF JEFFERSON COUNTY EPIS 2059561831 4941 MONTEVALLO ROAD BIRMINGHAM AL 35210 MICHAEL FAULKNER CFO 2059561831 2019-04-15 1 JOSEPH B MCCURLEY P00611915 2056253472 2019-04-15 72.243.182.2 2019-04-15 08:58:19 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 97D60A56E9095C430832F2C6B925065C0803164D 2017 2019-02-21 02:37:17Z MICHAEL FAULKNER 4941 MONTEVALLO ROAD BIRMINGHAM AL 35210 21919204 0 X STMARTINSINTHEPINES.ORG X 1957 AL THE MISSION OF ST MARTIN'S IN THE PINES IS TO SERVE GOD THROUGH A MINISTRY THAT PROVIDES A CONTINUUM OF CARE AND QUALITY OF LIFE TO AGING INDIVIDUALS AND THEIR FAMILIES. WE DO THIS BY PROVIDING LONG TERM CARE SERVICES AND SUPPORTS TO THE ELDERS OF JEFFERSON COUNTY, ALABAMA. REVENUES GENERATED FROM THESE SERVICES AND SUPPORTS ARE PAID BY PRIVATE CARE FUNDS, MEDICAID, MEDICARE, PRIVATE INSURANCE AND THE VETERANS ADMINISTRATION. SERVICES ARE PROVIDED ON A PLEASANT SUBURBAN SITE AND IN A HOME LIKE ENVIRONMENT WHENEVER POSSIBLE. WE PROVIDE HOUSING AND HOME CARE SERVICES TO APPROXIMATELY 400 ELDERS AND CLIENTS DAILY. 13 13 654 50 0 0 170920 214774 20081750 21180696 15491 60119 472824 463615 20740985 21919204 0 0 0 0 11807197 13037943 0 0 0 9575422 9358308 21382619 22396251 -641634 -477047 34922037 35588872 22587166 23479702 12334871 12109170 SEE SCHEDULE O 0 0 21060374 21704430 THE MISSION OF ST MARTIN'S IN THE PINES IS TO SERVE GOD THROUGH A MINISTRY THAT PROVIDES A CONTINUUM OF CARE AND QUALITY OF LIFE TO AGING INDIVIDUALS AND THEIR FAMILIES. WE DO THIS BY PROVIDING LONG TERM CARE SERVICES AND SUPPORTS TO THE ELDERS OF JEFFERSON COUNTY, ALABAMA. REVENUES GENERATED FROM THESE SERVICES AND SUPPORTS ARE PAID BY PRIVATE CARE FUNDS, MEDICAID, MEDICARE, PRIVATE INSURANCE AND THE VETERANS ADMINISTRATION. SERVICES ARE PROVIDED ON A PLEASANT SUBURBAN SITE AND IN A HOME LIKE ENVIRONMENT WHENEVER POSSIBLE. WE PROVIDE HOUSING AND HOME CARE SERVICES TO APPROXIMATELY 400 ELDERS AND CLIENTS DAILY. 21060374 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 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 60 0 1 654 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL FAULKNER 2059561831 4941 MONTEVALLO ROAD BIRMINGHAM AL 35210 JAMES C THOMPSON CHAIRMAN 0.00 X 0 0 0 CURTIS O LILES III SECRETARY 0.00 X 0 0 0 TRAVIS MCGOWIN TREASURER 0.00 X 0 0 0 FRANKLIN BRADFORD CHAIRMAN-ELECT 0.00 X 0 0 0 PATSY DREHER DIRECTOR 0.00 X 0 0 0 FRED ELLIOTT DIRECTOR 0.00 X 0 0 0 PAUL GOLDMAN DIRECTOR 0.00 X 0 0 0 PRICE HIGHTOWER DIRECTOR 0.00 X 0 0 0 LAURA MURPHY DIRECTOR 0.00 X 0 0 0 BECKY SMITH DIRECTOR 0.00 X 0 0 0 MARCELLUS L SMITH JR DIRECTOR 0.00 X 0 0 0 REV CHARLES YOUNGSON DIRECTOR 0.00 X 0 0 0 MEMILY COLVIN DIRECTOR 0.00 X 0 0 0 ZACHARY JACOBSEN CEO 40.00 X 236897 0 18612 MIKE FAULKNER CFO 40.00 X 166259 0 24946 ANICA MCDONALD DIRECTOR OF MARKETING 40.00 X 109697 0 12588 NANCY COBB OPS DIRECTOR SENIOR LIVING 40.00 X 121925 0 11279 634778 0 67425 4 0 1 0 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 HOSPITALITY SERVICES 1841773 ST VINCENTS HOME HEALTH 1400 URBAN CENTER DRIVE STE 240 BIRMINGHAM AL 35242 THERAPY SERVICES 870206 TURENNE PHARMEDCO 355 INDUSTRIAL PARK BLVD MONTGOMERY AL 36117 MEDICAL SUPPLIES AND PHARMACY SERVICES 641063 FITE BUILDING COMPANY 3116 SEXTON ROAD DECATUR AL 35603 GENERAL CONTRACTOR 615690 RIVERCHASE CARPET & FLOORING 2130 PELHAM PKWY PELHAM AL 35124 GENERAL CONTRACTOR 243154 11 214774 214774 PROG.SERV.REVENUE-RELATED-990 623000 21180696 21180696 21180696 60119 60119 456772 0 456772 456772 456772 MISC. REVENUE-RELATED-990 900099 6843 6843 6843 21919204 21704430 0 0 403156 403156 10587199 10338422 248777 99644 94032 5612 1157824 1087793 70031 790120 747990 42130 191800 191800 113447 113360 87 132192 46813 85379 89969 50953 39016 61482 21420 40062 570603 570603 1532410 1532410 285550 285550 CONTRACT SERVICES 2351278 2351278 UTILITIES 1049113 1049113 RAW FOOD 1034333 1034333 SUPPLIES 983168 983168 962963 753136 209827 22396251 21060374 1335877 0 216545 104809 1023736 984519 1304336 1249481 126854 112215 105493 94417 54085029 25893042 27518559 28191987 4357275 4598541 154519 138176 114720 114727 34922037 35588872 904569 902252 17552400 17795670 1771452 2219195 2358745 2562585 22587166 23479702 X 11827676 11561205 507195 547965 12334871 12109170 34922037 35588872 -477047 251346 0 X 0 1 X 1 0 X 137522 228236 216320 170920 214774 967772 20208347 20389368 20457582 20081750 21180696 102317743 20345869 20617604 20673902 20252670 21395470 103285515 0 0 0 103285515 64535 60829 -17407 15491 60119 183567 64535 60829 -17407 15491 60119 183567 238386 374056 385202 472824 463615 1934083 20648790 21052489 21041697 20740985 21919204 105403165 0.97990 0.98460 0.00170 0.00120 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2013 AMOUNT: $ 238,386. 2014 AMOUNT: $ 374,056. 2015 AMOUNT: $ 385,202. 2016 AMOUNT: $ 472,824. 2017 AMOUNT: $ 463,615. 235236 235236 42140066 18556409 23583657 1617293 1010049 607244 10092434 6326584 3765850 28191987 REFUNDABLE DEPOSITS 2562585 2562585 X X X X X X 0 1 0 0 0 0 0 0 0 ZACHARY JACOBSEN CEO 210131 0 20833 0 5933 0 0 0 18612 0 255509 0 0 0 MIKE FAULKNER CFO 129292 0 29167 0 7800 0 6338 0 18608 0 191205 0 0 0 A 2015 SERIES BOND 260576198 2015-08-05 19270830 REFI/CONSTRUCTION FACILITY 0 0 0 A 638296 19270830 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 FORM 990, PART VI, SECTION B, LINE 11B THE CFO WILL ENSURE THE FORM 990 IS PREPARED ACCURATELY AND TIMELY. THE CEO WILL REVIEW THE FORM 990 AND THE CFO WILL CERTIFY THE INFORMATION IS CORRECT BY SIGNING THE FORM. THE FINANCE COMMITTEE WILL REVIEW THE FORM PRIOR TO FILING. THE FORM 990 WILL BE DISTRIBUTED TO THE FULL BOARD WITHIN 30 DAYS OF FILING. FORM 990, PART VI, SECTION B, LINE 12C THE POLICIES OF THE FOUNDATION REQUIRE ALL BOARD MEMBERS, OFFICERS AND MANAGEMENT EMPLOYEES PREPARE AND SIGN ANNUAL DOCUMENTS DISCLOSING ANY POTENTIAL CONFLICTS OF INTERESTS. ANY POTENTIAL CONFLICTS ARE REVIEWED AND DISCUSSED BY THE ENTIRE BOARD. ADDITIONALLY THE FOUNDATION POLICY REQUIRES CONTINUAL DISCLOSURE SHOULD CIRCUMSTANCES CHANGE. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION'S POLICIES REQUIRE THE CEO'S COMPENSATION TO BE SET AND MONITORED BY THE BOARD OF DIRECTORS. ADDITIONALLY AN OUTSIDE CONSULTING FIRM PREPARES A PERIODIC STUDY OF COMPENSATION FOR SENIOR MANAGEMENT AND PRESENTS ITS RECOMMENDATIONS TO THE BOARD. FURTHERMORE THE POLICIES REQUIRE THE CEO TO PREPARE COMPENSATION RECOMMENDATIONS FOR SENIOR STAFF FOR THE COMPENSATION COMMITTEE TO REVIEW AND APPROVE. THE COMPENSATION COMMITTEE REVIEWS AND APPROVES COMPENSATION FOR KEY EMPLOYEES ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 INFORMATION RETURNS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. EAST DALE PROPERTIES 4941 MONTEVALLO ROAD BIRMINGHAM AL 35210 REAL ESTATE AL 5699 877374