2019-10-30T13:31:03-05:00 2019-06-30 593070669 MOORE STEPHENS LOVELACE PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2018-07-01 590624420 PENNEY RETIREMENT COMMUNITY INC PENN 9042848200 PO BOX 555 PENNEY FARMS FL 320790555 TERESA SCOTT PRESIDENT 9042848200 2019-10-29 1 NORMAN B NEAL CPA P00071411 4077405400 104.178.77.115 2019-10-29 15:06:35 ED P AA06F16595B971911646E1ABD4EF9FD1205D715B 7FC0E18F63597829422D687723989F114BEB8769 2018 2019-02-21 02:37:17Z TERESA SCOTT PO BOX 555 PENNEY FARMS FL 320790555 15072610 0 X WWW.PENNEYRETIREMENTCOMMUNITY.ORG X 1965 FL PENNEY RETIREMENT COMMUNITY SERVES SENIORS WHO DESIRE TO LIVE THE FINAL THIRD OF THEIR LIVES IN A CHRISTIAN ENVIRONMENT. PROGRAMS AND SERVICES, INCLUDING HEALTH CARE, ARE PROVIDED TO ENHANCE DAILY LIVING AND DIMINISH FEARS OF THE FUTURE. 17 17 282 346 0 0 2347104 746643 12707454 13841316 1544540 369476 149821 56037 16748919 15013472 0 1500 0 0 6643732 6806663 0 0 54618 6559194 7118895 13202926 13927058 3545993 1086414 57188348 57516616 39762781 39164435 17425567 18352181 PENNEY IS AN INCLUSIVE CHRISTIAN CONTINUING CARE RETIREMENT COMMUNITY SEEKING THE ABUNDANT LIFE THROUGH SOCIAL INTERACTION AND SERVICE. 0 0 12457515 1500 13905972 THE ORGANIZATION PROVIDES HOUSING, HEALTH CARE AND OTHER RELATED SERVICES THROUGH THE OPERATION OF A RETIREMENT COMMUNITY. THE COMMUNITY INCLUDES 297 APARTMENTS, COTTAGES AND HOMES, A 20-BED MEMORY CARE CENTER, 55 INDEPENDENT LIVING UNITS OFFERING ASSISTIVE SERVICES AND A LICENSED SKILLED NURSING CENTER WITH A CAPACITY OF 40 RESIDENTS. THE COMMUNITY ALSO INCLUDES RECREATIONAL AMENITIES, INCLUDING A NINE-HOLE GOLF COURSE, INDOOR SWIMMING POOL, FITNESS CENTER, ART STUDIO, CRAFTS FACILITIES, LIBRARIES AND DINING FACILITIES. 12457515 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 79 0 1 282 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X TERESA SCOTT 9042848200 PO BOX 555 PENNEY FARMS FL 32079 BERT VAN ROYAL DIRECTOR/CHAIRMAN 2.00 0.00 X X 0 0 0 VERNON K SMITH PHD DIRECTOR/FIRST VICE CHAIR 2.00 0.00 X X 0 0 0 ALISON E HICKMAN DIRECTOR/SECOND VICE CHAIR 2.00 0.00 X X 0 0 0 DARIN C ROARK BSN MBA RN DIRECTOR/TREASURER 2.00 0.00 X X 0 0 0 EVELYN DOLLY HILLMAN SECRETARY 2.00 0.00 X X 0 0 0 STANLEY BISHOP DIRECTOR 2.00 0.00 X 0 0 0 RON COLEMAN DIRECTOR 2.00 0.00 X 0 0 0 WILLIAM COURTNEY DIRECTOR 2.00 0.00 X 0 0 0 MARTHA GALE DIRECTOR 2.00 0.00 X 0 0 0 JAMES KNIGHT DIRECTOR 2.00 0.00 X 0 0 0 JIMMY LOVELACE DIRECTOR 2.00 0.00 X 0 0 0 JENNIFER MORTON DIRECTOR 2.00 0.00 X 0 0 0 CHAD PATRICK DIRECTOR 2.00 0.00 X 0 0 0 SUSAN PONDER-STANSEL DIRECTOR 2.00 0.00 X 0 0 0 DR WILLIAM L PROCTOR DIRECTOR 2.00 0.00 X 0 0 0 DAVID J QUIRK DIRECTOR 2.00 0.00 X 0 0 0 JAMES JB RENNINGER DIRECTOR 2.00 0.00 X 0 0 0 CYNTHIA RUSSELL DIRECTOR 2.00 0.00 X 0 0 0 HELEN STEPHENS DIRECTOR 2.00 0.00 X 0 0 0 GEORGE D WEST DIRECTOR 2.00 0.00 X 0 0 0 DAVID A MCINNIS DIRECTOR 2.00 0.00 X 0 0 0 PAUL SABIN DIRECTOR 2.00 0.00 X 0 0 0 WARREN STEVENSON DIRECTOR 2.00 0.00 X 0 0 0 WILLIAM WATERSON DIRECTOR 2.00 0.00 X 0 0 0 CHANCE IRVINE DIRECTOR 2.00 0.00 X 0 0 0 CATHERINE PARROT DIRECTOR 2.00 0.00 X 0 0 0 JAMES CHESTER DIRECTOR 2.00 0.00 X 0 0 0 TERESA SCOTT PRESIDENT/CHIEF EXECUTIVE 40.00 0.00 X 167682 0 13743 WILLIAM D FISH CHIEF FINANCIAL OFFICER 40.00 0.00 X 113634 0 15803 281316 0 29546 2 0 1 0 SAUER INC 9728-1 FL MINING BLVD WEST JACKSONVILLE FL 32257 CONSTRUCTION CONTRACTOR 4965109 STEVENSON CONSTRUCTION COMPANY INC PO BOX 1178 STARKE FL 32091 CONSTRUCTION CONTRACTOR 1555538 FUNCTIONAL PATHWAYS 10133 SHERRILL BLVD SUITE 200 KNOXVILLE TN 37932 PATIENT THERAPY 616106 WORLD ELECTRIC SUPPLY INC PO BOX 741020 ATLANTA GA 30374 ELECTRICAL WORK 233209 XGRASS PO BOX 846 DALTON GA 30722 CONTRACTOR 226663 5 17709 3200 725734 746643 RESIDENT SERVICE 623000 9896746 9896746 EARNED ENTRANCE FEES 623000 2523189 2523189 RESIDENT SERVICE - OTH 623000 1421381 1421381 13841316 419995 419995 50519 -50519 -50519 -50519 0 17709 8619 -8619 -8619 MISCELLANEOUS INCOME 900099 34134 34134 TRANSPORTATION INCOME 900099 30522 30522 64656 15013472 13905972 0 360857 1500 1500 320376 320376 5171720 4607333 564288 99 209309 186137 23172 684786 637616 44804 2366 420472 362061 58411 911696 785053 126643 23661 23661 91584 22940 68644 2600403 2573715 25418 1270 2099 460 1572 67 321864 313335 8529 2295968 2228927 67041 201532 184888 16644 SUPPLIES AND EQUIPMENT 581061 483419 46947 50695 BAD DEBT EXPENSE 33558 33558 EMPLOYEE RELATED EXPENS 17121 10610 6487 24 MEDICARE/MEDICAID EXPEN 16656 16656 21692 9307 12288 97 13927058 12457515 1414925 54618 466182 555185 617848 698880 1468892 1938652 121393 130257 37055 43178 70264127 30756311 30253023 39507816 24067091 14642648 156864 0 57188348 57516616 1271786 1258479 23728065 25238264 12675134 10199219 2087796 2468473 39762781 39164435 X 13922380 15268069 3503187 3084112 17425567 18352181 57188348 57516616 1086414 -159800 0 X X 0 1 X 1 0 X 1597661 540671 961357 2347104 746643 6193436 11437652 11600081 12117395 12707454 13841316 61703898 13035313 12140752 13078752 15054558 14587959 67897334 0 432534 915400 413876 733209 1115849 3610868 432534 915400 413876 733209 1115849 3610868 64286466 168108 179330 211736 308123 419995 1287292 168108 179330 211736 308123 419995 1287292 52377 39777 95740 149821 64662 402377 13255798 12359859 13386228 15512502 15072616 69587003 0.92380 0.92980 0.01850 0.01550 X 1593951 60103 1654054 1476354 117597 1593951 1361189 115165 1476354 1262325 98864 1361189 1278025 -15700 1262325 1.00000 0 0 2857555 2857555 51094856 27189424 23905432 4853402 3566887 1286515 11458314 11458314 39507816 CASH AND CASH EQUIVALENTS 1991076 F U.S. GOVERNMENT AND AGENCY OBLIGATIONS 5866096 F DEBT SECURITIES 2078103 F MUTUAL FUNDS - EQUITY SECURITIES 1406334 F MUTUAL FUNDS - DEBT SECURITIES 2782806 F BOND FUNDS 518233 F 14642648 DEPOSITS 234400 CHARITABLE ANNUITY OBLIGATION 175057 ACCRUED GIFT BONDS 1610022 INTEREST RATE SWAP AGREEMENT 448994 2468473 14352099 -179800 -179800 14531899 481573 481573 15013472 13440059 0 13440059 486999 486999 13927058 PART V, LINE 4: THE COMMUNITY'S SPENDING POLICY OBJECTIVE IS TO PROTECT THE VALUE AND GROW THE ENDOWMENT FUNDS TO PROVIDE FUTURE CASH FLOWS FOR OPERATONS, GIFT BOND REDEMPTIONS AND OTHER STIPULATED PURPOSES. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESIDENTS AID FUND OF PRC, LLC - TOTAL REVENUE 129,234. ASSOCIATION OF PRC RESIDENTS, LLC - TOTAL REVENUE 352,339. PART XII, LINE 4B - OTHER ADJUSTMENTS: RESIDENTS AID FUND OF PRC, LLC - TOTAL EXPENSES 160,782. ASSOCIATION OF PRC RESIDENTS, LLC - TOTAL EXPENSES 326,217. CIRCLE OF FAMILY AND FRIENDS 17709 17709 1182 4510 2927 17709 17709 1182 4510 2927 8619 -8619 X X X 0 0 0 0 0 0 0 0 0 TERESA SCOTT PRESIDENT/CHIEF EXECUTIVE 167682 0 0 0 0 0 8483 0 5260 0 181425 0 0 0 A CLAY COUNTY DEVELOPMENT AUTHORITY 596583087 2017-12-07 13355113 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 459025 13355113 2762691 267102 10325319 173546 2018 0 0 0 0 A 0 0 0 0 0 0 0 A 0 1 0 0 1 1 BRANCH BANKING AND TRUST COMPANY 12.000000000000 0 0 0 0 0 A 0 SCHEDULE K, ROW A, PART I (F) IN DECEMBER 2017, THE CLAY COUNTY DEVELOPMENT AUTHORITY ISSUED ON BEHALF OF THE COMMUNITY, A $13,355,113 HEALTHCARE FACILITIES AND IMPROVEMENT REVENUE BOND, SERIES 2017 ("SERIES 2017 BOND") TO PAY FOR THE CONSTRUCTION OF A NEW 50-BED SKILLED NURSING FACILITY, TO FUND AN ESCROW ACCOUNT TO DEFEASE THE PREVIOUS BONDS, AND TO PAY CERTAIN COSTS OF ISSUING THE SERIES 2017 BOND. THE SERIES 2017 BOND WAS PURCHASED BY A FINANCIAL INSTITUTION. THE SERIES 2017 BOND HAS A VARIABLE INTEREST RATE EQUAL TO 82.6% OF LIBOR PLUS .91%, ADJUSTED FOR ANY CHANGE IN THE HIGHEST CORPORATE INCOME TAX RATE SUBSEQUENT TO ISSUANCE, (2.93% AT JUNE 30, 2019). PRINCIPAL AND INTEREST PAYMENTS ON THE SERIES 2017 BOND ARE PAYABLE MONTHLY THROUGH MATURITY IN DECEMBER 2042. THE COMMUNITY ENTERED INTO A VARIABLE-TO-FIXED INTEREST RATE SWAP AGREEMENT TO EFFECTIVELY FIX THE ANNUAL INTEREST RATE OF THE SERIES 2017 BOND AT 3.018%. WARREN W STEVENSON BOARD OF DIRECTORS MEMBER 1555538 NEW HOME CONSTRUCTION AND COTTAGE RENOVATIONS 0 FORM 990, PART VI, SECTION B, LINE 11B PER PRC POLICY, THE BOARD CHAIRMAN WILL REVIEW THE ENTIRE FORM 990 WITH ALL BOARD MEMBERS BEFORE IT IS FILED WITH THE IRS. THE CHAIRMAN WILL CONFIRM IN WRITING THAT THE 990 WAS REVIEWED. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO AFFIRM ANNUALLY IN WRITING THAT THEY ARE NOT AWARE OF ANY CONFLICTS OF INTEREST WITHIN THE ORGANIZATION. EMPLOYEES SIGN THAT THEY HAVE READ THE POLICY UPON HIRE. THE POLICY IS REVIEWED PERIODICALLY. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION'S COMPENSATION POLICY REQUIRES THE PRESIDENT'S COMPENSATION BE DETERMINED BY THE DIRECTORS USING COMPARABILITY DATA GATHERED FROM OTHER RETIREMENT COMMUNITIES. ALL DIRECTORS ARE INDEPENDENT WITH REGARD TO THE COMPENSATION AND THE DELIBERATION AND DECISION ARE DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE AT THE CORPORATE OFFICE UPON REQUEST. FORM 990, PART XII, LINE 2C OVERSIGHT OF THE AUDIT: THE ORGANIZATION'S AUDIT COMMITTEE IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT AUDIT FIRM AND OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. ASSOCIATION OF PENNEY RETIREMENT COMMUNITY RESIDENTS LLC PO BOX 555 PENNEY FARMS FL 32079 273142533 SUPPORT THE RESIDENTS OF PENNEY RETIREMENT COMMUNITY FL 352340 302539 PENNEY RETIREMENT COMMUNITY RESIDENTS' AID FUND OF PENNEY RETIREMENT COMMUNITY LLC PO BOX 555 PENNEY FARMS FL 32079 273456236 SUPPORT THE RESIDENTS OF PENNEY RETIREMENT COMMUNITY FL 133275 458048 PENNEY RETIREMENT COMMUNITY