2018-11-15T14:31:51-06:00 2017-12-31 593070669 MOORE STEPHENS LOVELACE PA 201 EAST KENNEDY BLVD SUITE 650 TAMPA FL 33602 990 2017-01-01 591031820 PLYMOUTH HARBOR INC PLYM 9413652600 700 JOHN RINGLING BLVD SARASOTA FL 34236 HARRY E HOBSON PRESIDENT/CEO 9413652600 2018-11-15 1 KURT A ALTER CPA P00059492 8133142600 64.132.121.122 2018-11-15 15:30:17 ES P AA06F16595B971911646E1ABD4EF9FD1205D715B AA06F16595B971911646E1ABD4EF9FD1205D715B 2017 2018-06-14 16:35:46Z HARRY E HOBSON 700 JOHN RINGLING BLVD SARASOTA FL 34236 27863752 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. 15 15 401 45 0 0 2461095 1385852 23993495 25305768 194996 153096 397379 812020 27046965 27656736 0 15500 0 0 12136433 12803377 0 0 182447 12073194 12619240 24209627 25438117 2837338 2218619 82746008 129617822 69169314 100063580 13576694 29554242 X 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 14045304 15500 18727188 SENIOR ADULT LIVING SERVICE - CARING FOR SENIOR ADULTS THROUGH THE OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF APPROXIMATELY 214 INDEPENDENT APARTMENT UNITS AND 60 ASSISTED LIVING APARTMENT UNITS AND A LICENSED HOME HEALTH AGENCY THAT SERVICES SENIOR ADULTS IN THEIR OWN HOME. 5049875 4695581 SENIOR ADULT HEALTH CARE CENTER SERVICE - PROVIDES SKILLED NURSING SERVICES TO THE ELDERLY IN ITS 56 BED SKILLED NURSING CENTER. 3546478 2502038 SENIOR ADULT DIETARY SERVICE - SERVICING THE DIETARY NEEDS OF SENIOR ADULTS AT THE CONTINUING CARE RETIREMENT COMMUNITY. 0 0 THE LEGACY FUND PROVIDES SUPPORT - FOR OPERATING AND MAINTAINING A LIFE CARE FACILITY AIDING NEEDY RESIDENTS OF THE CORPORATION. 32195 1625612 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. 32195 1625612 22673852 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 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 82 0 1 401 1 0 0 0 0 0 0 0 0 0 0 X 15 15 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 BRIAN HALL CHAIRMAN 1.00 2.00 X X 0 0 0 CINDY MALKIN VICE CHAIRMAN 1.00 2.00 X X 0 0 0 NORA PATTERSON SECRETARY 1.00 2.00 X X 0 0 0 WILLIAM WOELTJEN TREASURER 1.00 2.00 X X 0 0 0 TOM BELCHER TRUSTEE 1.00 2.00 X 0 0 0 KATHRYN ANGELL CARR TRUSTEE 1.00 2.00 X 0 0 0 JOHN CRANOR III TRUSTEE 1.00 2.00 X 0 0 0 LEE DELIETO SR TRUSTEE 1.00 2.00 X 0 0 0 TOM ELLIOTT TRUSTEE 1.00 2.00 X 0 0 0 ALAN GRINDAL TRUSTEE 1.00 2.00 X 0 0 0 JAMES MCGEE TRUSTEE 1.00 2.00 X 0 0 0 CADE SIBLEY TRUSTEE 1.00 2.00 X 0 0 0 JON SWIFT TRUSTEE 1.00 2.00 X 0 0 0 MARIE UNDERWOOD TRUSTEE 1.00 2.00 X 0 0 0 DALE WOODLING TRUSTEE 1.00 2.00 X 0 0 0 HARRY E HOBSON PRESIDENT/CEO 38.00 2.00 X 302379 0 15818 GARRY H JACKSON SR. VICE PRESIDENT/CFO 38.00 2.00 X 174415 0 14309 GORDON OKAWA VP OF MARKETING/COMMON AFF 40.00 X 116386 0 8722 JOSEPH DEVORE VP OF HEALTH SERVICES 40.00 X 158291 0 8208 REBECCA PAZKOWSKI VP OF PHILANTHROPY 40.00 X 145080 0 9622 ELIZABETH SPARR RESIDENCY SALES COUNSELOR 40.00 X 112102 0 6106 HOLLY J WILLIAMS RESIDENCY SALES COUNSELOR 40.00 X 114533 0 5980 TENA WILSON VP OF RESIDENT SERVICES 40.00 X 108222 0 8562 DINAH STAMP ADMINISTRATOR OF DESIGN AN 40.00 X 107298 0 8376 1338706 0 85703 9 0 1 0 WILLIS A SMITH CONSTRUCTION 5001 LAKEWOOD RANCH BLVD N SARASOTA FL 34240 CONSTRUCTION 4524288 THW DESIGN 2100 RIVEREDGE PKWY SUITE 900 ATLANTA GA 30328 ARCHITECTS 1219008 FUNCTIONAL PATHWAYS OF TENNESSEE 10133 SHERRILL BLVD SUITE 200 KNOXVILLE TN 37932 REHABILITATION SERVICES 313531 WBRC ARCHITECTS ENGINEERS INC 44 CENTRAL STREET BANGOR ME 04401 ARCHITECTS 131958 PLYMOUTH COIFFURES 700 JOHN RINGLING BLVD SARASOTA FL 34236 BEAUTY SALON 122604 5 1385852 1385852 MONTHLY SERVICE FEES 623000 18126151 18126151 ENTRANCE FEES 623000 7179617 7179617 25305768 220485 220485 139627 0 207016 139627 -207016 -67389 -67389 CAPITAL REIMBURSEMENTS 623000 812020 812020 812020 27656736 26117788 0 153096 15500 15500 529607 165234 364373 9500456 8572867 826033 101556 178268 146355 28581 3332 1877507 1771138 100854 5515 717539 647687 62859 6993 57825 57825 46500 46500 50072 50072 1335786 844368 488593 2825 201963 39740 159095 3128 358983 197081 133412 28490 66517 13029 53488 1700092 1692013 8079 15194 8079 4946 2169 5248840 5243543 5297 719900 694900 25000 FOOD & FOOD PRODUCTS 1009300 1009285 15 MEDICAL, OXYGEN & DRUGS 493711 493711 SUPPLIES 404435 293771 108227 2437 LINENS & UNIFORMS 215638 214981 657 694484 560498 107984 26002 25438117 22673852 2581818 182447 738823 607084 73396 110818 2861978 1820631 70130 69101 604357 490790 136107089 51089956 61668552 85017133 16582139 41373249 146633 129016 82746008 129617822 2296771 3514978 52140946 60275412 13153687 35000000 1577910 1273190 69169314 100063580 X 11341297 25853874 2235397 3609838 0 90530 13576694 29554242 82746008 129617822 X 2218619 142470 13616459 X X 0 1 X 1 0 X 111706 21908 922308 2461095 1385852 4902869 21015649 21956426 23813539 23993495 25305768 116084877 21127355 21978334 24735847 26454590 26691620 120987746 0 0 0 120987746 130173 116098 115907 149637 220485 732300 130173 116098 115907 149637 220485 732300 154625 397379 812020 1364024 21257528 22094432 25006379 27001606 27724125 123084070 0.98300 0.98920 0.00590 0.00590 X 1 430 144 286 0 12161627 90530 1654560 0 13906717 11477104 547064 233621 96162 12161627 11630413 262873 374487 41695 11477104 11136519 300238 301156 53379 54121 11630413 10472006 228067 1048525 563003 49076 11136519 0.99350 0.00650 0.00000 0 1 1 273228 273228 93337434 35106161 58231273 6873594 2585302 4288292 35622833 13398493 22224340 85017133 CASH AND CASH EQUIVALENTS 16141944 F ACCRUED INTEREST 57094 F CORPORATE BONDS 2846610 F U.S. GOVERNMENT OBLIGATIONS 3023393 F MUTUAL FUNDS 13261542 F CERTIFICATE OF DEPOSITS 1004600 F CORPORATE STOCK 5038066 F 41373249 ENTRANCE FEE DEPOSITS 320500 INTEREST RATE SWAP 676024 EMPLOYEE BENEFIT LIABILITY 276666 1273190 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. 0 SCHOLARSHIPS 8 15500 FAIR MARKET VALUE X 1 1 X X X X 0 1 0 0 0 0 0 0 0 HARRY E HOBSON PRESIDENT/CEO 302379 0 0 0 0 0 7939 0 7879 0 318197 0 0 0 GARRY H JACKSON SR. VICE PRESIDENT/CFO 174415 0 0 0 0 0 6430 0 7879 0 188724 0 0 0 JOSEPH DEVORE VP OF HEALTH SERVICES 158291 0 0 0 0 0 5373 0 2835 0 166499 0 0 0 REBECCA PAZKOWSKI VP OF PHILANTHROPY 145080 0 0 0 0 0 4769 0 4853 0 154702 0 0 0 PART I, LINE 4B PLYMOUTH HARBOR, INC. HAS AN EMPLOYEE DEFERRED COMPENSATION PLAN OPEN TO CERTAIN KEY EMPLOYEES UNDER INTERNAL SECTION 457(F) THAT IS A NON-TAX QUALIFIED RETIREMENT PLAN. THESE FUNDS REMAIN THE PROPERTY OF PLYMOUTH HARBOR, INC. THE ORGANIZATION HAS A FIDUCIARY DUTY OF ACCOUNTABILITY FOR THESE FUNDS. KEY EXECUTIVE (HARRY HOBSON, CEO) PARTICIPATES IN THE DEFERRED COMPENSATION PLAN UNDER IRC SEC. 457(F); HOWEVER, HE DID NOT RECEIVE ANY CURRENT YEAR PAYMENTS FROM THE PLAN. THE TERMS AND CONDITIONS OF THE PLAN ARE AS FOLLOWS: THE VESTED DATE SHALL BE JANUARY 1, 2018 AT WHICH TIME THE CEO CAN RECEIVE THE BENEFIT IN FULL. IF THE CEO RESIGNS OR OTHERWISE TERMINATES EMPLOYMENT PRIOR TO THE VESTING DATE, OR EMPLOYMENT IS TERMINATED BY THE EMPLOYER FOR CAUSE PRIOR TO THE VESTING DATE, THE CEO SHALL NOT BE ENTITLED TO ANY OF THE BENEFIT. IF EMPLOYMENT IS TERMINATED BY THE EMPLOYER OTHER THAN FOR CAUSE OR REASON OF DEATH OR PERMANENT DISABILITY OF THE CEO, THE CEO (OR HIS ESTATE, IN THE CASE OF DEATH) SHALL BE ENTITLED TO RECEIVE THE ENTIRE BENEFIT ACCRUED TO THE DATE OF TERMINATION. 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 SWAP AGREEMENT -225,684. NET UNREALIZED GAIN (LOSS) ON GIFT ANNUITIES 25,956. TRANSFER OF NET ASSETS FROM PLYMOUTH HARBOR ENDOWMENT FUND 13,816,187. 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 1625612 5652653 PLYMOUTH HARBOR INC PLYMOUTH HARBOR ENDOWMENT FUND 700 JOHN RINGING BLVD SARASOTA FL 34236 596231811 SUPPORT FOR PLYMOUTH HARBOR FACILITY FL 501(C)(3) LINE 12C, III-FI PLYMOUTH HARBOR INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0