2018-11-15T17:47:49-06:00 2017-12-31 410746749 CLIFTONLARSONALLEN LLP 5001 SPRING VALLEY ROAD SUITE 600W DALLAS TX 75244 990 2017-01-01 510190369 PRESBYTERIAN VILLAGE NORTH PRES 2143559001 8600 SKYLINE DRIVE DALLAS TX 75243 TIM MALLAD CHIEF EXECUTIVE OFFICER 2143559001 2018-11-15 1 MICHAEL SIEGEL P01587323 9723835700 67.137.57.251 2018-11-15 12:25:38 CS P 286219E15AFA19FAACC75CA249A921020E689FD8 E92CD7272A25738C44ECCB1DDD847714E5C7A195 2017 2019-02-21 02:37:17Z TIM MALLAD 12467 MERIT DRIVE DALLAS TX 75251 45701018 0 X WWW.PRESBYTERIANVILLAGENORTH.ORG X 1980 TX PRESBYTERIAN VILLAGE NORTH (PVN), AS A MEMBER OF THE PRESBYTERIAN COMMUNITIES AND SERVICES FAMILY OF NON-PROFIT ORGANIZATIONS, PLEDGES TO ENRICH THE LIVES OF THOSE IT SERVES BY PROVIDING EXCEPTIONAL CARE AND SERVICES IN A FAITH-BASED CULTURE. PVN, A CONTINUING CARE RETIREMENT COMMUNITY FOUNDED IN 1980 AND LOCATED ON 63 BEAUTIFUL, GARDEN-LIKE ACRES, PROVIDES A FULL RANGE OF RESIDENTIAL CHOICES AND CARE OPTIONS, INCLUDING RESIDENTIAL LIVING, ASSISTED LIVING, SKILLED NURSING, REHABILITATION, AND ALZHEIMER'S, DEMENTIA, AND OTHER LONG-TERM CARE. 5 5 701 210 0 0 3219237 1179561 39272414 44451196 8363 8694 166102 61567 42666116 45701018 747532 720447 0 0 23321287 22022221 0 0 0 17435686 28659805 41504505 51402473 1161611 -5701455 190667106 140882099 128028229 125727376 62638877 15154723 X PRESBYTERIAN VILLAGE NORTH (PVN), AS A MEMBER OF THE PRESBYTERIAN COMMUNITIES AND SERVICES FAMILY OF NON-PROFIT ORGANIZATIONS, PLEDGES TO ENRICH THE LIVES OF THOSE IT SERVES BY PROVIDING EXCEPTIONAL CARE AND SERVICES IN A FAITH-BASED CULTURE. 0 0 27135182 337908 27060115 PROVIDE SKILLED NURSING, ALZHEIMER'S AND DEMENTIA CARE TO OUR COMMUNITY RESIDENTS AND OUTPATIENT THERAPY CLIENTS INCLUDING 172 SKILLED NURSING BEDS. 7261892 12310 9126670 RETIREMENT AND OTHER RELATED SERVICES IN 2017. 3667585 370229 5414419 PROVIDE ASSISTED LIVING SERVICES TO 145 UNITS. 3852659 2849992 OTHER SERVICES RELATED TO ALL PROGRAMS. 3852659 2849992 41917318 1 1 0 0 0 0 0 1 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 162 0 701 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X STEVEN AILEY 2144131561 8600 SKYLINE DRIVE DALLAS TX 75243 CYNTHIA HUDGINS CHAIRPERSON 1.00 1.00 X X 0 0 0 DR LISA CLARK VICE CHAIRPERSON 1.00 2.00 X X 0 0 0 CRAIG MILLIS SECRETARY 1.00 0.00 X X 0 0 0 MOLLY STEWARD TRUSTEE 1.00 0.00 X 0 0 0 PHILLIP WENTWORTH TRUSTEE 1.00 2.00 X 0 0 0 TIM MALLAD PRESIDENT/CEO 10.00 30.00 X 0 324000 10667 STEVEN AILEY CHIEF FINANCIAL OFFICER 10.00 30.00 X 0 210000 11813 RON KELLY EXECUTIVE DIRECTOR - PVN 40.00 0.00 X 174517 0 13209 SCOTT POLZIN CORP DIRECTOR OF OPERATIONS 0.00 40.00 X 0 190000 5510 PETER LYNCH EXECUTIVE DIRECTOR - FOUNDATION 0.00 40.00 X 0 161123 9388 MICHAEL SIMS ASSOCIATE EXECUTIVE DIRECTOR - PVN 40.00 0.00 X 153399 0 1430 CHRISTOPHER SONGER DIRECTOR OF PROJECT DEVELOPMENT 0.00 40.00 X 0 151763 3809 AARON DENOVELLIS EXECUTIVE DIRECTOR - GPV 0.00 40.00 X 0 150000 12176 GODWIN DIXON FORMER PRESIDENT/CEO - FOUNDATION 0.00 0.00 X 0 229253 210 327916 1416139 68212 7 1 1 0 HEALTHPRO THERAPY SERVICES LLC 307 INTERNATIONAL CIRCLE STE 100 HUNT VALLEY MA 21030 THERAPY SERVICES 3819658 OLICON INC 4226 MAIN STREET DALLAS TX 75226 CONSTRUCTION SERVICES 1125911 JESUS ROJAS 2713 STAR AVENUE RED OAK TX 75154 CONSTRUCTION SERVICES 722780 PARKS REMODELING & CONSTRUCTION 413 KAMBER LANE WYLIE TX 75098 CONSTRUCTION SERVICES 383626 WEIS BUILDERS INC 7645 LYNDALA AVENUE SOUTH MINNEAPOLIS MN 55423 CONSTRUCTION SERVICES 361108 8 1179561 1179561 RESIDENT REVENUE 623000 44451196 44451196 44451196 6608 6608 2086 0 2086 2086 2086 OTHER INCOME 900099 44954 44954 GUEST HOUSING RENTAL 900099 16613 16613 61567 45701018 44451196 0 70261 X 720447 720447 174517 174517 17285703 13309991 3975712 150399 115807 34592 3011508 2318861 692647 1400094 1078072 322022 2579596 2579596 72105 72105 39367 39367 7510934 7510934 16532 12730 3802 138208 106420 31788 145445 111993 33452 1617109 1617109 17492 13469 4023 10166 7828 2338 3553976 3553976 5249167 4041859 1207308 278949 278949 MEDICAL 2218920 2218920 FOOD 1828816 1828816 BAD DEBTS 1340115 1340115 SUPPLIES 773714 595760 177954 1269194 1135262 133932 51402473 41917318 9485155 0 13853194 12438887 29183804 21578746 3735859 3556540 273186 282684 164195 121403 159022073 62701889 76722038 96320184 66734830 6583655 190667106 140882099 4105568 4667363 7219153 5584172 77456059 77564288 11000000 0 28247449 37911553 128028229 125727376 X 24999046 9600835 33106920 1186455 4532911 4367433 62638877 15154723 190667106 140882099 X -5701455 -41782699 X X 0 1 X 1 0 X 1792367 769508 1715574 3219237 1179561 8676247 36436690 37878091 39845792 39272414 44451196 197884183 38229057 38647599 41561366 42491651 45630757 206560430 0 0 0 206560430 106079 60607 19871 8021 6608 201186 106079 60607 19871 8021 6608 201186 393575 14253 31931 166102 61567 667428 38728711 38722459 41613168 42665774 45698932 207429044 0.99580 0.98960 0.00100 0.00140 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: INSURANCE SETTLEMENTS / OTHER INCOME - 2013 AMOUNT: $ 393,575. 2014 AMOUNT: $ 14,253. 2015 AMOUNT: $ 31,931. 2016 AMOUNT: $ 142,935. 2017 AMOUNT: $ 44,954. GUEST HOUSING RENTAL - 2016 AMOUNT: $ 23,167. 2017 AMOUNT: $ 16,613. 153370 X X 0 3408923 3408923 113003891 33237346 79766545 5498477 5152373 346104 25883525 19686208 6197317 11227257 4625962 6601295 96320184 ASSET RETIREMENT OBLIGATION 782748 REFUNDABLE TENANT DEPOSITS 32206814 CONSTRUCTION PAYABLE 4307510 DUE TO RELATED PARTY 503518 OTHER LIABILITIES 110963 37911553 X 44980571 0 44980571 720447 720447 45701018 50682026 0 50682026 720447 720447 51402473 PART III, LINE 4: COLLECTION OF PORCELAIN FIGURINES - BIRDS. AS A RETIREMENT AND NURSING COMMUNITY, THESE ITEMS ENRICH THE LIVES OF THOSE WE SERVE. THEY WERE DONATED TO EXHIBIT FOR THEIR BEAUTY AND TO IMPROVE THE ENVIRONMENT OUR RESIDENTS LIVE IN. PART X, LINE 2: THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION REPORTS ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES AND FILES ALL PROPER RETURNS RELATED TO THESE ACTIVITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSE 720,447. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT EXPENSE 720,447. 1 SUPPLEMENTAL ASSISTANCE 17 720447 PART I, LINE 2: THE ORGANIZATION PROVIDES ASSISTANCE TO RESIDENTS OF ITS CCRC CAMPUS WHO REACH FINANCIAL HARDSHIP AND ARE UNABLE TO PAY A PORTION OF THEIR MONTHLY FEES. AN APPLICATION FOR ASSISTANCE IS COMPLETED AND SUBMITTED TO THE EXECUTIVE DIRECTOR AND COMMITTEE FOR REVIEW AND APPROVAL PRIOR TO PROVIDING ASSISTANCE. THE RESIDENT'S FINANCIAL CIRCUMSTANCES ARE PERIODICALLY REVIEWED TO DETERMINE IF THE RESIDENT STILL QUALIFIES FOR ASSISTANCE. X X X X 1 1 0 0 0 0 0 0 0 TIM MALLAD PRESIDENT/CEO 0 324000 0 0 0 0 0 4355 0 6312 0 334667 0 0 STEVEN AILEY CHIEF FINANCIAL OFFICER 0 210000 0 0 0 0 0 11813 0 0 0 221813 0 0 RON KELLY EXECUTIVE DIRECTOR - PVN 174517 0 0 0 0 0 9719 0 3490 0 187726 0 0 0 SCOTT POLZIN CORP DIRECTOR OF OPERATIONS 0 190000 0 0 0 0 0 5510 0 0 0 195510 0 0 PETER LYNCH EXECUTIVE DIRECTOR - FOUNDATION 0 161123 0 0 0 0 0 9388 0 0 0 170511 0 0 MICHAEL SIMS ASSOCIATE EXECUTIVE DIRECTOR - PVN 153399 0 0 0 0 0 1430 0 0 0 154829 0 0 0 CHRISTOPHER SONGER DIRECTOR OF PROJECT DEVELOPMENT 0 151763 0 0 0 0 0 3809 0 0 0 155572 0 0 AARON DENOVELLIS EXECUTIVE DIRECTOR - GPV 0 150000 0 0 0 0 0 12176 0 0 0 162176 0 0 GODWIN DIXON FORMER PRESIDENT/CEO - FOUNDATION 0 0 0 0 0 229253 0 210 0 0 0 229463 0 0 PART I, LINES 4A-B GODWIN DIXON, FORMER PRESIDENT/CEO - FOUNDATION, WAS INCLUDED IN A 457(F)PLAN AND THERE WAS A TOTAL CONTRIBUTION TO THE PLAN OF $210 FOR 2017. GODWIN DIXON ALSO RECEIVED A SEVERANCE PACKAGE IN 2017 IN THE AMOUNT OF $229,253. A NEW HOPE CULTURAL EDUCATION FACILITIES FINANCE CORPORATION 261604618 64542TAN7 2014-12-11 80500000 CAPITAL EXPENDITURE AND CONSTRUCTION 0 0 0 A 80500000 14527019 1928989 64043992 2016 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 3 ON 5/1/2008, PRESBYTERIAN COMMUNITIES & SERVICES WAS FORMED TO PROVIDE MANAGEMENT AND SHARED SERVICES TO PRESBYTERIAN VILLAGE NORTH AND OTHER AFFILIATED ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND CEO WILL REVIEW THE DRAFT REPORT. THE DRAFT REPORT WILL BE PROVIDED TO ALL BOARD MEMBERS FOR REVIEW. ONE BOARD MEMBER WITH PARTICULAR KNOWLEDGE IN THIS AREA WILL REVIEW THE FINAL RETURN BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A COMPLIANCE OFFICER (CO) WHO REVIEWS ALL TRANSACTIONS OF THE ORGANIZATION THAT MAY RESULT IN A CONFLICT OF INTEREST. THE CO DETERMINES IF THE TRANSACTION WOULD RESULT IN UNDUE INFLUENCE AS A RESULT OF THE RELATIONSHIP AND NOT BE PURSUED. THE CO REPORTS ALL CONFLICTS OF INTEREST TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 REVIEWED ANUALLY BY AN OUTSIDE CONSULTANT AND SURVEYS FROM INDUSTRY ARE USED. THE BOARD ALSO HAS A COMPENSATION COMMITTEE THAT REVIEWS THE CURRENT COMPENSATION COMPARED TO LIKE ENTITIES AND MAKES RECOMMENDATIONS TO THE BOARD FOR CHANGES IN COMPENSATION. THE OUTSIDE CONSULTANT REVIEWS COMPENSATION, INDEPENDENT OF THE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE AT THE SITE, BASED ON WRITTEN REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR / OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 7,510,934. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,510,934. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS OF PC&S FOUNDATION 63,745. CHANGE IN NET ASSETS OF OTHER FOUNDATIONS -32,149,688. NET ASSET TRANSFER TO RELATED PARTY -9,696,756. FORM 990, PART XII, LINE 2C THE ORGANIZATION DOES HAVE A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, AND THE NEITHER THE OVERSIGHT PROCESS NOR THE SELECTION PROCESS HAS CHANGED DURING THE FILING YEAR. PRESBYTERIAN VILLAGE NORTH FOUNDATION 8600 SKYLINE DRIVE DALLAS TX 75243 752022746 PROVIDE SUPPORT FOR QUALITY OF LIFE FOR RESIDENTS OF PVN TX 501(C)(3) PF N/A 0 PRESBYTERIAN COMMUNITIES AND SERVICES 12467 MERIT DRIVE DALLAS TX 75251 261459224 SHARED SERVICES/MANAGEMENT TX 501(C)(3) LINE 12B, II N/A 0 GRACE PRESBYTERIAN MINISTRIES 550 E ANN ARBOR AVE DALLAS TX 75216 751094140 CCRC TX 501(C)(3) LINE 10 PRESBYTERIAN COMMUNITIES & SERVICES 0 PRESBYTERIAN COMMUNITIES AND SERVICES FOUNDATION 12467 MERIT DRIVE DALLAS TX 75251 751910084 FOUNDATION FOR AFFILIATES TX 501(C)(3) LINE 7 PRESBYTERIAN COMMUNITIES & SERVICES 0 FAITH PRESBYTERIAN PROVIDERS INC 12477 MERIT DRIVE DALLAS TX 75251 383800779 PALLATIVE/HOSPICE SERVICES TX 501(C)(3) LINE 10 PRESBYTERIAN COMMUNITIES & SERVICES 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0