2017-11-13T15:20:11-06:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2016-01-01 362169165 PLYMOUTH PLACE INC PLYM 7083540340 315 N LAGRANGE ROAD LAGRANGE PARK IL 60526 DALE LILBURN CHIEF EXECUTIVE OFFICER 7083540340 2017-11-13 1 GREGORY S ADAMS P00095597 6305738600 2017-11-13 67.137.57.251 2017-11-13 11:09:36 CS P 573A7FE416AD6C5E032A0E46635AF7078886CB08 1A575DA7D4580FEB092587E941B69D20BC1E409C 2016 2017-02-10 21:41:12Z DALE LILBURN 315 N LAGRANGE ROAD LAGRANGE PARK IL 60526 30411119 0 X WWW.PLYMOUTHPLACE.ORG X 1938 IL RETIREMENT HOME FOR SENIOR CITIZENS 14 14 472 45 0 0 890766 1279970 27078516 27836642 690724 1294507 0 0 28660006 30411119 0 0 0 0 11015469 12197131 0 0 0 18737620 18927516 29753089 31124647 -1093083 -713528 139718992 137699421 177084512 177741142 -37365520 -40041721 PLYMOUTH PLACE IS DEDICATED TO PROVIDING A WELCOMING ENVIRONMENT FOR OLDER ADULTS. WITH A FOCUS ON THE DIGNITY AND WORTH OF EACH INDIVIDUAL, WE HONOR EVERY RESIDENT'S RIGHT TO EXPERIENCE LIFE TO THE FULLEST. 0 0 27896222 27836642 PLYMOUTH PLACE IS A NONPROFIT CORPORATION WHICH PROVIDES HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO THE RESIDENTS OF THE LANDING AT PLYMOUTH PLACE, A RETIREMENT COMMUNITY IN LAGRANGE PARK, ILLINOIS. THE LANDING, A REDEVELOPMENT OF THE ORGANIZATION'S FORMER RETIREMENT COMMUNITY, CONSISTS OF 182 INDEPENDENT LIVING APARTMENTS, 52 ASSISTED LIVING, 26 MEMORY SUPPORT UNITS, 86 HEALTH CARE BEDS, AND 11 OCCUPIED OR FUNCTIONAL COTTAGES. 27896222 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 32 0 1 472 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X DALE LILBURN 7083540340 315 N LAGRANGE ROAD LAGRANGE PARK IL 60526 JANET MCDERMED DIRECTOR 1.00 X 0 0 0 MARK CLOGHESSY DIRECTOR 1.00 X 0 0 0 DORIS BRYANT DIRECTOR 1.00 X 0 0 0 BILL COATES DIRECTOR 1.00 X 0 0 0 DR LOREN HORTEN DIRECTOR 1.00 X 0 0 0 DR LARRY LAPALIO DIRECTOR 1.00 X 0 0 0 REV CARLY STUCKLEN SATHER DIRECTOR 3.50 X 0 0 0 HARRIET VERGOWE DIRECTOR 2.30 X 0 0 0 BOB WESTRICK DIRECTOR 1.80 X 0 0 0 LAURA WEYRAUCH DIRECTOR 1.00 X 0 0 0 DR KENT ARMBRUSTER DIRECTOR 1.00 X 0 0 0 MARVIN BALDWIN DIRECTOR 1.00 X 0 0 0 ELIZABETH ASPERGER DIRECTOR 1.00 X 0 0 0 THOM SERAFIN DIRECTOR 1.00 X 0 0 0 DALE LILBURN CEO 45.00 X 215215 0 1988 SHARON SLEEZER DIRECTO OF SALESR 45.00 X 116904 0 9148 LATISHA WARD-SYKES RN 45.00 X 103722 0 1556 MARGARET GILBERT SENIOR LIVING COUNSELOR 45.00 X 116794 0 15609 RAYMOND FELSON EXECUTIVE DIRECTOR 45.00 X 140945 0 11243 693580 0 39544 5 0 1 0 SODEXO INC PO BOX 70060 CHICAGO IL 60673 DIETARY AND MAINTENANCE SERVICE 2839181 HEALTHPRO REHABILITATION 3703 WEST LAKE AVENUE SUITE 200 GLENVIEW IL 60025 NURSING THERAPY 1436312 PROVIDENCE LIFE SERVICES 18601 NORTH CREEK DRIVE TINLEY PARK IL 60477 MANAGEMENT AND IT 958792 OMNICARE INC 2313 S MT PROSPECT RD DES PLAINES IL 60018 LONG TERM CARE PHARMACY 533500 NOVASTAFF HEALTHCARE SERVICES 2021 MIDWEST RD 200 OAK BROOK IL 60523 HEALTHCARE SERVICES 475121 8 1279970 145225 1279970 SENIOR HOUSING, ASSISTANCE 623000 27836642 27836642 27836642 1294507 1294507 30411119 27836642 0 1294507 217680 217680 9399484 8284086 1115398 80945 69941 11004 1802819 1464379 338440 696203 606644 89559 1502699 1416419 86280 35949 35949 104248 104248 410556 410556 128851 67234 61617 200735 200735 1188941 1188941 4281309 4281309 3856864 3737307 119557 211385 211385 OTHER 2463141 2237124 226017 DIETARY AND DINING 1994918 1994918 NURSING - THERAPY 1434919 1434919 MEDICAL SUPPLIES AND PH 1113001 1113001 31124647 27896222 3228425 0 14789510 7343871 4277040 2863374 0 119457 263234 132735616 37560856 98352419 95174760 15734395 25676249 6446171 6377933 139718992 137699421 2429163 2316608 12697829 11358705 78834210 78482646 83123310 85583183 177084512 177741142 X -43697291 -46352519 202097 171290 6129674 6139508 -37365520 -40041721 139718992 137699421 X -713528 45934 -2008607 X 0 1 X 1 0 X 2366140 2214687 256138 890766 1593246 7320977 24405170 27768454 27290957 27078516 27836642 134379739 26771310 29983141 27547095 27969282 29429888 141700716 0 0 0 141700716 527393 643930 1168375 690724 981231 4011653 527393 643930 1168375 690724 981231 4011653 27298703 30627071 28715470 28660006 30411119 145712369 0.97250 0.97670 0.02750 0.02330 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 85418 85418 126784835 34387244 92397591 463337 202271 261066 5269215 2971341 2297874 132811 132811 95174760 REFUNDABLE ENTRANCE FEES 83250668 RESIDENT DEPOSITS 147997 WAITING LIST DEPOSITS 166077 FUTURE SERVICE OBLIGATION 2018441 85583183 X 28448445 45934 -2008608 -1962674 30411119 0 30411119 31124647 0 31124647 0 31124647 PART X, LINE 2: THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARDS FOR INCOME TAXES IN EVALUATING UNCERTAIN TAX POSITIONS. THE ORGANIZATION FILES INFORMATIONAL RETURNS AS A TAX-EXEMPT ORGANIZATION. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE FEDERAL AND STATE RETURNS FOR THE ORGANIZATION FOR THE FISCAL YEARS ENDED DECEMBER 31, 2013-2015 ARE OPEN TO EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THE DATE OF FILING. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST 9,833. CHANGE IN VALUE OF FUTURE SERVICE OBLIGATION -2,018,441. OTHER X X 0 0 0 0 0 0 0 0 0 DALE LILBURN CEO 193215 0 22000 0 0 0 1988 0 0 0 217203 0 0 0 RAYMOND FELSON EXECUTIVE DIRECTOR 131945 0 9000 0 0 0 2467 0 8776 0 152188 0 0 0 A ILLINOIS FINANCE AUTHORITY 861091967 45203HQP0 2013-05-15 24765000 REFINANCING OF SERIES 2005 BONDS 0 0 0 B ILLINOIS FINANCE AUTHORITY 861091967 45203H6A5 2015-10-21 56547882 REFINANCING OF SERIES 2005 BONDS 0 0 0 A 24765000 495300 24269700 0 1 1 1 B 450000 56547882 1125200 2334371 53088311 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 A 0 B 0 X 1 145225 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 3 PLYMOUTH PLACE HAS CONTRACTED WITH PROVIDENCE MANAGEMENT TO PROVIDE CFO AND RELATED ACCOUNTING SERVICES, IT SERVICES AND NURSING CENTER ADMINISTRATION. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE 990 IS PROVIDED DIRECTLY TO THE AUDIT COMMITTEE WHO IS RESPONSIBLE FOR REVIEWING AND APPROVING IT. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS REVIEW AND UPDATE THEIR ANNUAL DISCLOSURE OF INTERESTS. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD ANNUALLY RECEIVES AND REVIEWS THE COMPENSATION SURVEYS OF AAHSA & LEADINGAGE ILLINOIS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE FACILITY OFFICE. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF PERPETUAL TRUST 9,833. OTHER 1. CHNAGE IN VALUE OF FUTURE SERVICE OBLIGATION -2,018,441.