2017-12-18T10:59:52-06:00 2017-06-30 410746749 CLIFTONLARSONALLEN LLP 5001 SPRING VALLEY ROAD SUITE 600W DALLAS TX 75244 990 2016-07-01 742070670 CARILLON INC CARI 8062816500 1717 NORFOLK AVE LUBBOCK TX 79416 J SCOTT WYNN EXECUTIVE DIRECTOR 8062816000 2017-12-15 1 MICHAEL SIEGEL P01587323 9723835700 67.137.57.251 2017-12-15 15:43:44 CS P B6B6F2B8D30A14866FB848EA848D3547AA51FF29 3E4F18CB77D6EAFB55BE5397643245C4E488A262 2016 2018-03-14 21:41:22Z CARILLON LIFECARE COMMUNITY J SCOTT WYNN 1717 NORFOLK AVE LUBBOCK TX 79416 26635098 0 X WWW.CARILLONWEB.COM X 1975 TX TO PROVIDE OUR RESIDENTS WITH QUALITY, AFFORDABLE LIFECARE WHILE PROMOTING SECURITY, COMFORT, DIGNITY, INDEPENDENCE AND A STRONG FAMILY ATMOSPHERE. 9 9 520 10 1800 0 152880 144727 24690291 25679990 58765 180946 26239 629435 24928175 26635098 0 0 0 0 12276366 12528559 0 0 0 15105255 15524424 27381621 28052983 -2453446 -1417885 54101096 57472441 91916361 95355845 -37815265 -37883404 PROVIDE OUR RESIDENTS WITH QUALITY AFFORDABLE LIFECARE WHILE PROMOTING SECURITY, COMFORT, DIGNITY, INDEPENDENCE AND A STRONG FAMILY ATMOSPHERE. 0 0 23762985 25781218 PROVIDING HEALTH CARE FACILITIES WITH SERVICES AVAILABLE SUCH AS HOSPITAL, NURSING CARE, AND OTHER LIVING CARE SERVICES TO SENIOR CITIZENS. ALL SERVICES PROVIDED IN A SECURE LIVING AREA. PROVIDING OUR EMPLOYEES WITH A SATISFYING WORK ENVIRONMENT AND THE TRAINING NECESSARY TO DELIVER EXCEPTIONAL SERVICES AND QUALITY CARE. BUILDING STRONG RELATIONSHIPS BETWEEN CARILLON AND THE LUBBOCK COMMUNITY. BROADENING OUR KNOWLEDGE IN THE FIELD OF GERONTOLOGY THROUGH RESEARCH AND EDUCATION TO ENHANCE THE QUALITY OF LIFE FOR SENIORS. 23762985 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 150 0 520 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X JON SORENSON 8062816696 1717 NORFOLK AVE BUILDING B LUBBOCK TX 79416 X JACK MCCLENDON CHAIRMAN 2.00 0.00 X X 0 0 0 ELIZABETH HALEY VICE CHAIRMAN 2.00 0.00 X X 0 0 0 CHARLES AINSWORTH DIRECTOR 1.00 2.00 X 0 0 0 BEVERLY BYERS DIRECTOR 1.00 0.00 X 0 0 0 ROBERT FREEMAN DIRECTOR 2.00 0.00 X 0 0 0 LONNIE HOLLINGSWORTH DIRECTOR 1.00 0.00 X 0 0 0 JUANITA KIESLING DIRECTOR 2.00 1.00 X 0 0 0 MARSHA SHARP DIRECTOR 2.00 2.00 X 0 0 0 MIKE WEISS DIRECTOR 2.00 0.00 X 0 0 0 J SCOTT WYNN EXECUTIVE DIRECTOR 39.00 1.00 X 0 0 0 PAMELA RODDY ADMINISTRATOR - CARILLON HOUSE 40.00 0.00 X 0 0 0 JOE SOLIS PLANT DIRECTOR 40.00 0.00 X 102084 0 6654 102084 0 6654 1 0 0 0 REHABCARE GROUP THERAPY PO BOX 503534 ST LOUIS MO 63150 THERAPY SERVICES 1460505 LIFE CARE SERVICES LLC 400 LOCUST ST SUITE 820 DES MOINES IA 50309 MANAGEMENT SERVICES 845494 DESIGN ENVY PO BOX 3156 LUBBOCK TX 79412 ADVERTISING SERVICES 142340 CYCLONE SPORTS PO BOX 843038 KANSAS CITY MO 641843038 MARKETING 107657 4 144727 144727 NET SERVICE REVENUE 623000 22114477 22114477 ENTRANCE FEE AMORTIZATION 623990 3565513 3565513 25679990 116078 116078 132277 0 132277 132277 101228 1800 29249 63986 882 0 0 63986 882 64868 64868 MEAL REVENUE 812900 461744 461744 OTHER REVENUE 812900 29176 29176 BEAUTY, BARBER AND GIFT SHOP 453220 6238 6238 497158 26635098 25781218 1800 707353 10494875 8395900 2098975 37668 30134 7534 1036620 829296 207324 959396 767517 191879 413771 331017 82754 2991 2991 84575 84575 168717 134974 33743 484309 484309 86594 69275 17319 138036 110429 27607 922885 738308 184577 21220 16976 4244 33942 27154 6788 2614014 2614014 4875010 4353429 521581 308920 247136 61784 MEDICAL/THERAPY EXPENSE 2621819 2621819 FOOD 1387553 1387553 SUPPLIES 569508 455606 113902 MAINTENANCE & EQUIPMENT 386591 309273 77318 403969 323175 80794 28052983 23762985 4289998 0 2703381 2889159 12321018 15242724 1530521 1009087 320203 444493 82000760 46209212 37172610 35791548 53363 2095430 54101096 57472441 3978247 3376575 23617964 22436583 54050106 58991580 156087 28033 10113957 10523074 91916361 95355845 X -37815265 -39338758 647073 808281 -37815265 -37883404 54101096 57472441 X -1417885 -105608 1549904 -94550 X X 0 1 X 1 0 X 23505 98199 44624 152880 144727 463935 21446756 22252048 23734270 24690291 25679990 117803355 21470261 22350247 23778894 24843171 25824717 118267290 0 0 0 118267290 288157 274447 226602 197922 248355 1235483 288157 274447 226602 197922 248355 1235483 145210 36741 74837 26239 497158 780185 21903628 22661435 24080333 25067332 26570230 120282958 0.98320 0.98290 0.01030 0.01070 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: GIFT/CONVENIENCE STORE INCOME - 2012 AMOUNT: $ 23,331. 2013 AMOUNT: $ 14,582. 2014 AMOUNT: $ 34,414. 2015 AMOUNT: $ 10,782. 2016 AMOUNT: $ 6,238. CATERING AND VENDING INCOME - 2012 AMOUNT: $ 16,223. 2013 AMOUNT: $ 14,619. 2014 AMOUNT: $ 8,625. 2015 AMOUNT: $ 11,146. 2016 AMOUNT: $ 461,744. MISCELLANEOUS INCOME - 2012 AMOUNT: $ 105,656. 2013 AMOUNT: $ 7,540. 2014 AMOUNT: $ 31,798. 2015 AMOUNT: $ 4,311. 2016 AMOUNT: $ 29,176. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2661877 2661877 69337247 38018917 31318330 2631595 2030211 601384 7370041 6160084 1209957 35791548 DEPOSITS & ADVANCE PAYMENTS 301086 REFUNDABLE ENTRANCE FEES 9218850 ASSET RETIREMENT OBLIGATION 817643 REFUNDS IN PROCESS 185495 10523074 X 26529490 -105608 -105608 26635098 0 26635098 28052983 0 28052983 0 28052983 PART X, LINE 2: THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. A NEW HOPE CULTURAL EDUCATION FACILITIES FINANCE CORPORATION 261604618 64542UBC7 2016-07-22 60397469 REFINANCING OF SERIES 2005 BONDS AND CAPITAL EXPENDITURES 0 0 0 A 60397469 1207939 499607 54116749 4573174 1 0 0 1 A 0 0 0 0 0.00730 0.00020 0.00750 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, SUPPLEMENTAL INFORMATION THE SERIES 2016 BONDS WERE USED TO REFUND THE SERIES 2005 BONDS, WHICH WERE LEGALLY DEFEASED AT THE TIME OF REFUNDING. PROCEEDS OF THE SERIES 2005 BONDS, TOGETHER WITH FUNDS PROVIDED FROM ENTRANCE FEES AND EARNINGS ON SUCH PROCEEDINGS, WERE USED FOR (I) REFINANCING CERTAIN PRE-CONSTRUCTION DEBT OF THE CORPORATION RELATING TO A CONTINUING CARE RETIREMENT CENTER PROJECT (THE "PROJECT") TO BE OWNED AND OPERATED BY THE CORPORATION, (II) THE ACQUISITION, CONSTRUCTION, EQUIPPING AND FURNISHING OF THE PROJECT, (III) FUNDING A DEBT SERVICE RESERVE FUND UNDER THE BOND INDENTURE, (IV) FUNDING WORKING CAPITAL, MARKETING COSTS AND CAPITALIZED INTEREST FOR APPROXIMATELY TWO YEARS, AND (V) PAYING COSTS OF ISSUANCE OF THE SERIES 2005 BONDS AND OTHER FINANCING CHARGES. NON-REFUNDING PROCEEDS OF THE ISSUE USED FOR CAPITAL EXPENDITURES WAS $5,072,781. THE PROCEEDS REPORTED ON PAGE 1, PART II, LINE 11 REPRESENT THOSE USED TO REFUND THE PRIOR ISSUE. FORM 990, PART VI, SECTION A, LINE 3 CARILLON, INC. PAYS MANAGEMENT FEES TO AN UNRELATED ORGANIZATION, LIFE CARE SERVICES, A MANAGEMENT COMPANY, TO PROVIDE THE ORGANIZATION WITH DIRECTORS AS WELL AS OTHER SERVICES. THE DIRECTORS ARE COMPENSATED BY THE MANAGEMENT COMPANY, AND CARILLON, INC. REIMBURSES LIFE CARE SERVICES WITH MONTHLY MANAGEMENT FEES FOR THE COMPENSATION PAID AND OTHER SERVICES PROVIDED. J. SCOTT WYNN AND PAM RODDY ARE ON-SITE EMPLOYEES/ADMIN MANAGERS OF MANAGEMENT COMPANY, LIFE CARE SERVICES. FORM 990, PART VI, SECTION B, LINE 11B CLIFTONLARSONALLEN WILL BE ABLE TO PRESENT THE FORM 990 TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS DURING A REGULAR MEETING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE OFFICER IS PAM RODDY, ADMINISTRATOR OF CARILLON HOUSE. THE ORGANIZATION INTERNALLY REVIEWS TRANSACTIONS FOR POSSIBLE CONFLICTS ON A ROUTINE BASIS THROUGHT THE YEAR AND INCLUDES DISCUSSIONS AT BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR AND HEALTH CENTER ADMINISTRATOR ARE EMPLOYED BY LCS, CARILLON INC.'S MANAGEMENT COMPANY. THE BOARD OF DIRECTORS CONSULTS WITH AND NEGOTIATES PAY STANDARDS. DETERMINING COMPENSATION FOR OTHER OFFICERS AND/OR KEY EMPLOYEES IS DONE IN CONSULTATION WITH THE BOARD OF DIRECTORS AND LCS REGIONAL MANAGERS. THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY THE MANAGEMENT COMPANY USING A PROCESS FOR COMPENSATION THAT INVOLVES INDEPENDENT & CONTEMPORANEOUSLY WRITTEN DETERMINATIONS BASED ON COMPARABILITY DATA. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC. AS REQUIRED BY FINANCING, FINANCIAL STATEMENTS AND DEBT-RELATED ITEMS ARE DISCLOSED ON THE EMMA WEBSITE. ALL ITEMS REGARDING THE ORGANIZATION ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF CARILLON FOUNDATION -94,550. FORM 990, PART XII, LINE 2C: THE OVERSIGHT AND SELECTION PROCESSES HAVE NOT CHANGED DURING THE FILING YEAR. FORM 990, PART VII, SECTION A CARILLON HAS A MANAGEMENT AGREEMENT WITH LCS. PURSUANT TO THE AGREEMENT, LCS PROVIDES CARILLON'S EXECUTIVE DIRECTOR AND CERTAIN MANAGEMENT FINANCIAL SERVICES. DURING 2017 AND 2016, TOTAL FEES PAID TO LCS WERE APPROXIMATELY $413,700 AND $493,000, RESPECTIVELY. J. SCOTT WYNN WAS AN EMPLOYEE OF LCS, AN UNRELATED ORGANIZATION, THROUGH 6/30/2017, AND, UNDER HIS EMPLOYMENT FOR LCS, HE SERVED AS THE EXECUTIVE DIRECTOR FOR CARILLON. LCS PAID COMPENSATION TO J. SCOTT WYNN IN THE AMOUNT OF $179,633 FOR 2017. PAM RODDY WAS ALSO AN EMPLOYEE OF LCS, AND SERVED AS THE ADMINISTRATOR FOR CARILLON HOUSE. LCS PAID COMPENSATION TO PAM RODDY IN THE AMOUNT OF $121,805 FOR 2017. CARILLON FOUNDATION 1717 B NORFOLK AVE LUBBOCK TX 79416 750123537 FUNDRAISING TX 501(C)(3) LINE 7 N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0