2017-11-03T13:07:41-05:00 2016-12-31 593070669 MOORE STEPHENS LOVELACE PA 201 EAST KENNEDY BLVD SUITE 650 TAMPA FL 33602 990 2016-01-01 591031820 PLYMOUTH HARBOR INC PLYM 9413652600 700 JOHN RINGLING BLVD SARASOTA FL 34236 GARRY H JACKSON SR. VICE PRESIDENT - CFO 9413652600 2017-11-03 1 KURT A ALTER CPA P00059492 8133142600 64.132.121.122 2017-11-03 12:47:18 ED P A6970DBB2853E0D2E5FB43C562937A4824D79D77 A6970DBB2853E0D2E5FB43C562937A4824D79D77 2016 2018-03-14 21:41:22Z HARRY E HOBSON 700 JOHN RINGLING BLVD SARASOTA FL 34236 27046965 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. 17 17 338 30 0 0 922308 2461095 23813539 23993495 -218322 194996 154625 397379 24672150 27046965 0 0 0 0 10991043 12136433 0 0 0 11935050 12073194 22926093 24209627 1746057 2837338 68403729 82746008 57818719 69169314 10585010 13576694 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 9307013 15296931 SENIOR ADULT LIVING SERVICE - CARING FOR SENIOR ADULTS THROUGH THE OPERATION OF A CONTINUING CARE RETIREMENT COMMUNITY CONSISTING OF APPROXIMATELY 208 INDEPENDENT APARTMENT UNITS AND 10 ASSISTED LIVING APARTMENT UNITS. 4882222 4735806 SENIOR ADULT HEALTH CARE CENTER SERVICE - PROVIDES SKILLED NURSING SERVICES TO THE ELDERLY IN ITS 60 BED SKILLED NURSING CENTER. 3258557 2422130 SENIOR ADULT DIETARY SERVICE - SERVICING THE DIETARY NEEDS OF SENIOR ADULTS AT THE CONTINUING CARE RETIREMENT COMMUNITY. 1782585 1936007 HOME HEALTH AGENCY - A LICENSED HOME HEALTH AGENCY THAT SERVICES SENIOR ADULTS IN THEIR OWN HOME. 1782585 1936007 19230377 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 85 0 1 338 1 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 GARRY JACKSON 9413652600 700 RINGLING BLVD SARASOTA FL 34236 DR DUNCAN FINLAY 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 BRIAN HALL TREASURER 1.00 2.00 X X 0 0 0 KATHRYN ANGELL CARR 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 MYRON ROBINSON TRUSTEE 1.00 2.00 X 0 0 0 MARIE UNDERWOOD TRUSTEE 1.00 2.00 X 0 0 0 WILLIAM WOELTJEN TRUSTEE 1.00 2.00 X 0 0 0 JOHN CRANOR TRUSTEE 1.00 2.00 X 0 0 0 TERRY ALDRICH TRUSTEE 1.00 2.00 X 0 0 0 DALE WOODLING TRUSTEE 1.00 2.00 X 0 0 0 JON SWIFT TRUSTEE 1.00 2.00 X 0 0 0 HARRY E HOBSON PRESIDENT/CEO 38.00 2.00 X 283989 0 26781 GARRY H JACKSON SR. VICE PRESIDENT/CFO 38.00 2.00 X 173303 0 8235 GORDON OKAWA VP OF MARKETING/COMMON AFFAIRS 40.00 X 188267 0 11174 JOSEPH DEVORE VP OF HEALTH SERVICES 40.00 X 146889 0 7580 REBECCA PAZKOWSKI VP OF PHILANTHROPY 40.00 X 134080 0 9167 ELIZABETH SPARR RESIDENCY SALES COUNSELOR 40.00 X 123897 0 6478 HOLLY J WILLIAMS RESIDENCY SALES COUNSELOR 40.00 X 124153 0 5270 TENA WILSON VP OF RESIDENT SERVICES 40.00 X 101445 0 8232 DINAH STAMP ADMINISTRATOR OF DESIGN AND RENOVATION 40.00 X 101477 0 8032 1377500 0 90949 9 0 1 0 FUNCTIONAL PATHWAYS OF TENNESSEE 614 MABRY HOOD ROAD SUITE 301 KNOXVILLE TN 37932 THERAPY SERVICE 497528 PLYMOUTH COIFFURES 33 CHURCH STREET OSPREY FL 34229 BEAUTY SALON OPERATOR 122135 VALCOURT BUILDING SERVICES OF FL 4695 18TH ST EAST BRADENTON FL 34203 BUILDING EXTERIOR REPAIRS 103824 3 2461095 2461095 MONTHLY SERVICE FEES 623000 17503847 17503847 ENTRANCE FEES 623000 6489648 6489648 23993495 149637 149637 45359 0 45359 45359 45359 CAPITAL REIMBURSEMENTS 623000 397379 397379 397379 27046965 24390874 0 194996 492309 492309 8908088 7350609 1557479 187742 126678 61064 1851913 1611721 240192 696381 564368 132013 23728 485 23243 51500 51500 44202 44202 1112493 626441 486052 254324 106772 147552 323519 159010 164509 38608 38608 1565714 1441679 124035 26989 8017 18972 5151296 4091817 1059479 776519 616811 159708 FOOD & FOOD PRODUCTS 924404 924404 MEDICAL, OXYGEN & DRUGS 563173 563173 SUPPLIES 269678 236565 33113 REPAIRS & MAINTENANCE 234639 224147 10492 712408 577680 134728 24209627 19230377 4979250 0 730197 738823 21117 73396 764105 2861978 73320 70130 564769 604357 112997647 51329095 51215130 61668552 14861894 16582139 173197 146633 68403729 82746008 1445366 2296771 49015296 52140946 5582639 13153687 1775418 1577910 57818719 69169314 X 9933539 11341297 651471 2235397 10585010 13576694 68403729 82746008 X 2837338 -50698 -40 205084 X X 0 1 X 1 0 X 262059 111706 21908 922308 2461095 3779076 18407017 21015649 21956426 23813539 23993495 109186126 18669076 21127355 21978334 24735847 26454590 112965202 0 0 0 112965202 166158 130173 116098 115907 149637 677973 166158 130173 116098 115907 149637 677973 154625 397379 552004 18835234 21257528 22094432 25006379 27001606 114195179 0.98920 0.99290 0.00590 0.00570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 697 267 430 0 11477104 547064 233621 96162 12161627 11630413 262873 374487 41695 11477104 11136519 300238 301156 53379 54121 11630413 10472006 228067 1048525 563003 49076 11136519 9459414 419981 995208 350000 52597 10472006 1.00000 0.00000 0.00000 0 1 1 273228 273228 91156608 41508186 49648422 1837464 836690 1000774 19730347 8984219 10746128 61668552 CASH AND CASH EQUIVALENTS 9707083 F ACCRUED INTEREST 33431 F CORPORATE BONDS 1578970 F FOREIGN CORPORATE BONDS 1172334 F U.S. GOVERNMENT OBLIGATIONS 2928476 F MUTUAL FUNDS 134973 F CERTIFICATE OF DEPOSITS 1001003 F INTEREST RECEIVABLE 25869 F 16582139 ENTRANCE FEE DEPOSITS 875763 INTEREST RATE SWAP 450340 EMPLOYEE BENEFIT LIABILITY 251807 1577910 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. PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUND IS HELD BY THE RELATED ORGANIZATION PLYMOUTH HARBOR ENDOWMENT FUND. THE BOARD OF TRUSTEES, WHICH SERVE BOTH THE FILING ORGANIZATION AND THE ENDOWMENT FUND, MAY DISTRIBUTE CORPUS OF THESE FUNDS AT ITS SOLE DISCRETION. THE INTENDED USE OF THE ENDOWMENT FUND MONIES IS EXCLUSIVELY FOR CHARITABLE ACTIVITIES CONDUCTED BY THE FILING ORGANIZATION. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 HARRY E HOBSON PRESIDENT/CEO 283989 0 0 0 0 0 14095 0 12686 0 310770 0 0 0 GARRY H JACKSON SR. VICE PRESIDENT/CFO 173303 0 0 0 0 0 5580 0 2655 0 181538 0 0 0 GORDON OKAWA VP OF MARKETING/COMMON AFFAIRS 188267 0 0 0 0 0 6901 0 4273 0 199441 0 0 0 JOSEPH DEVORE VP OF HEALTH SERVICES 146889 0 0 0 0 0 4852 0 2728 0 154469 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 EVALUATE 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 149,697. NET UNREALIZED GAIN (LOSS) ON GIFT ANNUITIES 55,387. FORM 990, PART XII, LINE 2C OVERSIGHT OF FINANCIAL STATEMENT AUDIT: THE ORGANIZATION'S AUDIT 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 0 2940957 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 12B, II PLYMOUTH HARBOR INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0