2017-05-12T13:29:01-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2016-01-01 237324298 NEW FLORENCE NURSING HOME C/O ST ANDREWS MANAGEMENT SVC NEWF 3147260111 515 PICNIC STREET NEW FLORENCE MO 63363 CAROLYN CREECH PRESIDENT OF THE BOARD 3147260111 2017-05-09 1 JEFF PARKER P00970069 3149254300 2016 2022-09-23 18:48:47Z NEW FLORENCE NURSING AND CARE CENTER CAROLYN CREECH 515 PICNIC STREET NEW FLORENCE MO 63363 4645978 0 X HTTP://WWW.NEWFLORENCECARECENTER.COM/ X 1973 MO PROVIDE SENIOR CARE AND HOUSING WITH SKILLED AND RESIDENTIAL CARE. 7 7 123 40 0 0 355 370 4837758 4629646 8292 7926 8613 8036 4855018 4645978 0 0 0 0 2513682 2504887 0 0 0 2247741 2218429 4761423 4723316 93595 -77338 3500249 3384702 1482727 1444518 2017522 1940184 TO PROVIDE PROFESSIONAL CARE TO OLDER ADULTS, TO GIVE RESPECT AND INDIVIDUALITY FROM OUR CARING AND COMPASSIONATE STAFF, TO ENRICH LIVES WITH LOVE AND ATTENTION. WE ARE A FAMILY AND STRIVE TO UPHOLD YOUR WISHES AND DESIRES WITH AN ATTITUDE OF REVERENCE AND NOTHING LESS. 0 0 4000941 4629646 SKILLED NURSING AND ASSISTED LIVING HOUSING AND SERVICES. FACILITY IS LICENSED FOR 120 BEDS, WITH MEDICARE AND MEDICAID BEDS AVAILABLE. 4000941 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 0 123 1 0 0 0 0 0 0 0 0 0 0 X 7 7 1 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X ST ANDREW'S MANAGEMENT SVC 3147260111 6633 DELMAR BLVD ST LOUIS MO 63130 X CAROLYN CREECH PRESIDENT 1.00 X X 0 0 0 RICK JONAS VICE PRESIDENT 1.00 X X 0 0 0 DON BROZ SECRETARY 1.00 X X 0 0 0 DARRYL DEEKER TREASURER 1.00 X X 0 0 0 DON DEEKER BOARD MEMBER 1.00 X 0 0 0 PIT MILLER BOARD MEMBER 1.00 X 0 0 0 JOANNE SCHLANKER BOARD MEMBER 1.00 X 0 0 0 MARSHA COPE EXECUTIVE DIRECTOR 40.00 X 0 0 0 0 0 0 0 0 0 0 ST ANDREW'S MANAGEMENT SERVICES INC 6633 DELMAR BLVD ST LOUIS MO 63130 MANAGEMENT SERVICES 267614 SELECT REHABILITATION INC PO BOX 809056 CHICAGO IL 606809056 THERAPY SERVICES FOR RESIDENTS 229325 2 370 370 NURSING HOME SERVICES 623000 4629646 4629646 4629646 7926 7926 OTHER REVENUE 623000 3763 3763 EMPLOYEE MEALS 623000 3521 3521 GUEST MEALS 623000 752 752 8036 4645978 4629646 0 15962 77983 77983 1858421 1745777 112644 401301 361795 39506 167182 150724 16458 267614 267614 2716 2716 27457 27457 364715 363849 866 38013 38013 491689 410066 81623 10237 4732 5505 187958 187958 13784 700 13084 3941 3941 46129 46129 208048 208048 85404 64161 21243 NFRA/NFAC FEES 353399 353399 BAD DEBT 92814 92814 MISCELLANEOUS 17986 10789 7197 DUES AND SUBSCRIPTIONS 6525 6525 4723316 4000941 722375 0 207710 179543 1415425 1430337 486234 554654 18492 16453 37619 75294 4515361 3386940 1299480 1128421 19643 0 15646 0 3500249 3384702 300923 328699 86315 7104 9093 1174700 1020411 1482727 1444518 X 2017522 1940184 2017522 1940184 3500249 3384702 -77338 0 X X 0 1 X 0 1 1 X 948 530 340 355 370 2543 4378176 4481326 4334536 4837758 4629646 22661442 4379124 4481856 4334876 4838113 4630016 22663985 0 955880 1094986 2050866 955880 1094986 2050866 20613119 10377 9099 8409 8292 7926 44103 10377 9099 8409 8292 7926 44103 14354 8860 26036 8613 8036 65899 4403855 4499815 4369321 4855018 4645978 22773987 0.90510 0.95240 0.00190 0.00210 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: BEAUTY/BARBERSHOP - 2012 AMOUNT: $ 1,400. 2013 AMOUNT: $ 1,275. 2014 AMOUNT: $ -25. MEAL PLAN REVENUE - 2012 AMOUNT: $ 4,525. 2013 AMOUNT: $ 4,538. 2014 AMOUNT: $ 4,835. 2015 AMOUNT: $ 5,291. 2016 AMOUNT: $ 4,273. MISCELLANEOUS - 2012 AMOUNT: $ 8,429. 2013 AMOUNT: $ 3,047. 2014 AMOUNT: $ 21,226. 2015 AMOUNT: $ 3,322. 2016 AMOUNT: $ 3,763. 0 1 X 8504 8504 3250684 2452396 798288 71310 44042 27268 1183683 890502 293181 1180 1180 1128421 X 4645978 0 4645978 0 4645978 4723316 0 4723316 0 4723316 PART IV, LINE 2B: THE PROJECT MAINTAINS SAVINGS ACCOUNTS ON BEHALF OF CERTAIN RESIDENTS. THE PROJECT ACTS AS A TRUSTEE OF THESE FUNDS WHICH ARE MAINTAINED FOR THE PERSONAL USE OF THOSE RESIDENTS. THE FUNDS ARE EXPENDED AT THE DIRECTION OF THE RESIDENTS. PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION A, LINE 2 DARRYL DEEKER AND DON DEEKER HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION HAS AN OPERATING MANAGEMENT AGREEMENT WITH ST. ANDREW'S MANAGEMENT SERVICES INC TO PROVIDE ADMINISTRATIVE AND OPERATIONAL LEADERSHIP FOR THIS FACILITY. THIS AGREEMENT HAS BEEN IN PLACE FOR MORE THAN TWENTY YEARS. IN 2016, MARSHA COPE, EXECUTIVE DIRECTOR, WAS PAID $77,983 BY ST. ANDREW'S MANAGEMENT SERVICES, INC. FOR HER SERVICES AS EXECUTIVE DIRECTOR FOR THE ORGANIZATION. ALL EMPLOYEES ARE EMPLOYEES OF NEW FLORENCE NURSING HOME, EXCEPT FOR THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE COMMITTEES, THE BOARD OF DIRECTORS HANDLES ALL MATTERS. FORM 990, PART VI, SECTION B, LINE 11B THE DRAFT OF FORM 990 IS REVIEWED BY THE MANAGEMENT COMPANY FOR ACCURACY AND MADE AVAILABLE TO THE ENTIRE BOARD OF DIRECTORS. THE FINAL FORM 990 IS MAILED TO THE PRESIDENT OF THE BOARD FOR REVIEW AND SIGNATURE. FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL CONFLICT OF INTEREST DISCLOSURE IS COMPLETED BY EACH BOARD OF DIRECTORS MEMBER, SUBMITTED AND REVIEWED BY THE ENTIRE BOARD OF DIRECTORS. THE MEMBER IS THEN EXCLUDED IN ANY VOTING FOR APPLICABLE SUBJECT AREAS IF A CONFLICT ARISES. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT COMPENSATE A CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIAL, OTHER OFFICERS OR KEY EMPLOYEES. THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF ST. ANDREW'S MANAGEMENT SERVICES. SALARY REVIEWS OCCUR ANNUALLY (WITH INPUT FROM THE CEMO STUDY), MOST RECENTLY IN 2016, AND ARE APPROVED BY THE BOARD OF DIRECTORS. OTHER OFFICER AND KEY EMPLOYEES COMPENSATION SALARIES ARE REVIEWED ANNUALLY DURING THE BUDGET PROCESS BY THE EXECUTIVE DIRECTOR AND THE MANAGEMENT COMPANY. ACCOUNTING AND OPERATIONS PERSONNEL DURING THIS REVIEW SALARY RANGES FOR ALL POSITIONS ARE COMPARED WITH SURROUNDING FACILITIES. THE BUDGET IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 NEW FLORENCE MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.