2017-02-14T11:35:37-06:00 2016-06-30 593070669 MOORE STEPHENS LOVELACE PA 701 BRICKELL AVENUE SUITE 550 MIAMI FL 33131 990 2015-07-01 161676095 ALDERSGATE RETIREMENT INC ALDE 3055565654 5300 W 16TH AVENUE HIALEAH FL 33012 NICK ANTONACCI EXECUTIVE DIRECTOR 3055565654 2017-02-14 1 HARRY E HARP CPA P00176471 3058199555 2015 2021-01-29 14:40:06Z NICK ANTONACCI 5300 W 16TH AVENUE HIALEAH FL 33012 5795519 0 X WWW.EPWORTHVILLAGE.NET X 2003 FL THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO OPERATE, AND TO FURTHER THE EFFORTS OF THE UNITED METHODIST CHURCH BY OPERATING, A HOUSING FACILITY SPECIFICALLY DESIGNED TO MEET THE PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS OF ELDERLY AND HANDICAPPED PERSONS, AND TO PROMOTE THEIR HEALTH, SECURITY AND HAPPINESS IN LONGER LIVING. 14 14 171 16 0 0 2675 67625 5178882 5672331 0 0 49424 -8070 5230981 5731886 0 0 0 0 3045796 3230125 0 0 0 2380765 2568517 5426561 5798642 -195580 -66756 1219720 1456782 2756019 3059837 -1536299 -1603055 X THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO OPERATE, AND TO FURTHER THE EFFORTS OF THE UNITED METHODIST CHURCH BY OPERATING, A HOUSING FACILITY SPECIFICALLY DESIGNED TO MEET THE PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS OF ELDERLY AND HANDICAPPED PERSONS, AND TO PROMOTE THEIR HEALTH, SECURITY AND HAPPINESS IN LONGER LIVING. 0 0 4336197 5690413 THE ORGANIZATION OPERATES A 290-UNIT ASSISTED LIVING AND INDEPENDENT LIVING FACILITY IN MIAMI-DADE COUNTY, FLORIDA THAT PROVIDES RETIREMENT HOUSING, AS WELL AS LIMITED NURSING CARE. 4336197 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 37 0 1 171 1 0 0 0 0 0 0 0 1 1 0 X 14 14 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X BILL CONOL 3055565654 5300 W 16TH AVENUE HIALEAH FL 33012 JONAH PRUITT PRESIDENT 1.00 1.00 X X 0 0 0 GERTRUDE STEWART SECRETARY 1.00 1.00 X X 0 0 0 DENNIS NICHOLS TREASURER 0.50 0.50 X X 0 0 0 CYNTHIA WEEMS DIRECTOR 0.50 0.50 X 0 0 0 AVIS BROWN DIRECTOR 0.50 0.50 X 0 0 0 MARY CAY BLANKS DIRECTOR 0.50 0.50 X 0 0 0 MICHELLE DUNAJ LUCKING DIRECTOR 0.50 0.50 X 0 0 0 GEORGE FERNANDEZ DIRECTOR 0.50 0.50 X 0 0 0 HARRY JORDAN DIRECTOR 0.50 0.50 X 0 0 0 BERYL LOUGACHI DIRECTOR 0.50 0.50 X 0 0 0 JAKE ROUDENBUSH DIRECTOR 0.50 0.50 X 0 0 0 RENE RAMIREZ DIRECTOR 0.50 0.50 X 0 0 0 TASHA SMITH DIRECTOR 0.50 0.50 X 0 0 0 GUILLERMO SANCHEZ DIRECTOR 0.50 0.50 X 0 0 0 ANA DURAN ADMINISTRATOR 40.00 X 78175 0 0 NICK ANTONACCI EXECUTIVE DIRECTOR 40.00 X 0 0 0 78175 0 0 0 0 0 0 NEIGHBORHOOD HEALTH PARTNERSHIP PO BOX 580046 CHARLOTTE NC 28258 EMPLOYEE HEALTH INSURANCE 839385 DOS HEALTH MANAGEMENT 300 71ST STREET SUITE 400 MIAMI BEACH FL 33141 MANAGEMENT FEE 243239 ASCENDANT COMMERCIAL INSURANCE INC PO BOX 141368 CORAL GABLES FL 33114 WORKERS COMPENSATION 174627 3 67625 67625 RESIDENT SERVICE REVEN 623000 5672331 5672331 5672331 37481 67625 63633 -26152 -26152 OTHER INCOME 623000 18082 18082 18082 5731886 5690413 0 -26152 2634984 2223069 411915 44111 30184 13927 341059 254275 86784 209971 172872 37099 292360 292360 25000 25000 24574 7080 17494 93634 93634 892343 636299 256044 999205 983794 15411 4657 38 4619 500 500 107445 107445 25009 25009 PHARMACY EXPENSE 39771 39771 BAD DEBT EXPENSE 35433 35433 MEDICAL SUPPLIES 28586 28586 5798642 4336197 1462445 0 50681 291128 112527 81407 4530 4530 34170 45176 1288542 380725 993016 907817 24796 126724 1219720 1456782 342778 407240 43040 18268 2370201 2634329 2756019 3059837 X -1536299 -1603055 -1536299 -1603055 1219720 1456782 -66756 0 X X 0 1 X 1 0 X 2278 18500 10000 2675 26783 60236 3804957 4356574 4332080 5179167 5672331 23345109 3807235 4375074 4342080 5181842 5699114 23405345 0 0 0 23405345 1538909 2124 1916 6521 18082 1567552 5346144 4377198 4343996 5188363 5717196 24972897 0.93720 0.88290 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 279058 184146 463204 0 1048645 251368 797277 239897 129357 110540 907817 OTHER ASSETS 126724 126724 OTHER LIABILITIES 39621 DUE TO INTERCOMPANY 2594708 2634329 5731886 0 5731886 0 5731886 5798642 0 5798642 0 5798642 PART IV, LINE 1B: THE COMPANY COLLECTS A SECURITY DEPOSIT FROM EACH RESIDENT WHEN A RESIDENT AGREEMENT IS EXECUTED. THE INITIAL TERM OF EACH AGREEMENT IS FOR ONE YEAR FROM THE MOVE-IN DATE. THE AGREEMENT IS AUTOMATICALLY RENEWED FOR ANOTHER ONE-YEAR TERM, UNLESS WRITTEN NOTICE OF INTENT TO CANCEL THE AGREEMENT IS RECEIVED FROM THE RESIDENT AT LEAST 45 DAYS PRIOR TO THE EXPIRATION DATE OF THE AGREEMENT. IF THE AGREEMENT IS TERMINATED WITHIN THE FIRST YEAR, THE SECURITY DEPOSIT IS FORFEITED. AT JUNE 30, 2016 AND 2015, THE AMOUNT OF SECURITY DEPOSITS APPROXIMATED $463,000 AND $279,000, RESPECTIVELY. GOLF TOURNAMENT 53092 40280 12812 1450 0 27705 CASINO 18397 11000 7397 7269 3 33617 16345 17272 0 27209 105106 67625 37481 1450 62183 63633 -26152 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATED MANAGEMENT DUTIES TO DOS HEALTH SERVICES, INC. THROUGH A BOARD-APPROVED CONTRACT. FORM 990, PART VI, SECTION B, LINE 11 THE ACCOUNTING DIRECTOR CONDUCTS A COMPREHENSIVE REVIEW OF THE FORM 990 BEFORE IT IS FILED WITH THE IRS. A COPY OF THE FORM 990 IS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS BEFORE ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT-OF-INTEREST POLICY COVERS ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS. IT IS THE RESPONSIBILITY OF ALL PERSONS COVERED TO SCRUTINIZE THEIR TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES WHEN DETERMINED. THE ORGANIZATION'S BOARD OF DIRECTORS MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD OF DIRECTORS REVIEWS ACTUAL CONFLICTS THAT ARE IDENTIFIED BY THE DISCLOSURE PROCESS AND DETERMINES WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO THE ORGANIZATION. THE PERSON WITH THE CONFLICT OF INTEREST WILL BE EXCLUDED FROM DISCUSSION AND APPROVAL OF SUCH TRANSACTION. 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. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF AN INDEPENDENT AUDIT FIRM AND OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. ALDERSGATE HEALTHCARE INC 5300 WEST 16TH AVENUE HIALEAH FL 33012 161676092 OPERATES ASSISTED AND INDEPENDENT LIVING FACILITY FL 501(C)(3) LINE 9 N/A 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 ALDERSGATE HEALTHCARE INC E 2594708 FMV