2017-05-04T13:35:30-05:00 2016-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2016-01-01 020446675 PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM INC PETE 6039240062 150 RIVERMEAD ROAD PETERBOROUGH NH 03458 MARTIN J CONLEY III CFO 6039240062 2017-05-04 1 JULIUS GREEN CPA P00350393 2159720701 96.89.178.154 2017-05-04 10:31:24 ED P 28BAEDB381CC9909BEF06710D01DD1BFACC931C4 9D0D8DD59390B7764A3ECE0F40BBFE3618018605 2016 2021-01-29 14:40:06Z RIVERMEAD WILLIAM H JAMES JR 150 RIVERMEAD ROAD PETERBOROUGH NH 03458 33774226 0 X WWW.RIVERMEAD.ORG X 1991 NH CCRC COMMITTED TO PROVIDING EXCELLENT HOUSING AND HEALTH CARE SERVICES TO ITS RESIDENTS. 14 14 365 100 0 0 9530 40637 17124615 18274091 287142 580417 488925 302006 17910212 19197151 118703 117918 0 0 9150847 9584316 0 0 0 10094160 10054691 19363710 19756925 -1453498 -559774 75233893 76958886 95177977 96906547 -19944084 -19947661 X RIVERMEAD IS A PROGRESSIVE NOT-FOR-PROFIT CONTINUING CARE RETIREMENT COMMUNITY THAT ADVOCATES FOR AN ENRICHED LIFESTYLE WITH CULTURAL AND EDUCATIONAL OPPORTUNITIES. WE CONTINUOUSLY STRIVE TO PROVIDE HIGH-QUALITY, HOLISTIC LIFECARE PROGRAMS AND HEALTHCARE SERVICES IN A FINANCIALLY RESPONSIBLE MANNER. IN SERVING THIS COMMITMENT, WE SEEK TO PROVIDE A POSITIVE AND SUPPORTIVE WORK ENVIRONMENT. 0 0 17994596 117918 18274091 INDEPENDENT LIVING:RIVERMEAD HAS 153 INDEPENDENT LIVING RESIDENCES AVAILABLE FOR INDIVIDUALS AGED 62 AND OLDER. THESE RESIDENCES ARE AVAILABLE UNDER A LIFECARE CONTRACT, WHICH GUARANTEES RESIDENTS ACCESS TO ASSISTED LIVING, MEMORY SUPPORT AND SKILLED NURSING CARE WITH NO SIGNIFICANT CHANGE IN THEIR MONTHLY FEES AS THEY MOVE BETWEEN LEVELS OF CARE. RIVERMEAD HAS NEVER TERMINATED A RESIDENCE AND SERVICES AGREEMENT SOLELY BASED UPON A RESIDENT'S INABILITY TO PAY HIS OR HER MONTHLY FEE IN FULL. RIVERMEAD PROVIDED OVER $112,000 IN CHARITABLE ASSISTANCE TO RESIDENTS IN 2016.HEALTH CARE SERVICES: RIVERMEAD HAS 49 ASSISTED LIVING RESIDENCES, 17 MEMORY SUPPORT RESIDENCES, 33 SKILLED NURSING RESIDENCES AND A HOME HEALTH PROGRAM.PROGRAMS & AMENITIES:RIVERMEAD IS COMMITTED TO PROVIDING QUALITY PROGRAMS, SERVICES AND AMENITIES TO ENRICH RESIDENTS' LIVES INCLUDING: EXCEPTIONAL DINING EXPERIENCES, THERAPY SERVICES, HOUSEKEEPING, MAINTENANCE SERVICES, A WELLNESS CENTER, AN INDOOR POOL, TRANSPORTATION, TWO LIBRARIES, A MOVIE THEATER, A WOODWORKING SHOP, A GREEN HOUSE, AN ART GALLERY, WALKING TRAILS, CROQUET COURTS, BOCCE COURTS AND RAISED GARDEN BEDS. 17994596 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 41 0 1 365 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X MARTIN J CONLEY III 6033710431 150 RIVERMEAD RD PETERBOROUGH NH 03458 MICHAEL J RAFFERTY CHAIR 1.00 X X 0 0 0 JOHN ROUND VICE CHAIR 1.00 X X 0 0 0 JAMES C ADAMS TREASURER 1.00 X X 0 0 0 CLAY G HOLLISTER SECRETARY 1.00 X X 0 0 0 RICHARD P CHURCH TRUSTEE 1.00 X 0 0 0 JEFFREY R CROCKER TRUSTEE 1.00 X 0 0 0 RODERICK J FALBY JR TRUSTEE 1.00 X 0 0 0 CHRISTOPHER J FLYNN TRUSTEE 1.00 X 0 0 0 JANET S GRANT TRUSTEE 1.00 X 0 0 0 BETSEY HARRIS TRUSTEE 1.00 X 0 0 0 CONSTANCE G OLIVER TRUSTEE 1.00 X 0 0 0 ANNE PEIRCE TRUSTEE 1.00 X 0 0 0 THEODORE RENNA MD TRUSTEE 1.00 X 0 0 0 CALVIN SHOLL TRUSTEE 1.00 X 0 0 0 WILLIAM H JAMES JR CHIEF EXECUTIVE OFFICER 40.00 X 219367 0 32391 MARTIN J CONLEY III CHIEF FINANCIAL OFFICER 40.00 X 145303 0 29078 JAN EATON DIR MARKETING/RESIDENT SVCS 40.00 X 149060 0 22641 KARYN MINER HEALTH SVCS ADMINISTRATOR 40.00 X 145358 0 20907 DOUGLAS SHARP DIRECTOR OF FACILITIES 40.00 X 122012 0 29905 JULIE SIMO CONTROLLER 40.00 X 101383 0 18271 DIANNE TISDALE DIR HUMAN RESOURCES 40.00 X 100608 0 28778 983091 0 181971 7 0 1 0 FLIK LIFESTYLES PO BOX 102289 ATLANTA GA 303682289 DINING SERVICES 470303 HUNTER NORTH ASSOCIATES LLC PO BOX 56346 ATLANTA GA 30343 SECURITY SERVICES 228105 EYLES CONTRACTING INCORPORATED 65 AIRPORT ROAD FITCHBURG MA 01420 CONSTRUCTION SERVICES 210250 PRECISION TEMPERATURE CONTROL INC 460 ROUTE 101 BEDFORD NH 03110 CONSTRUCTION SERVICES 151591 HUTTER CONSTRUCTION 810 TURNPIKE RD NEW IPSWICH NH 03071 CONSTRUCTION SERVICES 135214 8 40637 40637 RESIDENT SERVICE FEES 623000 9905169 9905169 EARNED ENTRANCE FEES 623000 3342106 3342106 ASSISTED LIVING FEES 623000 2706781 2706781 HEALTH CENTER FEES 623000 1359366 1359366 SPECIAL CARE UNIT FEES 623000 960669 960669 18274091 374751 374751 15363 4097 11266 11266 11266 14778005 639 14572978 0 205027 639 205666 205666 GUEST MEAL REV 900099 79386 79386 NURSING SERVICES 900099 57863 57863 GUEST ROOM RENTAL 900099 47307 47307 106184 106184 290740 19197151 18274091 0 882423 4950 4950 112968 112968 426138 426138 6592056 6143337 448719 217819 205810 12009 1152315 1058408 93907 1195988 1056152 139836 15317 15317 97435 97435 1427 1427 825881 821521 4360 23160 23160 626328 438571 187757 198515 198515 2090676 2090676 66079 40139 25940 1870590 1870590 2596377 2596377 179450 179450 FOOD 883965 883965 REPAIRS & MAINTENANCE 303995 303995 RESIDENT ACTIVITIES 87289 87289 MEDICAL SUPPLIES 63639 63639 124568 36759 87809 19756925 17994596 1762329 0 1000 6967 2910627 1728453 230853 351520 31984 30295 449656 487254 76718779 27557294 50226068 49161485 20099107 23997970 1284598 1194942 75233893 76958886 1526030 1747046 60093988 62475483 33231200 32435375 6674 8391 167857 125000 152228 115252 95177977 96906547 X -20381002 -20381140 224995 206500 211923 226979 -19944084 -19947661 75233893 76958886 X -559774 541141 15056 X 0 1 X 1 0 X 255591 34895 122747 9530 40637 463400 11586314 13479888 15823703 17012462 18274091 76176458 11841905 13514783 15946450 17021992 18314728 76639858 0 0 0 76639858 418647 375108 381179 371090 390114 1936138 418647 375108 381179 371090 390114 1936138 207341 231135 344347 488925 290740 1562488 12467893 14121026 16671976 17882007 18995582 80138484 0.95630 0.95360 0.02420 0.02660 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1427 1427 0 PART II-B, LINE 1: PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC. IS A MEMBER OF LEADINGAGE MAINE AND NEW HAMPSHIRE AND THE LEADINGAGE NATIONAL ASSOCIATION. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS ARE AVAILABLE FOR LOBBYING EXPENDITURES ON BEHALF OF PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC. TO FURTHER OUR EXEMPT PURPOSE. PETERBOROUGH RETIREMENT COMMUNITY AT UPLAND FARM, INC. DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. 0 1 X 2121461 26390 109414 88632 3501 2165132 2203281 6030 -40245 45104 2501 2121461 2012677 95740 107514 12650 2203281 1781470 27380 205555 1728 2012677 1633304 151745 3579 1781470 0.79980 0.09540 0.10480 0 0 2295263 2295263 57941679 22721712 35219967 9425109 4734761 4690348 7056728 100821 6955907 49161485 GIFT ANNUITIES PAYABLE 115252 115252 X 19644477 541141 -97912 443229 19201248 -4097 -4097 19197151 19648054 4097 4097 19643957 112968 112968 19756925 PART IV, LINE 2B: RIVERMEAD MAINTAINS A RESIDENT TRUST ACCOUNT FOR RESIDENTS IN ITS ASSISTED LIVING AND SKILLED NURSING TO UTILIZE FOR PERSONAL EXPENSES. PART V, LINE 4: RIVERMEAD MAINTAINS TEMPORARILY RESTRICTED FUNDS, WHICH HAVE BEEN CONTRIBUTED WITH DONOR SPECIFIC RESTRICTIONS THAT ARE REASONABLY EXPECTED TO BE MET IN THE NEAR TO MID-TERM. THESE RESTRICTIONS ARE OUTLINED BY THE DONOR AT THE TIME OF THE GIFT. PRINCIPAL AND EARNINGS OF THESE GIFTS ARE RESTRICTED TO THE PURPOSE OUTLINED BY THE DONOR. RIVERMEAD MAINTAINS PERMANENTLY RESTRICTED FUNDS, THE PRINCIPAL OF WHICH SHALL BE MAINTAINED IN PERPETUITY, WHILE INCOME IS AVAILABLE TO PROVIDE CHARITABLE ASSISTANCE TO RIVERMEAD RESIDENTS. PART X, LINE 2: RIVERMEAD ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2016 OR 2015. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 15,056. CHARITIBLE ASSISTANCE TO RESIDENTS -112,968. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -4,097. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 4,097. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHARITIBLE ASSISTANCE TO RESIDENTS 112,968. 1 CHARITABLE ASSISTANCE WITH RESIDENT MONTHLY FEES 2 112968 0 PART I, LINE 2: MANAGEMENT IDENTIFIES RESIDENTS WHO MAY NEED CHARITABLE ASSISTANCE TO PAY THEIR MONTHLY FEES. ONCE IDENTIFIED, A REVIEW IS CONDUCTED OF THE RESIDENT'S FINANCES AND, IF THE RESIDENT TRULY HAS AN INABILITY TO PAY HIS OR HER MONTHLY FEE IN FULL, THEN THE REQUEST IS SENT TO THE CEO FOR APPROVAL. X X X 0 0 0 0 0 0 0 1 0 WILLIAM H JAMES JR CHIEF EXECUTIVE OFFICER 199002 0 20163 0 202 0 9307 0 23084 0 251758 0 0 0 MARTIN J CONLEY III CHIEF FINANCIAL OFFICER 133986 0 11244 0 73 0 5934 0 23144 0 174381 0 0 0 JAN EATON DIR MARKETING/RESIDENT SVCS 141743 0 7244 0 73 0 6360 0 16281 0 171701 0 0 0 KARYN MINER HEALTH SVCS ADMINISTRATOR 138041 0 7244 0 73 0 6126 0 14781 0 166265 0 0 0 DOUGLAS SHARP DIRECTOR OF FACILITIES 114695 0 7244 0 73 0 5192 0 24713 0 151917 0 0 0 PART I, LINE 7 THE MANAGEMENT BONUS IS CONTINGENT UPON MULTIPLE FACTORS INCLUDING OCCUPANCY, ACTUAL VS. BUDGETED RESULTS, RESIDENT SATISFACTION SURVEYS, STAFFING LEVELS, ETC. A NEW HAMPSHIRE HEALTH AND EDUCATON FACILITIES AUTHORITY 020279866 644614Q36 2011-12-15 31210000 EXPANSION OF FACILITY 0 0 0 B NEW HAMPSHIRE HEALTH AND EDUCATON FACILITIES AUTHORITY 020279866 2013-12-23 13550000 REFUNDING ISSUE OF SERIES 1998 BONDS 0 0 0 A 9540000 31184338 2161659 3752370 950885 24232513 2152096 2013 0 0 0 1 B 2331000 15841589 228202 15613388 2014 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: NEW HAMPSHIRE HEALTH AND EDUCATON FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/15/2016 PART II, LINE 3 THE DIFFERENCE BETWEEN THE TOTAL PROCEEDS OF ISSUE REPORTED IN PART II, LINE 3 AND THE ISSUE PRICE IN PART I, COLUMN (E) FOR BOND A REPRESENTS CONTRIBUTIONS OF $1,505,469.29 FROM THE 1998 DSR FUND AND $786,120.19 FROM THE 1998 DEBT SERVICE FUND FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT, INCLUDING THE CFO AND CEO WILL REVIEW INITIAL DRAFT VERSIONS OF THE 990. AFTER THEIR REVIEW AND ANY CHANGES RESULTING FROM THEIR REVIEW HAVE BEEN MADE THE 990 WILL BE REVIEWED BY THE AUDIT COMMITTEE IN DEPTH. AFTER THEIR REVIEW AND UPON RECOMMENDATION FOR APPROVAL BY THE AUDIT COMMITTEE, THE 990 WILL BE PROVIDED TO THE ENTIRE BOARD FOR THEIR REVIEW AND APPROVAL. CONTACT INFORMATION FOR THE CEO, CFO, AUDIT COMMITTEE AND 990 PREPARER (BAKER TILLY) WILL BE PROVIDED TO ALL BOARD MEMBERS SHOULD THEY HAVE QUESTIONS OR CONCERNS. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE AND OFFICER OF RIVERMEAD MUST BE EVER COGNIZANT AND AWARE OF POSSIBLE CONFLICT OF INTEREST SITUATIONS. ANY SUCH POSSIBLE CONFLICT MUST BE FULLY DISCLOSED IN WRITING TO THE BOARD OF TRUSTEES, AND WILL BE CONSIDERED BY THE BOARD FOR DISCUSSION, APPROVAL, OR ANY OTHER APPROPRIATE ACTION IN ACCORDANCE WITH THE REQUIREMENTS OF APPLICABLE LAW, AND ONLY IF THE MATTER SERVES THE BEST INTERESTS OF RIVERMEAD. RIVERMEAD IDENTIFIES POSSIBLE CONFLICTS OF INTEREST BY HAVING ALL TRUSTEES AND OFFICERS COMPLETE CONFLICT OF INTEREST QUESTIONNAIRES ANNUALLY. THE CEO IS RESPONSIBLE FOR ENSURING ALL QUESTIONNAIRES ARE COMPLETED. THE BOARD OF TRUSTEES REVIEWS EACH POTENTIAL CONFLICT OF INTEREST. BOARD MEMBERS WITH A CONFLICT ARE REQUIRED TO ABSTAIN FROM VOTING ON THE MATTER. NEW HAMPSHIRE AND FEDERAL LAWS REGARDING DISCLOSURE OF CONFLICTS OF INTEREST ARE FOLLOWED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CEO IS DETERMINED BY THE BOARD OF TRUSTEES USING DATA FROM THE LEADINGAGE NATIONAL SALARY SURVEY AND FROM FORM 990 DATA FROM COMPARABLE REGIONAL ORGANIZATIONS. THE CEO'S ANNUAL PERFORMANCE REVIEW IS ALSO CONSIDERED IN DETERMINING HIS ANNUAL COMPENSATION PACKAGE. THIS PROCESS IS DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. COMPENSATION OF OTHER MANAGEMENT STAFF IS DETERMINED BY THE CEO AND HR DIRECTOR. A COMPENSATION STUDY HAS BEEN CONDUCTED TO DEVELOP WAGE GRADES FOR EACH POSITION WITHIN THE ORGANIZATION. WAGE GRADES ARE REVIEWED ANNUALLY, UPDATED AS NEEDED AND ARE AN INTEGRAL PART OF DETERMINING COMPENSATION FOR NEW HIRES AND ADJUSTMENTS TO COMPENSATION FOR CURRENT EMPLOYEES. SALARY BENCHMARKING INFORMATION IS ALSO REVIEWED ANNUALLY TO DETERMINE THE APPROPRIATENESS OF COMPENSATION LEVELS. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE INCLUDED IN RIVERMEAD'S DISCLOSURE STATEMENT AND UPON REQUEST. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 15,056.