2017-05-09T07:23:04-05:00 2016-06-30 410746749 CLIFTONLARSONALLEN LLP 610 W GERMANTOWN PIKE STE 400 PLYMOUTH MEETING PA 19462 990 2015-07-01 232613942 RIDDLE VILLAGE RIDD 6108913777 1048 W BALTIMORE PIKE MEDIA PA 19063 ROBERT BERTOLETTE CEO PRESIDENT/CEO 6108913777 2017-05-01 1 SETH BRODY P01586423 2156433900 2015 2021-01-29 14:40:06Z ROBERT BERTOLETTE 1048 W BALTIMORE PIKE MEDIA PA 19063 29002818 0 X WWW.RIDDLEVILLAGE.COM X 1993 PA TO ENRICH THE VALUE OF RETIREMENT LIVING FOR RESIDENTS & LIVES OF THOSE WHO SUPPORT THEM. 9 9 503 40 0 0 126030 102615 27575296 28793820 121087 106383 0 0 27822413 29002818 0 0 0 0 11372405 11574715 0 0 0 15918675 15904997 27291080 27479712 531333 1523106 50288665 54371143 91310862 93822950 -41022197 -39451807 X TO ENRICH THE VALUE OF RETIREMENT LIVING FOR OUR RESIDENTS AND THE LIVES OF THOSE WHO SUPPORT THEM. 0 0 14334233 0 19049320 INDEPENDENT LIVING FACILITY, CONSISTING OF 365 UNITS, IS DESIGNED TO ALLOW EACH RESIDENT TO LIVE THEIR LIFE TO THE FULLEST WITHOUT THE CONCERNS ASSOCIATED WITH POSSIBLE FUTURE HEALTHCARE NEEDS. THE ORGANIZATION PROVIDE MEALS, HOUSEKEEPING, ACTIVITIES, WELLNESS, 24 HOUR NURSE AVAILABILITY AND A FITNESS CENTER THAT ENCOURAGES RESIDENTS TO REMAIN AS ACTIVE AS POSSIBLE. AS A CCRC, RIDDLE VILLAGE PROVIDES SUBSIDIES TO ANY RESIDENT WHO IS UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS TO THE COMMUNITY. THE ORGANIZATION CURRENTLY HAS AT LEAST TWO RESIDENTS WHO ARE IN NEED OF THIS SUBSIDY WITH OTHERS REQUESTING ASSISTANCE RECENTLY DO TO THE DOWNTURN IN THE ECONOMY. RIDDLE VILLAGE HOSTS MANY COMMUNITY EVENTS, IS A VOTING CENTER DURING ELECTIONS AND SUPPORTS THE OVERALL COMMUNITY BY PARTICIPATING IN THE PAYMENT OF LOCAL, COUNTY AND SCHOOL TAXES. 3825897 0 5888661 PERSONAL CARE UNIT - CONSISTS OF 49 APARTMENTS BOTH STUDIO AND ONE-BEDROOMS. THERE WAS A RECENT EXPANSION AND REFURBISHING PROJECT FOR BOTH PERSONAL CARE UNIT AND SKILLED NURSING FACILITY TO ALLOW FOR A MORE HOME LIKE ENVIRONMENT, MORE GATHERING PLACES FOR RESIDENTS, FAMILY AND FRIENDS AND KITCHEN FACILITIES TO BETTER SERVE OUR RESIDENTS. IT IS OUR PHILOSOPHY THAT EACH RESIDENTS CARE, PHYSICAL AND EMOTIONAL HEALTH IS EQUALLY IMPORTANT. THIS UNIT CONSISTS OF BOTH LIFECARE RESIDENTS AND PRIVATE PAY RESIDENTS. ALL LIFECARE RESIDENTS ARE GUARANTEED CARE REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. 5255374 0 3855839 SKILLED NURSING FACILITY - CONSISTS OF 86 SKILLED BEDS. THE FACILITY IS DESIGNED TO PROVIDE A HOME LIKE ATMOSPHERE TO ENSURE THAT RESIDENTS ARE COMFORTABLE IN ALL STAGES OF THEIR LIFE. THIS FACILITY ALSO CARES FOR LIFECARE RESIDENTS AND PRIVATE PAY RESIDENTS. WE ALSO PROVIDE FOR MEDICARE AND OTHER THIRD PARTY BILLING RESIDENTS. ALL LIFECARE RESIDENTS ARE GUARANTEED CARE REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH SERVICES. 23415504 1 1 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 24 0 503 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X KIMBERLY ROGUSZEWSKI 6108913777 1048 WEST BALTIMORE PIKE MEDIA PA 19063 DANIEL E KENNEDY CHAIR 1.00 X X 0 0 0 JOSEPH P BROOKS VICE CHAIR 1.00 X X 0 0 0 JOHN D HELMS SECRETARY 1.00 X X 0 0 0 MARIA C BUCCO DIRECTOR 1.00 X 0 0 0 ROBERT F FISCHER DIRECTOR 1.00 X 0 0 0 JOSEPH LUNDY ESQ DIRECTOR 1.00 X 0 0 0 LEONARD MCCANDLESS DIRECTOR 1.00 X 0 0 0 EDWARD MCKILLIP DIRECTOR 1.00 X 0 0 0 ROBERT L SUMNER DIRECTOR 1.00 X 0 0 0 ROBERT G BERTOLETTE PRESIDENT/CEO 40.00 X 335640 0 46363 KIMBERLY ROGUSZEWSKI VICE PRESIDENT/CFO 40.00 X 203206 0 33882 RONALD WATERMAN VICE PRESIDENT/COO 40.00 X 194990 0 35878 KRISTEN LAMANNA DIRECTOR OF MARKETING 40.00 X 143578 0 547 CARMEN GIDDINGS ASST. NURSING HOME ADMINISTRATOR 40.00 X 113124 0 28480 990538 0 145150 5 0 1 0 REHAB CARE GROUP INC SRS DIVISION PO BOX 503534 ST LOUIS MO 631503534 PHYSICAL AND SPEECH THERAPY 1176858 WEST CHESTER MECHANICAL 20 MCDONALD BLVD SUITE 3 ASTON PA 19014 MECHANICAL SERVICES 1086734 CLASSIC KITCHENS 622 E GAY STREET WEST CHESTER PA 19380 REFURBISHING CONTRACTORS 829205 JOTTAN INC PO BOX 166 FLORENCE NJ 08518 ROOF REPLACEMENT 380736 TANGLEWOOD PAINTING CORP 278 BRIDGEWATER ROAD BROOKHAVEN PA 19015 REFURBISHING CONTRACTORS 208825 9 102615 102615 RESIDENT CARE 623000 14033396 14033396 NET PATIENT SERVICE REVENUE 623000 9815230 9815230 EARNED ENTRANCE FEE 623000 4912093 4912093 33101 33101 28793820 106383 106383 29002818 28793820 0 106383 760414 760414 8701216 7935621 765595 84494 76045 8449 1268513 1214029 54484 760078 684070 76008 22000 22000 60064 60064 319383 319383 884328 884328 2756069 2480462 275607 48622 10741 37881 1484944 1336450 148494 4555560 4100004 455556 737696 663926 73770 NURSING 1866189 1866189 0 DINING SERVICES 1707667 1707667 PLANT AND MAINTENANCE 1221747 1099572 122175 240728 240728 27479712 23415504 4064208 0 723261 960818 5067004 4504972 187823 201976 1455645 1434230 104735882 77741292 27263029 26994590 14802151 19583673 789752 690884 50288665 54371143 1267019 1407825 41455392 45539816 45645000 44315000 1688453 1369392 1254998 1190917 91310862 93822950 X -43490793 -42023018 693907 796486 1774689 1774725 -41022197 -39451807 50288665 54371143 X 1523106 -16796 64080 X X 0 1 X 1 0 X 1138619 103398 121058 126030 102615 1591720 26083204 26415152 26349671 27575296 28793820 135217143 27221823 26518550 26470729 27701326 28896435 136808863 0 0 0 136808863 104166 147744 79363 121087 106383 558743 104166 147744 79363 121087 106383 558743 27325989 26666294 26550092 27822413 29002818 137367606 0.99590 0.99560 0.00410 0.00440 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1777330 76963 26314 1880607 1651352 125978 1777330 1530294 69474 48943 1648711 1426896 103398 1530294 777704 649192 1426896 1.00000 0.00000 0.00000 0 0 68713413 41182076 27531337 5897402 5448233 449169 30125067 31110983 -985916 26994590 INTEREST RATE SWAP AGREEMENT 1190917 1190917 X 29050102 -16796 64080 47284 29002818 0 29002818 27479712 0 27479712 0 27479712 PART IV, LINE 2B: THE ORGANIZATION HAS BEEN HOLDING DEPOSITS RECEIVED FROM PROSPECTIVE RESIDENTS THAT ARE FULLY REFUNDABLE UNTIL THEY SIGN A RESIDENT AGREEMENT, AT WHICH TIME THE DEPOSITS ARE APPLIED TOWARD THE RESIDENTS' ENTRANCE FEE. PART V, LINE 4: THE VILLAGE HAS ESTABLISHED AN ENDOWMENT FUND TO PROVIDE A SOURCE FOR FINANCIAL ASSISTANCE TO RESIDENTS OF THE COMMUNITY WHO ARE ABLE TO DEMONSTRATE FINANCIAL NEED FOR THE COST OF CARE. PART X, LINE 2: FIN 48 FOOTNOTE: THE VILLAGE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 509(A)(2) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REQUIRED. THE VILLAGE FOLLOWS THE PROVISIONS OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE VILLAGE BELIEVES THAT THERE IS NO UNCERTAINTY IN THE TAX POSITIONS TAKEN BY THE VILLAGE AND THESE PROVISIONS HAVE NO IMPACT ON THE VILLAGE'S FINANCIAL STATEMENTS. THE VILLAGE'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 64,080. X X X X 0 0 0 0 0 0 0 0 0 ROBERT G BERTOLETTE PRESIDENT/CEO 232268 0 86944 0 16428 0 18000 0 28363 0 382003 0 0 0 KIMBERLY ROGUSZEWSKI VICE PRESIDENT/CFO 174947 0 25759 0 2500 0 5000 0 28882 0 237088 0 0 0 RONALD WATERMAN VICE PRESIDENT/COO 166131 0 26359 0 2500 0 5000 0 30878 0 230868 0 0 0 A DELAWARE COUNTY AUTHORITY 231973437 2011-10-03 30000000 TO REFINANCE THE 2005 BONDS AND PARTIAL 2006 BONDS 0 0 0 B DELAWARE COUNTY AUTHORITY 231973437 2013-10-31 18610000 TO REFUND THE 2006 BONDS 0 0 0 A 2870000 30000000 390000 29610000 2011 1 0 1 1 B 1425000 18610000 18610000 2013 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 1 1 1 CITIZEN'S BANK OF PENNSYLVANIA 5.000000000000 0 0 0 0 1 B 1 1 1 CITIZEN'S BANK OF PENNSYLVANIA 5.000000000000 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE AUTHORITY OF THE BOARD, TO THE EXTENT PERMITTED BY APPLICABLE LAW, BETWEEN MEETINGS OF THE BAORD. MEETINGS OF THE EXECUTIVE COMMITTEE MAY BE CALLED AT ANY TIME BY THE CHAIR OF COMMITTEE, BY THE CHAIR OF THE BOARD OR BY ANY TWO MEMBERS OF THE COMMITTEE. NOTICE OF SPECIAL MEETINGS OF THE EXECUTIVE COMMITTEE SHALL BE GIVEN AT LEAST TWO DAYS BEFORE SUCH MEETING, BUT WRITTEN NOTICE SHALL NOT BE REQUIRED. FORM 990, PART VI, SECTION A, LINE 7A ONE DIRECTOR SHALL BE NOMINATED BY THE RIDDLE HEALTH CARE FOUNDATION, AND PROVIDED THAT SUCH NOMINEE IS OTHERWISE QUALIFIED UNDER THESE BYLAWS AND APPLICABLE LAW, SUCH NOMINEE SHALL BE ELECTED BY THE BOARD TO SERVE FOR A TERM OF ONE YEAR, AND SHALL BE ELIGIBLE FOR SUCCEEDING ONE-YEAR TERMS WITHOUT LIMIT. AT ALL TIMES, A MAJORITY OF ALL OF THE DIRECTOS SHALL BE NON-RESIDENTS OF RIDDLE VILLAGE. NO DIRECTOR, EXCEPT THE DIRECTOR NOMINATED BY THE RIDDLE HEALTH CARE FOUNDATION, MAY SERVE MORE THAN TWO CONSECUTIVE FULL TERMS. FORM 990, PART VI, SECTION B, LINE 11 ALL MEMBERS OF THE BOARD REVIEW THE FORM PRIOR TO THE FILING THEREOF. FORM 990, PART VI, SECTION B, LINE 12C CURRENTLY, ALL MEMBERS OF THE BOARD REVIEW THE CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. THEY CONFIRM THAT THEY HAVE NO SUCH CONFLICT IF APPROPRIATE. IF CONFLICT WERE TO EXIST, THE BOARD AS A WHOLE WOULD REVIEW EACH POTENTIAL CONFLICT AND DETERMINE THE APPROPRIATENESS OF THE ACTION. ANY BOARD MEMBER INVOLVED IN A CONFLICT WOULD BE UNABLE TO VOTE ON ANY ACTION, PURCHASE OR DECISION BEING MADE. IN ADDITION, EACH SENIOR MANAGEMENT REPRESENTATIVE SIGNS A SIMILAR STATEMENT. DIRECTORS WITH A POTENTIAL CONFLICT ARE EXCLUDED FROM DECISION MAKING IN THAT AREA. FORM 990, PART VI, SECTION B, LINE 15 RIDDLE VILLAGE HAS A COMPENSATION COMMITTEE AS PART OF THE RIDDLE VILLAGE BOARD OF DIRECTORS. THE COMMITTEE IS MADE UP OF SEVERAL INDEPENDENT MEMBERS OF THE BOARD WHO REVIEW SALARY SURVEYS, WORK PERFORMANCE, COMPLETION OF ANNUAL GOALS AND JOB DESCRIPTIONS IN DETERMINING A FAIR WAGE FOR THE CEO. THEY ALSO REVIEW COO AND CFO POSITIONS RELATED TO THE SAME AREAS TO GIVE FINAL APPROVAL OF THE CEO'S RECOMMENDATION OF THEIR SALARIES. THIS PROCESS WAS LAST PERFORMED IN DECEMBER, 2015. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES ITS FORM 1023 AND FORM 990 AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE DISTRIBUTED TO RESIDENTS AND FILED WITH THE PA INSURANCE DEPARTMENT. THE FINANCIAL STATEMENTS ARE ALSO MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF SWAP AGREEMENT 64,080. FORM 990, PART XI, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. RIDDLE VILLAGE DEVELOPMENT LLC 1048 WEST BALTIMORE PIKE MEDIA PA 19063 262397145 IMPLEMENTING DEVELOPMENT OF ADDITIONAL FACILITIES PA 0 0 RIDDLE VILLAGE