2017-05-09T13:46:44-05:00 2016-06-30 593070669 MOORE STEPHENS LOVELACE PA 201 E KENNEDY BLVD SUITE 650 TAMPA FL 33602 990 2015-07-01 592269292 MENORAH MANOR INC MENO 7273452775 255 59TH STREET NORTH ST PETERSBURG FL 33710 ROBERT GOLDSTEIN CHIEF EXECUTIVE OFFICER 7273452775 2017-05-09 1 HARRY E HARP CPA P00176471 8133142600 2015 2021-01-29 14:40:06Z ROBERT GOLDSTEIN 255 59TH STREET NORTH ST PETERSBURG FL 33710 25092062 0 X WWW.MENORAHMANOR.ORG X 1981 FL THE ORGANIZATION'S MISSION IS TO OPERATE AND MAINTAIN A HOME AND PROVIDE OTHER SERVICES TO SHELTER, PROTECT AND PROVIDE SERVICES TO THE AGED. 19 18 530 150 0 0 682330 628464 24951339 24460683 491 2915 -1462632 0 24171528 25092062 0 0 0 0 12022311 12513187 0 0 0 12936291 13035007 24958602 25548194 -787074 -456132 33591153 31200544 35299159 34870640 -1708006 -3670096 THE ORGANIZATION'S MISSION IS TO OPERATE AND MAINTAIN A HOME AND PROVIDE OTHER SERVICES TO SHELTER, PROTECT AND PROVIDE SERVICES TO THE AGED. 0 0 20898164 24463183 SEE SCHEDULE O 20898164 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 1 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 1 0 0 0 1 33 0 1 530 1 0 0 0 0 0 0 0 0 0 0 X 19 18 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DONNA PERRYMAN 7273023702 255 59TH STREET NORTH ST PETERSBURG FL 33710 BERNARD KANNER ESQ CHAIR 1.00 X X 0 0 0 ROBERT WEISBERG PHD VICE CHAIR AND CHAIR-ELECT 1.00 X X 0 0 0 HOWARD MILLER SECRETARY 1.00 X X 0 0 0 DAVID DELRAHIM ESQ TREASURER 1.00 X X 0 0 0 NAOMI ABEL MD TRUSTEE 1.00 X 0 0 0 BARBARA BAUGHMAN TRUSTEE 1.00 1.00 X 0 0 0 LENNY ENGLANDER ESQ TRUSTEE 1.00 X 0 0 0 RUTH GLICKMAN TRUSTEE 1.00 X 0 0 0 STEVE KLEIN TRUSTEE 1.00 X 0 0 0 ERIC LUDIN ESQ TRUSTEE 1.00 X 0 0 0 DAVID MARGER TRUSTEE 1.00 X 0 0 0 LARRY KRUG TRUSTEE 1.00 X 0 0 0 ERROL PEGLER TRUSTEE 1.00 X 0 0 0 SUSIE KLEMOW BERMAN TRUSTEE 1.00 1.00 X 0 0 0 STEVEN WARREN MD TRUSTEE 1.00 1.00 X 0 0 0 DAVID WEIN MD TRUSTEE 1.00 X 0 0 0 STEPHEN WEIN ESQ TRUSTEE 1.00 X 0 0 0 ROBERT GOLDSTEIN CHIEF EXECUTIVE OFFICER 40.00 10.00 X X 177055 42763 20674 DONNA PERRYMAN CHIEF FINANCIAL OFFICER 40.00 10.00 X 128979 29059 20400 ANNABELLE LOCSIN CHIEF NURSING OFFICER 40.00 10.00 X 144025 0 2768 JUDY LUDIN CHIEF DEVELOPMENT OFFICER 1.00 40.00 X 36743 90970 2233 GREG YANN CONTROLLER 40.00 10.00 X 101645 0 1835 588447 162792 47910 4 0 1 0 SELECT REHABILITATION INC PO BOX 809056D SUITE 2415 CHICAGO FL 60680 REHABILITATION THERAPY 1630448 TAMPA BAY TEMPS INC 2441 5TH AVENUE N ST PETERSBURG FL 33713 NURSING 472782 MMI DINING SYSTEMS 1000 RED FERN PLACE FLOWOOD MS 39232 DIETARY 281973 NSI STAFFING BRASWELL HOLDINGS LLC PO BOX 4729 WINTER PARK FL 32793 NURSING 266560 ARBOR TEMP PO BOX 354526 PALM COAST FL 32135 NURSING 140368 12 19714 366795 241955 628464 NET RESIDENT SERVICE REVENUE 623000 19278528 19278528 ASSISTED LIVING REVENUE 623000 5052555 5052555 OTHER OPERATING REVENUE 900099 129600 129600 24460683 415 415 2500 0 2500 2500 2500 25092062 24463183 0 415 X 308348 308348 10258168 8872480 1385688 64675 64675 1104473 166860 937613 777523 619079 158444 40709 40709 34585 34585 4225007 4020594 204413 42682 42682 619492 153653 465839 1135147 975090 160057 5937 3375 2562 39983 9198 30785 840740 840740 1628969 1338745 290224 502625 6750 495875 SUPPLIES 1181658 1181658 QUALITY ASSESSMENT FEE 1173160 1173160 RESIDENT CARE 1116737 1116737 EQUIPMENT RENTAL & MAIN 253897 226366 27531 193679 193679 25548194 20898164 4650030 0 2410 2410 1217284 986112 2445243 2184167 123861 123208 249045 358504 45589069 19888976 27649890 25700093 411718 1491702 1846050 33591153 31200544 1480472 1606362 31689065 30409144 48296 0 2081326 2855134 35299159 34870640 X -1708006 -3670096 -1708006 -3670096 33591153 31200544 X -456132 -1505958 X X 0 1 X 1 0 X 145870 91248 893678 682330 628464 2441590 145870 91248 893678 682330 628464 2441590 2441590 9891 1730 164 491 415 12691 12192 24547 25084 61823 2516104 111060254 0.97040 0.95810 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 85152 68149 153301 0 2911399 2911399 32560767 12071918 20488849 10023126 7817058 2206068 93777 93777 25700093 DUE FROM RELATED PARTY 196331 ASSETS WHOSE USE IS LIMITED 1565283 OTHER ASSETS 84436 1846050 RESIDENT DEPOSITS 58949 DUE TO RELATED PARTY 775000 EMPLOYEE BENEFIT LIABILITY 495375 INTEREST RATE SWAP AGREEMENT 1525810 2855134 23586104 -1505958 -1505958 25092062 0 25092062 25548194 0 25548194 0 25548194 PART IV, LINE 1B: THE ORGANIZATION OFFERS CASH MANAGEMENT SERVICES TO ITS RESIDENTS. THESE FUNDS REMAIN THE SOLE PROPERTY OF THE RESIDENTS AND ARE DISBURSED AS REQUESTED. THE ORGANIZATION ACTS ONLY AS A CUSTODIAN. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -722,555. IMPAIRMENT OF LOSS ON CARRYING VALUE OF LAND HELD FOR SALE -783,403. X X X X X X 0 1 0 0 0 0 0 0 0 ROBERT GOLDSTEIN CHIEF EXECUTIVE OFFICER 171055 42763 0 0 6000 0 17100 0 3574 0 197729 42763 0 0 DONNA PERRYMAN CHIEF FINANCIAL OFFICER 123883 29059 0 0 5096 0 17500 0 2900 0 149379 29059 0 0 PART I, LINE 4B ROBERT GOLDSTEIN PARTICIPATED IN A 457(F) PLAN - $17,100. DONNA PERRYMAN PARTICIPATED IN A 457(F) PLAN - $17,500. A CITY OF ST PETERSBURG HEALTH FACILITIES AUTHORITY 2014-10-01 32100000 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 1294286 32100000 200000 31489065 2014 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 0 0 NA 0 0 0 NA 0 0 0 A 1 SCHEDULE K, PART I, A,COLUMN(F) THE BOND PROCEEDS WILL BE USED FOR (1) FINANCING AND REFINANCING, INCLUDING THROUGH REIMBURSEMENT, OF ALL OR A PORTION OF THE COST OF THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF CERTAIN CAPITAL PROJECTS TO BE OWNED AND OPERATED BY MANORAH MANOR, INC, (2) REFINANCING CERTAIN LOANS FROM SUNTRUST BANK, (3) REFUNDING THE REFUNDING REVENUE AND REVENUE BONDS, SERIES 2009 AND 2012 PREVIOUSLY ISSUED BY THE AUTHORITY, (4) FUNDING AN OPERATING RESERVE AND REGULATORY RESERVE FUND AND, (5) FINANCING THE COSTS OF ISSUANCE OF THE SERIES 2014 BONDS. FORM 990, PART VI, SECTION A, LINE 2 DELL KRUG AND LARRY KRUG, FAMILY RELATIONSHIP WALTER LOEBENBERG AND MARION SAMSON-JOSEPH, FAMILY RELATIONSHIP FORM 990, PART VI, SECTION B, LINE 11 THE CEO AND A MEMBER OF THE EXECUTIVE COMMITTEE, AS DESIGNEES OF THE GOVERNING BOARD, CONDUCT A COMPREHENSIVE REVIEW OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT-OF-INTEREST POLICY COVERS ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS, ALL LEVELS OF STAFF, CONSULTANTS AND VOLUNTEERS, AND ANY OTHER INDIVIDUAL WITH FIDUCIARY RESPONSIBILITY TO THE ORGANIZATION. 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 CHIEF EXECUTIVE OFFICER MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY ANNUALLY. THE BOARD OF TRUSTEES 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 B, LINE 15 THE BOARD OF TRUSTEES DETERMINES THE COMPENSATION AND BENEFITS OF THE CHIEF EXECUTIVE OFFICER AND OTHER TOP MANAGEMENT OFFICIALS. THE BOARD OF TRUSTEES IS INDEPENDENT WITH RESPECT TO COMPENSATION ARRANGEMENTS BEING CONSIDERED. THE BOARD OF TRUSTEES UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, SALARY SURVEYS AND REVIEWS THE FORM 990 OF OTHER COMPARABLE ORGANIZATIONS. THE REVIEW AND APPROVAL PROCESS IS DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 1,742,312. MANAGEMENT AND GENERAL EXPENSES 187,118. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,929,430. CONSULTING FEES: PROGRAM SERVICE EXPENSES 74,918. MANAGEMENT AND GENERAL EXPENSES 17,295. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,213. REHABILITATION THERAPY SERVICE: PROGRAM SERVICE EXPENSES 1,756,729. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,756,729. DIETARY SERVICES: PROGRAM SERVICE EXPENSES 403,168. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 403,168. NURSING SERVICES: PROGRAM SERVICE EXPENSES 43,467. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,467. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -722,555. IMPAIRMENT LOSS ON CARRYING VALUE OF LAND HELD FOR SALE -783,403. FORM 990, PART XII, LINE 2C THE FINANCE COMMITTEE IS RESPONSIBLE FOR THE SELECTION, MONITORING AND EVALUATION OF THE INDEPENDENT AUDIT FIRM AND OVERSIGHT OF THE AUDIT. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE FINALIZED AND ISSUED SUBJECT TO THE APPROVAL OF THE BOARD OF TRUSTEES. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. MENORAH MANOR SENIOR LIVING LLC 255 59TH STREET NORTH ST PETERSBURG FL 33710 274697879 RESIDENTIAL LIVING FOR SENIOR CITIZENS FL 6446590 20558170 MENORAH MANOR INC MENORAH MANOR FOUNDATION INC 255 59TH STREET NORTH ST PETERSBURG FL 33710 592653608 PROVIDE SUPPORT FOR CHARITIES CARING FOR THE ELDERLY. FL 501(C)(3) LINE 11B, II N/A 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0