2017-05-15T10:27:03-05:00 2016-12-31 410746749 CLIFTONLARSONALLEN LLP 420 SOUTH ORANGE AVENUE SUITE 500 ORLANDO FL 32801 990 2016-01-01 591831906 JOHN KNOX VILLAGE OF CENTRAL FLORIDA INC JOHN 3867753840 101 NORTHLAKE DRIVE ORANGE CITY FL 32763 JOSEPH TRAINOR EXECUTIVE DIRECTOR 3867753840 2017-05-10 1 AMY CHAPMAN P00843460 4078021200 2017-05-10 67.137.57.251 2017-05-10 17:06:36 ED P DD57AA1B9DC831D7D4072B971DFBCA919264250B DD57AA1B9DC831D7D4072B971DFBCA919264250B 2016 2021-01-29 14:40:06Z JOSEPH TRAINOR 101 NORTHLAKE DRIVE ORANGE CITY FL 32763 46361674 0 X WWW.JOHNKNOX.COM X 1979 FL TO MEET THE PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS OF THE AGING AND TO CONTRIBUTE TO THEIR HEALTH. 8 8 792 80 32326 -69467 0 0 37892143 40709360 717 614880 581582 702472 38474442 42026712 0 0 0 0 19273370 19981414 0 0 0 14904440 15484949 34177810 35466363 4296632 6560349 103950036 114707382 44748178 45959249 59201858 68748133 MEET THE PHYSICAL, SOCIAL AND PSYCHOLOGICAL NEEDS OF THE AGING AND TO CONTRIBUTE TO THEIR HEALTH, SECURITY AND ENJOYMENT OF LIFE THROUGH THE PROVISION OF SERVICES THAT INCLUDE INDEPENDENT LIVING ACCOMMODATIONS, ASSISTED LIVING CARE, HOME HEALTH CARE, AND SKILLED NURSING CARE. 0 0 26695315 39400197 OPERATION OF A LIFE CARE RETIREMENT COMMUNITY PROVIDING HOUSING, HEALTH CARE, SECURITY, DIETARY, SOCIAL, AND RELATED SERVICES TO OVER 700 RESIDENTS IN A MODEL CAMPUS COMMUNITY TO PERSONS ABOVE 65 YEARS OF AGE WITHOUT REGARD TO RACE, SEX, COLOR, CREED OR NATIONAL ORIGIN. 2061856 1518052 OAK PARK: IN 2015 JOHN KNOX VILLAGE OF CENTRAL FLORIDA, INC. OPENED A NEW SENIOR SERVICES BUILDING INCLUDING A PHARMACY, OUTPATIENT REHABILITATION AND CLINIC. 28757171 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 38 0 792 1 1 1 0 0 0 0 0 0 0 0 0 X 8 8 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X X JOSEPH TRAINOR EXECUTIVE DIRECTOR 3867753840 101 NORTHLAKE DRIVE ORANGE CITY FL 32763 TAVER CORNETT CHAIRMAN 1.00 X X 0 0 0 DR BURL BURGESS VICE CHAIRMAN 1.00 X X 0 0 0 DENNIS STARK SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 DONALD DEMPSEY DIRECTOR 1.00 2.00 X 0 0 0 WILLIAM O'CONNOR DIRECTOR 1.00 X 0 0 0 JEFFERY RITCHEY DIRECTOR 1.00 2.00 X 0 0 0 CHERYL LANKFORD DIRECTOR 1.00 X 0 0 0 PAULA KELTON DIRECTOR 1.00 X 0 0 0 JOSEPH TRAINOR EXECUTIVE DIRECTOR 40.00 X 240500 0 34503 CARRIE GREIN DIRECTOR OF FINANCE 40.00 X 89084 0 4999 JOSEPH RUDOLPH DIRECTOR OF PLANNING & DEV 40.00 X 159848 0 19683 PAUL SKELTON DIRECTOR OF PHARMACY 40.00 X 123755 0 0 KENNETH BEHNKE DIRECTOR OF OPERATIONS 40.00 X 146203 0 16799 MARTHA NAVARRETE ARNP 40.00 X 137749 0 10731 LESLY MOMPOINT HEALTH SERVICES ADMINISTRATOR 40.00 X 146528 0 6318 1043667 0 93033 6 0 1 0 HARTY TRACTOR SERVICE INC PO BOX 741674 ORANGE CITY FL 32763 CONSTRUCTION 1029031 RIVERWOOD RETIREMENT MANAGEMENT INC 101 NORTHLAKE DRIVE ORANGE CITY FL 32763 MANAGEMENT 775342 STRAIGHT LINE MASONRY OF VOLUSIA LLC 2159 ADELIA BLVD DELTONA FL 32725 CONSTRUCTION 568914 I-TECH 2711 REW CIRCLE OCOEE FL 34761 IT SERVICES 372486 THYSSENKRUPP ELEVATOR PO BOX 933004 ATLANTA GA 31193 RENOVATION SERVICES 371878 23 HEALTH CARE SERVICES 623000 18136624 18136624 RESIDENT SERVICE FEES 623000 12111920 12111920 ENTRANCE FEES 623000 5875982 5875982 FOOD SERVICE FEES 623000 3034456 3034456 PHARMACY SERVICES 446110 1550378 1518052 32326 40709360 925902 925902 730542 269285 461257 461257 461257 3732635 22020 4034372 31305 -301737 -9285 -311022 -311022 ANCILIARY SERVICE 623000 241215 241215 241215 42026712 40918249 32326 1076137 548617 548617 15668352 13113533 2554819 126560 117830 8730 2437331 2111315 326016 1200554 1069430 131124 768800 393592 375208 100 100 74778 74778 965215 914001 51214 529829 54438 475391 406751 288761 117990 305857 261470 44387 2176609 1647190 529419 136439 105736 30703 39253 12420 26833 4312642 3323156 989486 435241 250895 184346 FOOD SERVICE EXPENSES 2595164 2437524 157640 MEDICAL SUPPLIES 993671 993671 REPAIRS AND MAINTENANCE 646942 624878 22064 LICENSES AND FEES 78574 58893 19681 1019084 978338 40746 35466363 28757171 6709192 0 6238289 5030200 672362 462159 1674641 2033111 339 215540 281019 229179 261373 127273336 69637948 54009883 57635388 38162528 43670220 2521307 5116592 225968 217320 103950036 114707382 1812001 2195124 24722026 24891662 18214151 18872463 44748178 45959249 X 58215091 67712736 75917 119571 910850 915826 59201858 68748133 103950036 114707382 6560349 2985926 0 X X 0 1 X 1 0 X 33550813 34678790 35801641 38011285 40950575 182993104 33550813 34678790 35801641 38011285 40950575 182993104 0 0 0 182993104 999353 1210144 1800474 1472830 1387159 6869960 999353 1210144 1800474 1472830 1387159 6869960 94866 25115 105918 225899 34645032 35914049 37708033 39484115 42337734 190088963 0.96270 0.96050 0.03610 0.03760 X 10657222 10657222 42109544 24576758 17532786 53435123 35987714 17447409 13210866 9073476 4137390 7860581 7860581 57635388 REFUNDABLE DEPOSITS 972146 REFUNDABLE ENTRANCE FEES 17900317 18872463 X 41649532 245673 245673 41403859 622853 622853 42026712 35089183 245673 245673 34843510 622853 622853 35466363 PART X, LINE 2: THE VILLAGE IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. PINE FOREST IS A FLORIDA LIMITED LIABILITY COMPANY WHICH WILL BE TREATED AS A DISREGARDED ENTITY FOR FEDERAL INCOME TAX PURPOSES. NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE TAXES. THE CORPORATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE CORPORATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE THEIR TAX-EXEMPT STATUS. THE CORPORATION IS SUBJECT TO TAX ON UNRELATED BUSINESS INCOME FOR MANAGEMENT FEES RECEIVED BUT IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO EXCISE OR OTHER TAXES. THE 2013, 2014, AND 2015 TAX RETURNS ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 245,673. PART XI, LINE 4B - OTHER ADJUSTMENTS: OTHER FOOD SERVICE REVENUE 622,853. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 245,673. PART XII, LINE 4B - OTHER ADJUSTMENTS: OTHER FOOD SERVICE REVENUE 622,853. X X X X X X 0 0 0 0 0 0 0 0 0 JOSEPH TRAINOR EXECUTIVE DIRECTOR 210500 0 30000 0 0 0 9568 0 24935 0 275003 0 0 0 JOSEPH RUDOLPH DIRECTOR OF PLANNING & DEV 149989 0 0 0 9859 0 8999 0 10684 0 179531 0 0 0 KENNETH BEHNKE DIRECTOR OF OPERATIONS 137330 0 0 0 8873 0 8240 0 8559 0 163002 0 0 0 LESLY MOMPOINT HEALTH SERVICES ADMINISTRATOR 125478 0 10525 0 10525 0 0 0 6318 0 152846 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE BOARD OF DIRECTORS HAS CONTRACTED WITH A MANAGEMENT COMPANY TO OPERATE THE ORGANIZATION'S ROUTINE FUNCTIONS AND RESERVES THE RIGHT TO EXERCISE CONTROL OVER THE ORGANIZATION'S OPERATIONS. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF THE FORM 990 IS GIVEN TO THE BOARD OF DIRECTORS PRIOR TO FILING. QUESTIONS OR COMMENTS ARE DISCUSSED PRIOR TO FILING THE FORM WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE OF POTENTIAL CONFLICTS ARE REQUIRED ON AN ANNUAL BASIS AND BEFORE EACH VOTE OF THE BOARD OF DIRECTORS ON MATTERS OF A FINANCIAL NATURE. THIS PROCESS IS COORDINATED AND VERIFIED BY THE CHAIRMAN OF THE BOARD AND CORPORATE COUNSEL. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CEO IS UNDERTAKEN BY THE MANAGEMENT COMPANY ENGAGED BY THE BOARD. THE PROCESS INCLUDES REVIEW OF THE STATE OF FLORIDA PUBLIC RECORDS OF SIMILARLY SITUATED ORGANIZATIONS AND INDUSTRY COMPENSATION GUIDES PUBLISHED ANNUALLY. THE FINAL DETERMINATION OF CEO COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS. COMPENSATION OF KEY EMPLOYEES IS UNDERTAKEN BY THE MANAGEMENT COMPANY ENGAGED BY THE BOARD. THE PROCESS INCLUDES REVIEW OF THE STATE OF FLORIDA PUBLIC RECORDS OF SIMILARLY SITUATED ORGANIZATIONS AND INDUSTRY COMPENSATION GUIDES PUBLISHED ANNUALLY. THE FINAL DETERMINATION OF KEY EMPLOYEE COMPENSATION IS APPROVED BY THE MANAGEMENT COMPANY AND EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES AVAILABLE FOR INSPECTION UPON REQUEST GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, FORM 990, AUDITED FINANCIAL STATEMENTS, AND OTHER REGULATORY FILINGS THAT LEND THEMSELVES TO INCREASED TRANSPARENCY. FORM 990, PART XII, LINE 2C: OVERSIGHT OF AUDIT: THE BOARD OF DIRECTORS OF JOHN KNOX VILLAGE OF CENTRAL FLORIDA, INC. HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. PINE FOREST PARK OF CENTRAL FLORIDA LLC 101 NORTHLAKE DRIVE ORANGE CITY FL 32763 464847895 MANAGEMENT OF RENTAL HOME COMMUNITY FL 675366 7960082 JOHN KNOX VILLAGE OF CENTRAL FLORIDA JKV FOUNDATION INC 101 NORTHLAKE DRIVE ORANGE CITY FL 32763 593108265 SUPPORT THE RESIDENTS OF JKV FL 501(C)(3) LINE 7 JOHN KNOX VILLAGE OF CENTRAL FLORIDA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0