2016-07-13T14:45:01-05:00 2015-12-31 593070669 MOORE STEPHENS LOVELACE PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2015-01-01 592555812 LIFE CARE PONTE VEDRA INC LIFE 9042731701 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 D BRUCE JONES CEO 9042731701 2016-07-13 1 HARRY E HARP CPA P00176471 4077405400 2015 2016-09-27 15:27:22Z VICAR'S LANDING D BRUCE JONES 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 20891925 0 X WWW.VICARSLANDING.COM X 1983 FL TO PROVIDE FOR THE HOUSING, PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, RELIGIOUS, HEALTH CARE AND FINANCIAL SECURITY NEEDS OF THE RESIDENTS OF VICAR'S LANDING. 8 8 470 148 0 0 410666 359184 18805200 19970508 -1639006 562233 0 0 17576860 20891925 0 150000 0 5864 8403263 8775802 0 0 0 10452701 11408070 18855964 20339736 -1279104 552189 74863872 71324119 110754170 107595519 -35890298 -36271400 TO PROVIDE FOR THE HOUSING, PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, RELIGIOUS, HEALTH CARE AND FINANCIAL SECURITY NEEDS OF THE RESIDENTS OF VICAR'S LANDING. 0 0 17348202 150000 20270220 THE RETIREMENT COMMUNITY CONSISTS OF 227 INDEPENDENT RESIDENTIAL UNITS, 38 ASSISTED LIVING UNITS, AND A 60-BED SKILLED NURSING CENTER. THE ORGANIZATION OPERATES UNDER THE "CONTINUING CARE" CONCEPT IN WHICH RESIDENTS ENTER INTO AN OCCUPANCY AGREEMENT, WHICH REQUIRES PAYMENT OF A ONE-TIME ENTRANCE FEE AND A MONTHLY SERVICE FEE. GENERALLY, THESE PAYMENTS ENTITLE RESIDENTS TO THE USE AND PRIVILEGE OF VICAR'S LANDING FOR LIFE, INCLUDING CERTAIN NURSING SERVICES IN THE ORGANIZATION'S SKILLED NURSING FACILITY. THE OCCUPANCY AGREEMENT DOES NOT ENTITLE THE RESIDENTS TO AN INTEREST IN THE REAL ESTATE OR ANY PROPERTY OWNED BY THE ORGANIZATION. 17348202 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 39 0 1 470 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X D BRUCE JONES 9042731701 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 BRUCE VORSANGER CHAIR 2.00 6.00 X X 0 0 0 MARK BONNER VICE CHAIR 4.00 2.00 X X 0 0 0 JOHN STROM TREASURER 1.00 3.00 X X 0 0 0 JUDITH HAM BOARD MEMBER 1.00 X 0 0 0 MICHAEL HARVICK BOARD MEMBER 1.00 2.00 X 0 0 0 BRUCE BARBER BOARD MEMBER 1.00 X 0 0 0 TOM REEDER BOARD MEMBER 1.00 X 0 0 0 ROBERT K OHNO BOARD MEMBER 1.00 X 0 0 0 D BRUCE JONES CHIEF EXECUTIVE OFFICER 15.00 25.00 X 0 200756 25185 DALE PIRKLE CHIEF OPERATING OFFICER 20.00 20.00 X 0 137513 8358 CANDACE BOWLING DIRECTOR OF FINANCE 18.00 22.00 X 0 112673 10145 THERESA CROSBY DIRECTOR OF MARKETING 40.00 X 135720 0 5429 135720 450942 49117 1 0 1 0 ELKINS CONSTRUCTORS INC 701 WEST ADAMS STREET JACKSONVILLE FL 32204 GENERAL CONTRACTOR SERVICES 4431627 ABACUS CONTRACTING LLC 1008 LORING AVE SUITE 29 ORANGE PARK FL 32073 CONSTRUCTION SERVICES 1616738 SIMPLEXGRINNELL 10255 FORTUNE PKWY JACKSONVILLE FL 32256 FIRE ALARM/SAFETY UPGRADES AND MONITORIN 640482 JAX HOME HEALTH INC 9191 RG SKINNER PARKWAY JACKSONVILLE FL 32256 MEMBER PAYMENT/PASSTHROUGH 287773 VALLEY CREST LANDSCAPING PO BOX 404083 ATLANTA GA 30384 LANDSCAPING SERVICES 256441 14 359184 359184 MONTHLY SERVICE FEES 623000 12344111 12344111 EARNED ENTRANCE FEEES 623000 3320375 3320375 SKILLED NURSING CENTER 623000 2468356 2468356 ASSISTED LIVING FACILITY 623000 1463499 1463499 HOME HEALTH 623000 374167 374167 19970508 262521 262521 299712 0 299712 299712 299712 20891925 20270220 0 262521 150000 150000 5864 5864 7216913 6104545 1112368 131485 111219 20266 902258 763190 139068 525146 504431 20715 347449 347449 53682 53682 208156 208156 59557 59557 230206 118341 111865 261808 261808 1741621 1741621 42097 1199 40898 43584 10149 33435 779286 664670 114616 4257344 3631181 626163 469272 400252 69020 DIETARY COSTS 1272438 1272438 MAINTENANCE & REPAIRS 1108068 1104428 3640 SUPPLIES 380921 349062 31859 TRANSPORTATION 78777 78777 73804 69122 4682 20339736 17348202 2991534 0 36423 260447 6050510 3268205 354831 552784 85263 81138 334701 452914 84945907 33806099 49348680 51139808 7658657 5135043 10994807 10433780 74863872 71324119 6059835 2559952 71053281 71950166 32984978 32279982 656076 805419 110754170 107595519 X -35890298 -36271400 -35890298 -36271400 74863872 71324119 552189 -933291 0 X X 0 1 X 1 0 X 976483 401096 208425 410666 359184 2355854 19419536 20904634 18821989 18805200 19970508 97921867 20396019 21305730 19030414 19215866 20329692 100277721 0 0 0 100277721 549862 489639 380107 361774 262521 2043903 549862 489639 380107 361774 262521 2043903 20945881 21795369 19410521 19577640 20592213 102321624 0.98000 0.97720 0.02000 0.02280 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3191859 3191859 65781153 27021607 38759546 15234200 6598595 8635605 738695 185897 552798 51139808 CASH AND CASH EQUIVALENTS 439016 F COMMON STOCKS 2925400 F FIXED INCOME - NONGOVERNMENT OBLIGATIONS 1768089 F ACCRUED INTEREST 2538 F 5135043 ASSETS WHOSE USE IS LIMITED 9927805 DEFERRED FINANCING COSTS, NET 505975 10433780 ENTRANCE FEE AND WAIT LIST DEPOSITS 730466 RELATED PARTY PAYABLE 74953 805419 19852546 -933291 -933291 20785837 106088 106088 20891925 20233648 0 20233648 106088 106088 20339736 1 ST JOHNS COUNTY COUNCIL ON AGING 180 MARINE STREET ST AUGUSTINE FL 32084 591525829 150000 TO DEVELOP DAY PROGRAM IN PONTE VEDRA BEACH 0 0 0 0 0 0 0 0 0 D BRUCE JONES CHIEF EXECUTIVE OFFICER 0 200756 0 0 0 0 0 0 0 25185 0 225941 0 0 A ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 79039NAV0 2007-02-15 23590000 SEE SUPPLEMENTAL INFORMATION 0 0 0 B ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 2014-01-01 8000000 SEE SUPPLEMENTAL INFORMATION 0 0 0 C ST JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY 2014-01-01 8000000 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 6810000 24104950 1895750 568587 3454650 18185963 2007 1 0 1 1 B 330000 8000000 642851 365550 6991599 2014 0 0 1 1 C 330000 8000000 507747 7492253 2014 0 0 1 1 A 0 1 0 1 0 0 0 0 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 A 1 B 0 C 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: ST. JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/15/2014 SCHEDULE K, ROW A, PART I(F) PURPOSE OF SERIES 2007 BONDS: IN FEBRUARY 2007, THE ST. JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY ISSUED ON BEHALF OF THE ORGANIZATION $23,590,000 HEALTH CARE REVENUE REFUNDING BONDS (THE "SERIES 2007 BONDS") TO REFUND A PRIOR BOND ISSUE, PAY FOR CERTAIN CAPITAL IMPROVEMENTS, FUND A DEBT SERVICE RESERVE ACCOUNT, AND PAY CERTAIN COSTS OF ISSUING THE SERIES 2007 BONDS. THE SERIES 2007 BONDS ARE COLLATERALIZED BY ASSETS IN TRUST, A MORTGAGE ON THE PROPERTY AND EQUIPMENT, AND GROSS REVENUES OF THE ORGANIZATION. SCHEDULE K, ROW A ADDITIONAL INFORMATION RELATED TO BOND ISSUANCE: ST. JOHNS COUNTY INDUSTRIAL DEVELOPMENT AUTHORITY REVENUE REFUNDING BONDS, SERIES 2007, PRINCIPAL DUE ANNUALLY ON FEBRUARY 15 IN VARYING INSTALLMENTS THROUGH 2027. INTEREST IS PAYABLE SEMI-ANNUALLY ON FEBRUARY 15 AND AUGUST 15, WITH A FIXED INTEREST RATE OF 5%. SCHEDULE K, PART II, ROW A, LINE 3 THE TOTAL PROCEEDS FOR SERIES 2007 BOND ISSUE ARE NOT IDENTICAL TO THE ISSUE PRICE LISTED IN PART I, COLUMN (E), THE DIFFERENCE IS A BOND PREMIUM OF $514,950. SCHEDULE K, PART I(C) INFORMATION PERTAINING TO CUSIP OF 2007 SERIES BOND ISSUE: THE SERIES 2007 BOND ISSUE CONSISTS OF THE FOLLOWING: CUSIP NO. 79039NAU2, $8,970,000 5.00% TERM BONDS DUE FEBRUARY 15, 2017 CUSIP NO. 79039NAV0, $14,620,000 5.00% TERM BONDS DUE FEBRUARY 15, 2027 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS LIFE CARE PASTORAL SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE CORPORATION'S SOLE MEMBER, LIFE CARE PASTORAL SERVICES, INC., HAS THE POWER TO ELECT ALL BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE APPROVAL OF THE SOLE MEMBER, LIFE CARE PASTORAL SERVICES, INC., SHALL BE REQUIRED FOR A NUMBER OF ACTIONS BY THE BOARD, AS WRITTEN WITHIN THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 COPY OF FORM 990 IS PROVIDED TO THE GOVERNING BODY FOR REVIEW BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THERE IS A YEARLY REVIEW AT THE BOARD LEVEL WHERE EACH BOARD MEMBER SIGNS A CONFLICT OF INTEREST POLICY AND DECLARES ANY CONFLICT. ADDITIONALLY, THERE IS A CONFLICT OF INTEREST POLICY IN THE EMPLOYEE HANDBOOK, AND IT IS REVIEWED WITH THE DEPARTMENT HEADS ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION COMMITTEE OF THE BOARD REVIEWS ACCOMPLISHMENTS AGAINST OBJECTIVES AND DETERMINES THE COMPENSATION OF CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIALS & KEY EMPLOYEES. 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 XII, LINE 2C OVERSIGHT OF AUDIT: THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. LIFE CARE ST JOHNS INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593474627 CCRC FL 501(C)(3) LINE 9 N/A 0 LIFE CARE PASTORAL SERVICES INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593480191 HOLDING ORGANIZATION FL 501(C)(3) LINE 11A, I N/A 0 LCPS MANAGEMENT INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593474336 MGMT SERVICES FL 501(C)(3) LINE 11C, III-FI N/A 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0