2016-07-14T15:57:36-05:00 2015-12-31 593070669 MOORE STEPHENS LOVELACE PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2015-01-01 593474336 LCPS MANAGEMENT INC LCPS 9042731701 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 D BRUCE JONES CHIEF EXECUTIVE OFFICER 9042731701 2016-07-14 1 HARRY E HARP CPA P00176471 4077405400 2015 2016-09-27 15:27:22Z D BRUCE JONES 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 1369483 0 X N/A X 1997 FL TO PROVIDE A FULL RANGE OF OPERATIONAL MANAGEMENT SERVICES TO ORGANIZATIONS OPERATING CONTINUING CARE RETIREMENT COMMUNITIES AND OTHER ORGANIZATIONS PROVIDING LONG-TERM CARE. 8 8 6 8 0 0 0 0 1352965 1369441 128 42 0 0 1353093 1369483 884983 418034 0 0 665345 702137 0 0 0 161573 67529 1711901 1187700 -358808 181783 234439 349682 40961 23549 193478 326133 TO PROVIDE A FULL RANGE OF OPERATIONAL MANAGEMENT SERVICES TO ORGANIZATIONS OPERATING CONTINUING CARE RETIREMENT COMMUNITIES AND OTHER ORGANIZATIONS PROVIDING LONG-TERM CARE. 0 0 819333 418034 1369441 MANAGEMENT SUPPORT SERVICES PROVIDED TO AFFILIATED ORGANIZATIONS: LIFE CARE PONTE VEDRA, INC. AND LIFE CARE ST JOHNS, INC. 819333 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 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 6 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 BOARD CHAIR 2.00 6.00 X X 0 0 0 GEORGE FETHERSTON VICE CHAIR 1.00 7.00 X X 0 0 0 GERALD REYNOLDS BOARD MEMBER 1.00 1.00 X 0 0 0 WILLIAM J MURDOCK III BOARD MEMBER 1.00 7.00 X 0 0 0 MARK BONNER BOARD MEMBER 1.00 5.00 X 0 0 0 JOHN STROM BOARD MEMBER 1.00 3.00 X 0 0 0 MICHAEL HARVICK BOARD MEMBER 1.00 2.00 X 0 0 0 RODNEY BRACE BOARD MEMBER 1.00 5.00 X 0 0 0 D BRUCE JONES CHIEF EXECUTIVE OFFICER 10.00 30.00 X 200756 0 25185 CANDACE BOWLING CHIEF FINANCIAL OFFICER 4.00 36.00 X 112673 0 10145 DALE PIRKLE CHIEF OPERATING OFFICER 1.00 40.00 X 137513 0 8358 450942 0 43688 3 0 1 0 0 MANAGEMENT CONTRACT 623000 1350541 1350541 APPLICATION FEES 623000 18900 18900 1369441 42 42 1369483 1369441 0 42 418034 418034 494630 177899 316731 120619 120619 16108 16108 30389 30389 40391 23427 16964 30103 30103 4895 326 4569 4721 4721 2277 2277 EMPLOYEE RELATIONS 19533 19533 COMMUNITY EVENTS 6000 6000 1187700 819333 368367 0 227089 254497 7349 1 95185 234439 349682 38130 23549 2831 0 40961 23549 X 135322 317105 58156 9028 193478 326133 234439 349682 X 181783 -49128 X 0 0 0 X X X 2 LIFE CARE PONTE VEDRA INC 592555812 9 1 0 0 LIFE CARE ST JOHNS INC 593474627 9 1 418034 0 2 418034 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 PART IV, SECTION E, LINE 2A: LCPS MANAGEMENT, INC. PROVIDED A FULL RANGE OF MANAGEMENT SERVICES TO LIFE CARE PONTE VEDRA, INC. D/B/A VICAR'S LANDING (EIN: 59-2555812) AND LIFE CARE ST. JOHNS, INC. (EIN: 59-3474627), WHICH ASSISTED THOSE ORGANIZATIONS IN PROVIDING FOR THE HOUSING, PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, RELIGIOUS, HEALTH CARE AND FINANCIAL SECURITY NEEDS OF THE RESIDENTS OF VICAR'S LANDING AND LIFE CARE ST. JOHNS. PART IV, SECTION E, LINE 2B: LIFE CARE PONTE VEDRA, INC. D/B/A VICAR'S LANDING (EIN: 59-2555812) AND LIFE CARE ST. JOHNS, INC. (EIN: 59-3474627) WOULD BE ENGAGED IN THE ACTIVITIES OF PROVIDING FOR THE HOUSING, PHYSICAL, EMOTIONAL, RECREATIONAL, SOCIAL, RELIGIOUS, HEALTH CARE AND FINANCIAL SECURITY NEEDS OF THEIR RESIDENTS BUT FOR THE INVOLVEMENT OF LCPS MANAGEMENT, INC. LCPS MANAGEMENT, INC. PROVIDES MANAGEMENT SERVICES, THAT COULD BE PROVIDED INTERNALLY BY LIFE CARE PONTE VEDRA, INC. D/B/A VICAR'S LANDING AND LIFE CARE ST. JOHNS, INC. OR FROM A THIRD PARTY, UNRELATED TO LIFE CARE PONTE VEDRA, INC. D/B/A VICAR'S LANDING AND LIFE CARE ST. JOHNS, INC. 0 DUE TO/DUE FROM VICAR'S LANDING 95185 95185 0 LIFE CARE ST JOHNS INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593474627 501(C)(3) 418034 LCPS MANAGEMENT WOULD NORMALLY CHARGE LIFE CARE ST. JOHNS, INC. A FEE THAT REPRESENTS 5% OF OPERATING REVENUE. BOND DOCUMENTS RESTRICT AMOUNT TO $100K ANNUALLY. RECORDED ENTRY AS $518K MANAGEMENT FEE AND AN OFFSETTING $418K CONTRIBUTION BACK TO LIFE CARE ST. JOHNS, INC. X 0 0 0 0 0 0 0 0 0 D BRUCE JONES CHIEF EXECUTIVE OFFICER 200756 0 0 0 0 0 0 0 25185 0 225941 0 0 0 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 A COPY OF THE FORM 990 IS PROVIDED TO THE GOVERNING BODY VIA EMAIL FOR REVIEW PRIOR TO BEING 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 DEPATRTMENT HEADS ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD REVIEWS ACCOMPLISHMENTS AGAINST OBJECTIVES AND DETERMINES THE COMPENSATION OF 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 XI, LINE 9: RELEASE OF TEMPORARILY RESTRICTED ASSETS -49,128. LIFE CARE PONTE VEDRA INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 592555812 CONTINUING CARE RETIREMENT COMMUNITY FL 501(C)(3) LINE 9 LIFE CARE PASTORAL SERVICES 1 LIFE CARE ST JOHNS INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593474627 CONTINUING CARE RETIREMENT COMMUNITY FL 501(C)(3) LINE 9 LIFE CARE PASTORAL SERVICES 1 LIFE CARE PASTORAL SERVICES INC 1000 VICARS LANDING WAY PONTE VEDRA BEACH FL 32082 593480191 HOLDING COMPANY FL 501(C)(3) LINE 11A, I N/A 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0